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METHODS OF ACQUIRING KNOWLEDGE

Introduction
Knowledge is a complex, multifaceted concept.
Information sources for clinical practice vary in
dependability and validity. A brief discussion of some
alternative sources of evidence shows how research based
information is different.
Nursing has historically acquired knowledge through
traditions, authority, experience, borrowing, trial and error,
role modelling and mentorship, intuition, reasoning and
research.

Ways of Acquiring Knowledge ( Sources )

Schematic Presentation
Diagrammatic Representation

Tradition

The word ‘ tradition’ means “ a long established custom“


or “ the passing on of customs or beliefs from generation
to generation “
Many questions are answered and problems solved based
on inherited customs or traditions
Traditions include truths on beliefs that are based on
customs and past trends
Traditions can positively influence nursing practice
because they were developed from past experiences
Traditions can also narrow and limit the knowledge sought
for nursing practice
The nurses on patient care units quickly inform new staff
members about the accepted or traditional behaviour of
the unit

Advantages
It is efficient as an information source
Tradition or custom also facilitates communication by
providing a common foundation of accepted truth

Disadvantages
Tradition may interfere with the ability to perceive
alternatives
There is growing concern that many nursing interventions
are based on tradition , customs and “ unit culture” rather
than on sound evidence
Traditions are difficult to change because they have
existed for long periods of time and are frequently
supported by people with power and authority
Many traditions have not been evaluated or tested for
accuracy or efficiency
Traditions that have not been supported through research
tend to be persist

Authority
The term ‘ authority ‘ means ‘ a person or body with
special power ‘
An authority is a person with expertise and power who is
able to influence opinion and behaviour
There are authoritative people who will give decisions in
making judgment on an issue by virtue of specialized
training or experience where we had no direct experience
Knowledge acquired from authority is illustrated when one
person credits another person as the source of information
Nurses who publish articles and books or develop theories
are frequently considered authorities
An expert is only an authority when addressing his or her
area of expertise
Authorities in nursing must have both expertise and power

Disadvantages
Knowledge obtained from these authorities can be
inaccurate
Knowledge acquired from these authorities has frequently
not been validated and although it may be useful , it must
be verified through research

Experience

Experience means ‘practical involvement in an activity,


event etc’.
Experience represent a familiar and functional source of
knowledge
Personal experience involves gaining knowledge by being
personally involved in an event , situation or circumstance
Learning occurs during personal experience and enables
the nurse to cluster ideas in to a meaningful whole
In nursing personal experience enables one to gain skills
and expertise by providing care to patients and families in
clinical settings
Benner ( 1984 ) described 5 levels of experience in the
developmental of clinical knowledge and expertise i.e.
Novice
Advanced beginner
Competent
Proficient
Expert

Novice nurses have no personal experience in the work


that they are to perform , but they have pre conceived
notions and expectations about clinical practice that are
challenged, refined , confirmed or disconfirmed by
personal experience in a clinical settings

The advanced beginner has just enough experience to


recognize and intervene in recurrent situations.
eg: The advanced beginner nurse is able to recognize and
intervene to meet patients mobility needs.

Competent nurses frequently have been on job from 2


years to 3 years and often their personal experiences
enable them to generate and achieve long range goals
and plans. Through experience, competent nurse is able to
use personal knowledge to take conscious, deliberate
actions that are efficient and organized.

Proficient nurse views the patient as a whole and as a


member of a family and community. The proficient nurse
recognizes that each patient and family respond
differently to illness and health.

The expert nurse has an extensive background of


experience and is able to identify accurately and intervene
skillfully in a situation. The dynamics of expert nursing
practice need to be clarified through research.

Limitations
Each individuals experience is fairly restricted
Another limitation of experience is that the same objective
event is usually experienced or perceived differently by
two individuals.

Borrowing

Borrowing in nursing involves appropriation and use of


knowledge from other fields or disciplines to guide nursing
practice
Some nursing leaders have described part of nursing
knowledge as information borrowed from disciplines such
as medicine, sociology, psychology, physiology and
education
Nursing has borrowed in to two ways,
1) Some nurses have taken information from other
disciplines and applied it “ directly “ to nursing practice
This information was not integrated within the unique
focus of nursing.
eg: Some nurses have used the medical model to guide
their nursing practice, thus focusing on the diagnosis
and treatment of disease.

2) Another way of borrowing is the integration of


information from other disciplines within the focus of
nursing which is more functional in nursing

Disadvantages
Since disciplines share knowledge , it is sometimes
difficult to know where the boundaries exist between
nursing knowledge based and that of other disciplines
Borrowed knowledge has not been adequate for answering
many questions generated in nursing practice

Trial and Error

In this approach , alternatives are tried successively until a


solution to a problem is found
Trial and error offer a practical means of securing
knowledge
Trial and error is an approach with unknown outcome used
in a situation of uncertainty , when other source of
knowledge are unavailable
Because of this uncertainly , nurses must use trial and
error in providing nursing care

Disadvantages
There is frequently no formal documentation of effective
and ineffective nursing actions
Using this strategy, knowledge is gained from experience
but it often not shared with others
The trial and error way of acquiring knowledge can also be
time consuming , because multiple interaction might be
implanted before one is found to be effective
There is also a risk of implementing nursing actions that
are detrimental to a patients health
This method is haphazard and the knowledge obtained is
often unrecorded and hence inaccessible in subsequent
clinical studies

