Unknowing, a Model of Knowledge in Nursing

Document Type : Review Article

Authors

1 nursing and midwifery care research Center, Mashhad University of Medical sciences, Mashhad, iran

2 School of Nursing. Mashhad University of Medical Sciences, Mashhad, Iran.

Abstract

Background and Aims: Understanding the knowledge patterns used in nursing is the key to teaching and learning.  Carper proposed four models of empirics, personal, ethics and aesthetic knowledge. Since then, nursing scientists have expanded on her work and they suggested other models for basic knowledge in nursing. Munhall identified the fifth pattern of knowing, which is, paradoxically, unknowing.
Materials and Methods: This article is a narrative review. Previously published information on the pattern of unknowing in nursing was searched with the Persian and English keywords of patterns of knowledge in nursing, knowing and un knowing in the information sources Google Scholar, PubMed, Scopus, ISI, Science Direct. In order to cover the maximum aim, the search was done without applying time limit and using AND/OR operators. Finally, 28 articles and books were used.
Results: Unknowing is the knowledge that the nurse does not know the patient at the first meeting and by recognizing this unknowing, the nurse remains alert to the patients' point of view. Unknowing can be defined as a process of understanding or a condition of openness that gives meaning to an experience. In unknowing, people purposefully let go of their preconceptions, stereotypes, prejudices, and assumptions. This view of unknowing fosters an open mind by exploring multiple possibilities.
Conclusion: In this model, the nurse should discard the preconceived notions of what is best for the patient. Unknowing can be considered a vital pathway to new and undiscovered knowledge for nursing and all interpersonal relationships.

Keywords


1. Heydari A, Ghayebie E. Emancipatory knowing: Hidden necessity. Journal of Torbat Heydariyeh University of Medical Sciences. 2021;8(4):66-74. persian.
2. Fawcett J, Lee RC. Advancing nursing knowledge: a response to Burns’ letter to the editor. Nursing Science Quarterly. 2014 Jan;27(1):88-90 . doi: 10.1177/0894318413510636
3.Clements PT, Averill JB. Patterns of knowing as a method of assessment and intervention for children exposed to family-member homicide. Archives of Psychiatric Nursing. 2004 Aug;18(4):143-50. doi: 10.1016/j.apnu.2004.05.006
4. Bonis SA. Knowing in nursing: a concept analysis. Journal of Advanced Nursing. 2009 Jun;65(6):1328-41. doi: 10.1111/j.1365-2648.2008.04951.x
5. Jacobs BB. An innovative professional practice model: Adaptation of Carper's patterns of knowing, patterns of research, and Aristotle's intellectual virtues. Advances in nursing science. 2013 Oct1;36(4):271-88. doi: 10.1097/ANS0000000000002 
6. Carnago L, Mast M. Using ways of knowing to guide emergency nursing practice. Journal of Emergency Nursing. 2015 Sep 1;41(5):387-90. doi: 10.1016/j.jen.2015.01.011
7.Hunter LA. Stories as integrated patterns of knowing in nursing education. International Journal of Nursing Education Scholarship. 2008 Oct 9;5(1). doi: 10.2202/1548-923X.1630
8.Clements PT, Averill JB. Finding patterns of knowing in the work of Florence Nightingale. Nursing Outlook. 2006 Sep 1;54(5):268-74. doi: 10.1016/j.outlook.2006.06.003
9. Thomas EA. Place knowing of persons and populations: Restoring the place work of nursing. Journal of Holistic Nursing. 2013 Dec;31(4):267-75. doi: 10.1177/0898010113501019
10. Cranley L, Doran DM, Tourangeau AE, Kushniruk A, Nagle L. Nurses' uncertainty in decision‐making: A literature review. Worldviews on Evidence‐Based Nursing. 2009 Mar;6(1):3-15. doi: 10.1111/j.1741-6787.2008.00138.x
11.Peisachovich EH. Reflection-beyond-action: A modified version of the reflecting phase of Tanner’s clinical judgment model. International Journal of Nursing and Health Science. 2016 Mar;3(2):8-14.
12. Schott T. Nursing practice: what about not knowing? Victoria: University of Victoria; 2009 .
13. Fawcett J. Commentary: Finding patterns of knowing in the work of Florence Nightingale. Nursing Outlook. 2006 Sep 1;54(5):275-7. doi: 10.1016/j.outlook.2006.06.005
14. Lakeman R. Unknowing: A potential common factor in successful engagement and psychotherapy with people who have complex psychosocial needs. International Journal of Mental Health Nursing. 2014 Oct;23(5):383-8. doi: 10.1111/inm.12067
15. Heath H. Reflection and patterns of knowing in nursing. Journal of Advanced Nursing. 1998 May;27(5):1054-9. doi: 10.1046/j.1365-2648.1998.00593.x
16. Zander PE. Ways of knowing in nursing: The historical evolution of a concept. Journal of
Theory Construction & Testing. 2007 Apr 1;11(1):7-12 .
17.Pierson W. Considering the nature of intersubjectivity within professional nursing. Journal of Advanced Nursing. 1999 Aug;30(2):294-302. doi: 10.1046/j.1365-2648.1999.01081.x
18.Ehsani Maryam BS, Jafari Soheila, Galledar Nasrin, Mohammadi Sepide, Oji Parastoo,. Introduction to Philosophy of Science and Knowledge in Nursing 1, editor. Tehran: Jame-e Negar; 2017. (persian)
19. Stevens S. Ways of knowing and unknowing in psychotherapy and clinical practice. Journal of Trauma & Treatment. 2018 March 28;7(1):1000418. doi: 10.4172/2167-1222.1000418.
20.Averill JB, Clements PT. Patterns of knowing as a foundation for action-sensitive pedagogy. Qualitative HealthResearch. 2007 Mar;17(3):386-99 . doi: 10.1177/1049732306298250.
21. Munhall PL. Unknowing: Towards the understanding of multiple realities and manifold perceptions. A Contemporary Nursing Process. New York: Springer Publishing Company;2009 .
22. Sharifi F, Heydari A, Roudsari RL. Infertile women's healing experiences of using complementary and alternative medicine: A phenomenological inquiry. European Journal of Integrative Medicine. 2021 Oct 1;47:101369. doi: 10.1016/j.eujim.2021.101369
23. Assarroudi A, Heydari A. Phenomenography: A missed method in medical research. Acta Facultatis Medicae Naissensis. 2016;33(3):217-25. doi: 10.1515/afmnai-2016-0023
24.Burns M, Peacock S. Interpretive phenomenological methodologists in nursing: A critical analysis and comparison. Nursing Inquiry. 2019 Apr;26(2):e12280. doi: 10.1111/nin.12280
25. Moradi E. Reflection paper: A tool to improve teaching and learning process. Nursing And Midwifery Journal. 2018;15(12):885-7. (persian)
26.Moattari M, Abedi H. Nursing students experiences in reflective thinking: A qualitative study. Iranian Journal of Medical Education. 2008;8(1):101-11. (persian) .
27. Cotton AH, Roden J. Using patterns of knowing in nursing as a possible framework for nursing care of homeless families with children. Contemporary Nurse. 2007 Jan 1;23(2):331- 41. doi: 10.5172/conu.2006.23.2.331
28. Plowden KO, Wenger AFZ. Stranger to friend enabler: Creating a community of caring in African American research using ethnonursing methods. Journal of Transcultural Nursing.2001 Jan;12(1):34-9. doi: 10.1177/104365960101200105