The central role of practice in nursing research: Beyond the modern versus postmodern discourse

Article Type : Editorial

Authors

1 School of Nursing and Midwifery, Faculty of Health, Community, and Education, Mount Royal University, Calgary, Ab, Canada

2 Department of Medical-Surgical Nursing, School of Nursing and Midwifery, Guilan University of Medical Sciences, Rasht, Iran

Nursing is a practice-based profession with a unique science and body of knowledge that comprises “paradigms, frameworks, and theories” [1]. Over the centuries, the objective (modernism) way of knowing, informed by positivist philosophy and quantitative research method, has defined traditional sciences. According to Allmark (2003), objectivism views scientific knowledge as being gained solely through objective observation, measuring, and quantifying, with a view of predicting and generalizing [2]. This approach to epistemology emanating from popper's privileged view of scientific knowledge [3] has been held to higher esteem and standards over and above other ways of knowing, notably the subjective approach. In contrast, subjectivism (postmodernism) is informed by the relativist/constructivist philosophy and the qualitative methods of research that emanate from it. Subjectivism, informed by Rorty's pragmatic and pluralistic views of knowledge [4], proposes that the knower is interdependent with the known and that values mediate and shape what is understood. The constructivist argues that knowledge is situated and contextual and that events shape each other in multidirectional ways. 

Despite the widespread and dichotomous debate on modernism vs postmodernism, both paradigms have had overlapping influences on how nurses do things and generate new knowledge. Nursing has progressed beyond the discourse on the primacy of methods to a focus on paradigmatic pluralism, mixed methods, and research approaches that best answer the research question, with the understanding that the discipline of nursing will benefit more from a pluralistic approach to understanding ontology and epistemology. As a practice discipline, Nursing demands broad epistemologies to support its complexities and to honor the unique and contextual. Theoretical and methodological pluralism for nursing science suggests that no single worldview should be given primacy in nursing syntax; instead, the consequences of a particular worldview for substantive knowledge development need to be considered. Nagle and Mitchell (1991) added that “it is myopic and naïve to suggest that a single paradigm approach can adequately fulfil nursing’s mandate” [5]. Tarlier (2005) concluded that “epistemological diversity is necessary to define, evaluate, and value what constitutes evidence for nursing practice” [6].

Nursing practice is complex, nuanced, contextual, and multidimensional and acknowledges the client's holistic, intersubjective nature [7]. Nurse scholars have advocated nursing practice research as a valuable source of nursing knowledge that needs more acknowledgement within the discipline of nursing [8-10]. The complexity that characterizes nursing practice and its knowledge generation underscores the need for nursing as a human science and practical discipline to develop methods of inquiry that involve practicing nurses. To this end, Kim (1999) [11] suggests that nurses need knowledge from four domains to practice nursing. These domains include; the patient domain of experience of health and illness, the patient/nurse/carer domain that has as its primary focus, the interpersonal relationships that characterize nursing interventions, the practice domain that focuses on the nurse’s approach to care, and the contextual domain with a focus on the environment in which care is enacted. The nursing practice itself is a rich source of new knowledge for nursing because as practitioners are engaged in creating, as well as modifying knowledge to respond to specific clinical situations, their reflections and contextual challenges become the incubators of new ways of thinking about new nursing solutions to client’s problems. Thus, practice can change because of contextual issues and problems arising from the practice itself that need to be researched. 

Despite the primacy of clinical education in the professional socialization towards becoming a nurse, knowledge generated from the nursing practice itself has not been accorded the desired attention and value in the discourse about nursing epistemology. There is a wide acceptance among nurse scholars that the central mission of nursing is humanistic, and therefore knowledge and meanings are not only cultural, personal, and unique but also influenced by contexts [12, 13]. It is evident with new and various approaches to contemporary epistemology in nursing and other human sciences that the philosophy of science in Nursing is in transition, moving beyond the elementary dichotomy of modernism vs postmodernism to what Reed (1995) described as neo-modernism. Neomodernism tends to bridge the gap between the traditional approaches to science and imbibes the spirit of experimentation, non-adherence to dogma, desire to neutralize power, tolerance to ambiguity and critical thinking, with an open-ended view of nature and phenomena. In a neomodernist view, the practicing nurse is not merely a knowledge consumer but also a producer of knowledge within the practice [8]. Therefore, practice-guided research should be acknowledged as an essential aspect of generating new knowledge for nursing, not simply how nursing knowledge and theory are applied. Nursing practice research provides a dialogue between the client and the nurse, the empirical and the theoretical, by which situation-specific knowledge about health and healing can be interrogated.

Nursing practice research should be held to the same and even more stringent ethical standards/principles as other research involving human participants. These principles are, in many facets, natural extensions of the ethical principles involved in providing care for the patient. These include “respect for persons”, “beneficence”, “nonmaleficence”, “accountability”, “fidelity”, “autonomy”, “veracity”, “informed consent”, and “justice”. These principles must be adhered to in all stages of nursing research, enforced by the relevant ethics boards, and mandated by practice regulators. In addition, excellent and ethical nursing practice research must be “worthwhile”, “reproducible”, and “transparent” and must adhere to a strict “audit process”.

The Journal of Nursing Reports in Clinical Practice will champion and publish ethical nursing research from all domains, especially practice research. Our editorial board is committed to integrating knowledge from practice to build the professional and international reputation of nurses and nursing scholarship. We are happy to embark on this epistemological journey to empower nurses in clinical practice to contribute to the growth of the discipline of nursing through knowledge development and dissemination.

 

Acknowledgements

Not applicable.

 

Authors’ contributions

Substantial contributions to the conception or design of the work; or the acquisition, analysis, or interpretation of data for the work: JO, SK; Drafting the work or revising it critically for important intellectual content: JO, SK; Final approval of the version to be published: JO, SK; Agreement to be accountable for all aspects of the work in ensuring that questions related to the accuracy or integrity of any part of the work are appropriately investigated and resolved: JO, SK.

 

Funding

Self-funded.

 

Ethics approval and consent to participate

Not applicable.

 

Competing interests

We do not have potential conflicts of interest with respect to the research, authorship, and publication of this article.

 

This is an open access article under the terms of the Creative Commons Attribution-NonCommercial 4.0 License (CC BY-NC 4.0).

© 2023 The Author(s).

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Volume 1, Issue 1
April 2023
Pages 1-3
  • Receive Date: 11 May 2023
  • Accept Date: 11 May 2023
  • First Publish Date: 15 May 2023
  • Publish Date: 15 May 2023