nursing philosophy module 1

How people come to answer the question, "how do we know?"

-tradition: experiences that have shaped into a repetitive pattern -authority: inform what is known; may be a person, role, or institution -reason: without regard for religion or tradition -common sense -science as a way of knowing: to know=science.

Criteria for science

1. Inter subjective test ability 2. Reliability 3. Definiteness and precision 4. Coherence 5. Comprehensiveness and scope These serve to separate science from pseudoscience.

Four characteristic rules of positivism

1. Phenomenalism 2. Nominalism 3. The denial of cognitive value in value judgements and normative statements 4. The essential unity of the scientific method

Analytical

A major school of philosophical thought webbed to objectivity and reproducibility Focuses on the use of process of logic and rational disclosure than on the subject itself include positivism, empiricism, instrumentalism, pragmatism, rationalism These philosophers, often physical scientists, examine the nature of truth using a lens of objectivity, linear thinking, and rationality

Modernism

A school of philosophy All that is or can be known is known through a process of mental reasoning. Therefore, there are truths that can be known without prior experience of these truths (a priori) Predicated on the belief that valid knowledge could, and should, be achieved by the exercise of reason alone

Continental

A school of philosophy Focuses on the connection of an idea to the world and historical context around that idea About the relationships among people, ideas, meaning, and historical connectedness rather than theories Human science is dominated by continental philosophy and is based on connectedness, not cause and effect

Analytic

A school of philosophy Focuses on the search for a single truth through scientific process Based on the belief that a statement is meaningful only if it is proven true or false through experimentation Closely associated with logical positivism, rigid adherence to the scientific method, and the belief in external world structure

Postmodernism

A school of philosophy Social movement/theory of mid-20thcentury in which meaning derives from the relationship between viewer and art or reader and text. Science progresses thru elimination of error as successive theories are found to be false and replaced with "better" theories Science is a rational endeavor by virtue of its critical attitude, not conferred by certainty of Absolute Truth

Classical

A school of philosophy Western Philosophy marks its beginning with the ancient Greek philosophers and their students, including Socrates, Plato, Pythagoras, Epictetus, Hippocrates, etc. Attempts to understand the natural world Search for Absolute Truth to be conducted thru debate and questioning

Traditional science

A view of empiricism, embedded in analytical philosophy also known as received view of science how most people are taught in elementary and high schools in the US: learning physical science by having the opportunity to experience through observation is the gold standard sometimes also known as realism

Received view

A theory is either right or wrong Theories must be formalized [axioms], taken apart, and propositions tested There is a single truth!

Empirical science

Goal = to describe, to explain, and to predict the occurrences in the world we live in

How do nurses embody philosophy?

In their actions when they enact knowledge, ethics, and whole being in the care of others

Continental

A major school of philosophical thought about essence and experience viewpoint that the phenomena of interests are deeply embedded in the human experience Includes phenomenology, hermeneutics, critical social theory, feminism, structuralism, post-structuralism, and postmodernism These philosophers study the meaning and nature of truth from an individual lens focusing on the experince of truth from the perspective of the person which leads to some subjectivity of truth

Aim of science

Hard: - knowledge development and the search for truth. A single truth exists. -control phenomena through an empires approach of inquiry applied: -application of knowledge for a specific purpose, thereby yielding utility -development of applications that can better a situation, improve a process, or change the way situations are viewed human: -aims focus on individuals, families, and communities -improve quality of life -rigor (r/t RCTs, reliability, validity is NOT the goal)

Questions for APRNs from article

Is nursing a science? Does your practice meet criteria?

Objective

Natural and pure sciences are based on the assumption that reality is __ rather than subjective; meaning it is consistent, reproducible, reliable

Soft sciences

Sociology, psychology, and anthropology are examples of __ __ also known as applied sciences these have a unique body of knowledge, albeit a different one that is found in the natural sciences category and in a combination with others. This is a focus on the application of knowledge to meet a human need this does not rely on rigid belief and objectivity and reliability examples in healthcare - social work, therapy

Received view of science

States that a theory is either right or wrong, that mature or developed theories must be formalized, that a theory must be axiomized, all sciences should be patterned after physics, and that there is a clear separation between theoretical and empirical understanding based on search for truth, supportive of prominence and dominance of physical sciences Also known as "traditional" or "realism"

Ontology

The study of being and of meaning

Knowledge

The sum of what is known: the body of truth, information, and principles acquired by humankind over the course of time The sum or range of what has been perceived, discovered, or learned "Knowledge is power." [Francis Bacon, 1597]

Analytical and continental

Two major schools of philosophical thought

Disease focus

Using the physical sciences in health care involves assuming a __ __ rather than a person focus. Science is about diagnosis, treatment, outcomes of treatment, and patho.