Role Modelling and Mentorship

Role modelling is learning by imitating the behaviour


of an exemplar
An exemplar or role model is viewed as knowing the
appropriate and rewarded roles for a profession and
the roles reflect the attitudes and include the
standards and name of behaviour for that profession
An intense form of role modelling is Mentorship
In a mentorship, the expert nurse serves as a teacher
sponser guide, exemplar and counselor for the novice
nurse
There is an investment of time and active
involvement that results in a close, personal mentor-
mentee relationship. This relationship promotes a
mutual exchange of ideas and aspirations relative to
the mentee’s care plans. The mentee assumes the
values, attitudes and behaviour of the mentor while
gaining intuitive knowledge and personal experience

Intuition

Intuition means ‘ acquiring knowledge by ourselves’


It is a type of knowledge that cannot be explained on
the basis of reasoning or prior instruction
Intuition is an insight on understanding of a situation or
event as a whole that usually cannot be logically
explained
The knowledge is incorporated so deeply within that it is
difficult to bring it consciously to the surface and
express it in a logical manner
Even though intuition is often unexplained, it has some
important scientific uses
A burst of intuition may identify a problem for study,
indicate important variables to measure or link two
ideas together in interpreting the findings
It is difficult to develop policies and practices for nurses
on the basis of intuition

Reasoning

Reasoning is the processing and organizing of ideas in order to


reach conclusions. Through reasoning people are able to “make
sense” of both their thoughts and experiences.
Patterns of reasoning are used to develop theories and to
plan and implement research
Stevens identified 4 patterns of reasoning as being
essential to nursing, i.e,
1) Problematic
2) Operational
3) Dialectic
4) Logistic

Problematic Reasoning
Problematic reasoning involves identifying a problem and the
factors influencing the problem, selecting solutions to the
problems and resolving the problem.
For eg: Nurses uses problematic reasoning in the nursing
process to identify nursing diagnosis and to implement nursing
interventions to resolve these problems.
Problematic reasoning is also evident in the identification
of a research problem

Operational Reasoning
Operational reasoning involves the identification and
discrimination between many alternatives or view points.
The focus is on the process ( debating alternatives ) rather
than on resolution
Nurses uses operational reasoning in developing realistic,
measurable goals with patients and families
Debating which measurement methods on data analysis
technique to use in a study requires operational thoughts

Dialectic Reasoning
Dialectic reasoning involves looking at situations in a
holistic way
A dialectic thinker believes that the whole is greater that
the sum of the parts and that the whole organizes the
parts
For eg: A nurse using dialectic reasoning would view a
patient as a person with strength and weakness who is
experiencing illness.
Dialectic reasoning also includes examining factors that
are opposite and making sense of them by merging them
in to single unit or idea , which is greater than either alone
Eg: Analyzing studies with conflicting findings and
summarizing these findings to determine the current
knowledge base for a research problem requires dialectic
reasoning

Logistic Reasoning
The aim of logistic is to determine truth or to explain and
predict phenomena
Logistic reasoning is used to break the whole into parts
and that can be carefully examined as can the relationship
among the parts
Logistic reasoning is the opposite of dialectic reasoning
A logistic reasoner assumes that the whole is the sum of
the parts and the part organize the whole
Logistic reasoning is uses frequently in research to select a
study design, plan and implement data collection and
select analysis technique

Eg: A patient states that she is cold and the nurse logically
examines the following parts and their relationships,
1) Room temperature
2) Patient temperature
3) Patients clothing
4) Patient activity
Reasoning is also classified by the discipline of logic into,
Inductive Bandman and Bandmann, 1988 ,
Chin &
Deductive Krawmer 1991

Inductive reasoning
It is the process of developing generations from specific
observations.
Eg: The nurse may observe the anxious behaviour of
( specific ) hospitalized children and conclude that ( in
general ) children’s separation from their parents is
stressful

Deductive Reasoning
It is the process of developing specific predictions from
general principles
Eg. If we assume that separation anxiety occurs in
hospitalized children ( in general ), then we might predict
that ( specific ) children in memorial Hospital whose
parents do not room-in will manifest symptoms of stress.

Advantages
Both systems of reasoning are useful as a means of
understanding and organizing phenomena and both play a role
in nursing research.
However reasoning in and of itself is limited because the
validity of reasoning depends on the accuracy of the
information with which one starts and reasoning may be an
insufficient basis for evaluating accuracy.

Conclusion

Acquiring knowledge through tradition, authority,


borrowing, trial and error, personnel experience, role-
modelling, intuition and reasoning is important in nursing.
However these ways of acquiring knowledge are
inadequate in providing a scientific knowledge base for
nursing.
Research is needed to generate new, accurate scientific
information to direct nursing practice. Because the
knowledge nurses need is not only narrow and specific but
also broad and holistic, a variety of research methods are
needed to generate nursing knowledge.
Thus knowledge is acquired is a variety of ways and is
expected to be an accurate reflection of reality.

Reference

Denise. F.Popit, Cheryl Tatano Beck, Nursing Research –


Principles and methods, 7th Edition, Wolters Kluwer
company publications, page. No. 11-13
Nancy Burns, Susan.K.Groove, Practice of Nursing
Research, Saunder Elsevier, 5th Edition, Page.no.6-7,10-12
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