The art of knowing in nursing theory, more formerly known as the “Fundamental Patterns of Knowing in Nursing,” describes four basic concepts, or patterns of knowledge, as they relate to their advanced application in clinical practice. This model of nursing theory permits nurse practitioners to enhance patient care and recovery by applying real life experience, knowledge and cognitive reasoning that extends beyond the scientific methodology of empirical knowledge.
The four fundamental patterns of knowing in nursing theory were advanced in 1978 by Barbara A. Carper, R.N., Ed.D., Associate Professor and Chairman of the Division of Medical Surgical Nursing of the College of Nursing at Texas Women's University in Dallas. Carper first proposed these patterns in an article published in the October 1978 issue of Advances in Nursing Science. The rationale behind the establishment of Carper’s “ways of knowing” was to serve as a guide for nursing practitioners toward the acknowledgment of experience as a valuable tool with which to further the goals of patient management, education and research.
Generally referred to as the “science of nursing,” empirical knowledge represents the scientific essentials of nursing. This pattern of knowledge is founded in evidence-based research and objective experience.
Often called the “art of nursing,” aesthetic knowledge is subjective and intuition-based. It calls for recognizing and appreciating the unique qualities of individual patients, as well as responding with compassion and understanding to help patients and their families navigate the recovery process.
As the term implies, personal knowledge is defined by first-hand experience and self-awareness. Personal knowledge enables the nurse practitioner to relate to the patient with empathy in an authentic manner.
This pattern of knowledge refers to operating within a framework of ethical standards in order to recognize or judge what is correct or just when there is no “textbook answer.” This means drawing on knowledge and experience to identify and address legal, moral and social issues with integrity and professionalism.
Evolution in Practice
In an article published in the Journal of Advanced Nursing in 1998, expert Helen Heath wrote that Carper’s art of knowing in nursing theory transformed practical nursing from a dependence on empirical theory to reflective practice based on experience. However, this system continues to evolve clinical practice methods today. For instance, Lorraine Holtslander of the University of Saskatchewan College of Nursing suggests that applying these patterns of knowledge as a guide to “hope research” may help to better address the needs of bereaved caregivers as they cope with loss and grief.