Definiteness and precision

Words used to convey exactnesss and rigid adherence to objectivity

Coherence

Addresses connectedness and wholeness. How do the parts relate to one another to form a body of knowledge? Focus is on the parts and their relation to one another

Inter subjective test ability

Based on the belief in the value of corroboration and on the idea that two people who view the same entity in the same manner should obtain the same results, resulting in an objective method "objective" is used as a synonym, meaning -the belief is not based on hallucination or deception and is not a state of mind but truly exists. It can be verified and tested.

Logical positivist

Believe in verifiabilty principle: the beliefs that a statement is meaningful in science, science is a deductive experience, and the sources of knowledge are twofold (logical and empirical experience)

Schools of philosophy

Classical philosophy modernism analytic philosophy postmodernism continental philosophy neomodernism

Analytical philosophy of science

Closely associated with positivism and logical positivism (school of thought that human history progresses from the theological to the metaphysical to the positivisitc) Rigid adherence to scientific method, belief in cause and effect

Science

Comes from the Latin work "scientienta" meaning knowledge traditionally referees to both processes and the outcomes of processes, such as general laws and observations

Pseudoscience

Compromising theories that are presented as scientific but not provided with scientific method

Neomodernism

Contemporary philosophers synthesize analytic and continental philosophy into a new philosophy of science. Links empirical concepts [senses] with concepts of meaning and value [thought] Posits that the universe is a whole made of interrelated parts. This philosophy incorporates chaos and complexity science to bring together truth and understanding.

Human science

Emphasizes the importance of individual scientists on the scientific process. Posits that the nature of science and role of the scientist are different when a subject is viewed as human science rather than natural or applied science. In medicine, human science is the nurse's recognition of himself or herself as a scientist involved in providing care. The interrelation of life, expression, and understanding lived experience phenomenon of concern = human life

Phenomenology

Example of a philosophy that emanates from the continental philosophy of science value is placed on universal experiences entails a focus on examining phenomena that appear in the consciousness of the subjects

Hermeneutics

Example of continental philosophy desk with interpretation and understanding of a messsage that is being delivered assumes people are social and dialogical beings. Culture, language, skills, and experience create shared understanding meaning and understanding are aims of inquiry

Post structuralism

Example of continental philosophy study of structures must be viewed as a cultural phenomena both the object and its context for creation, development, and evaluation must be studied this suggests that when delivery in a message, the most important component is what the person hears and interprets the message to be

Soft applied sciences

Focus on the application of bodies of knowledge to meet human needs. Rely on inherent assumptions of natural sciences but do not assume that reality is objective. Sociology, psychology, and anthropology are examples of applied sciences.

What is philosophy?

From the Greek philosophia which means "love of wisdom" Involves the search for meaning and represents a perspective [worldview] with a corresponding set of beliefs Guides individual approach to situations and individual understanding of truth

Multitude of perspectives - scientist, as care provider, and from perspective of patient and family

How should nurses view science?

Asking the question - "how do we know?"

How to understand philosophy of science?

Organismic world view

Human = biologic organism composed of a complexity of interrelated pats Parts are understood from perspective of the whole Epistemology: objective & measurable, but includes context; multiple ways of knowing (social sciences) Person: Parts + relationships greater than sum of parts Change is probabilistic and directed toward an end goal

Developmental contextual worldview

Human = historic event; living systems develop through patterns of increasing complexity accompanied by increasing organization Epistemology: multiple ways of knowing Person: Can't separate into parts; unitary; indivisible Change is on-going and irreversible, innovative, and developmental

Mechanistic world view

Human = machine composed of parts that can be measured, controlled, predicted Whole = sum of parts Epistemology: objective and measureable; (based on biophysical sciences) Part is unit of study devoid of context Person: Known through parts: physical, emotional, spiritual Goal of change is to return to a state of equilibrium and balance

What is nursing science?

In nursing science the fundamental assumption concerns the view of human being with concept of person as the most central consensus concept, because the concept of health is built on the concept of the person, and the concept of nursing on the concept of health.

Philosophy of science

Intersection of philosophy and science aims to examine the body of knowledge and the approaches to the study of the body of knowledge in nursing, it is an "examination of nursing concepts, theories, laws and aims as they relate to nursing practice. Through an understanding and deliberate thought, praxis evolves" Explores the meaning of truth, the meaning of evidence, and the meaning of life through praxis

What is science?

Latin scientia meaning knowledge Knowledge covering general truths of the operation of general laws, esp. as obtained and tested through scientific method [and] concerned with the physical world Generally regarded as the systematic, controlled, empirical, and critical activities undertaken to generate and test theories Science = research [advancement of knowledge] + theory [the explanation of knowledge] -Intersubjective testability [corroboration] -Reliability [repeatability] -Definiteness and precision [rigor] -Coherence [relationships] Comprehensiveness and scope [applicability]

Ontology

Nature of being: how existence is constituted and how existing things relate to each other Includes questions concerning how knowledge is related to reality and consciousness Epistemic realism = reality is independent of person's ability to think and understand Epistemic idealism = what is real is dependent on person's mental efforts and capacity to apprehend the world

Philosophy

Originally from greek word "philosophia" means love of wisdom enjoyment of the thought process, the notion of thinking for the sake of thinking, examination of ideas, and the search for truth are all part of this. a search for meaning, search for truth captures the essence of the human being and what it means to be a provider in a caring profession more than a beleif, but the application of that belief to situations known and unknown the study of knowing and determining what knowledge is

Natural hard sciences

Physics, mathematics, and chemistry are examples of natural sciences. Considered "pure," or standalone, unique bodies of knowledge. Based on the assumption that reality is objective and, therefore, reproducible and reliable.

Natural sciences

Physics, mathematics, and chemistry are examples of scientific disciplines known as __ __ bc they employ the general laws of nature and begins with the physical notion of the world. Also known as pure sciences (or unique and definitive body of knowledge) And as hard science (such as biophysical and biochemical processes r/t diabetes, cardiovascular disease, cancer)

Research focused vs. practice focused programs

Place less emphasis on theory, meta theory, and research methods than do research research: PhD, professional DNS, DSN practice focused: advanced practice DNP, DNS, ND

Praxis

Planned, deliberate, and thoughtful creation of a plan of action to achieve a goal.

Continental philosophy of science

Rather than search for single truth (analytical), this process is concerned with connection of an idea to the world around the idea and it's historical context focuses on relationships between people, ideas, meaning, and historical connectedness human science is the domain philosophers examine lived experience in the past and present. Rather than looking as cause and effect, they look at connectedness to past - "past is prologue" also called: perceived view, anti realism, idealism

Empiricism

Relies on the scientific method for the production of truth, held to tenants similar to those underlying logical positivism, but requires actual experience this was created by logical positivist because the nursing field believe that a large amount of the literature was too rigid, too deductive, and lacking appreciation of human experience this is commonly called science in today's world. It requires science to be generated through the senses of experience

Reliability

Researchers achieve the same result time and again when the circumstances of their study have not changed

Factors propelling the practice doctorate

Several nursing leaders objected based on fears that the degree would detract from the heard fought growth and recogniation of research in nursing fear that the DNP would lead to remarginalization within the academy factors that lead to need for DNP: growing healthcare environment complexity, rapid expansion of knowledge, need for delivery of patient centered care, movement of doctoral entry in related health professions (like pharmacy and PT) issue that propelled was the way master's programs responded to growth in scientific knowledge some have rejected due to assumption that it was to replace physicians

Comprehensiveness and scope

The ability of the science to be used for something other than it's intended purpose

Subtle differences between professional degrees such as the DNS and DNP:

The doctorate is more focused on the application of knowledge to the solution of societal problem the DNShas as its purpose the testing and validation of knowlege to extend and generate nursing practice protocols the practice doctorate is the highest level preparation for the actual practice of the discipline the DrNp (now DNP) offered by Columbia provides greater depth of knowledge and practice than existing master's programs in clinical science, informatics, and research methods

General laws

The laws of nature that guide physical life, such as the laws of gravity, energy, and motion

Perceived view

Theories are neither right nor wrong Observation leads to value-laden theories. Observation is subjective due to the physical and mental components involved. What one chooses to observe is as much a part of the process as the observation itself. [Butts & Rich, 2018, p. 16] Multiple theories and multiple realities exist

Perceived view

Theories are neither right or wrong a term used for continental philosophy observations lead to generation of theory, and is inherently subjective proponents believe in using different kinds of theories and many methods to obtain truth or understanding. Use varied approaches other than scientific method (could be quantitative or qualitative, or mixture)

Primary reason for wanting doctoral education

To develop the knowledge necessary for practice and to gain credibility within the academy

Epistemology

What is knowledge? How is knowledge acquired? How do we know what we know? As the study of knowledge, epistemology is concerned with: -What are the necessary and sufficient conditions of knowledge? -What are its sources? -What is its structure? -What are its limits?

Epistemic realism

reality is independent of person's ability to think and understand

Human science

separate term from hard or soft science introduced by Wilhelm Dilthey in the late 1800s this captures human beings and their experiences as the source of knowledge contrast to other sciences, the scientists and the subject are one.

Epistemic idealism

what is real is dependent on person's mental efforts and capacity to apprehend the world