How experienced practitioners gain knowledge.

An evolution in nursing in the United Kingdom in the 1970s from rule-bound toward holistic, autonomous practice engendered an examination of nursing's body of knowledge and how it is incorporated into practice. This article describes Barbara Carper's (1978) Fundamental Patterns of Knowing in Nursing (empiric, ethical, aesthetic, and personal knowledge), and links it to three major worldviews of the way in which knowledge is sought (positivism, naturalism, and critical social theory). Carper's model was used in the United Kingdom as the basis for a curriculum of structured reflective practice using workshops, journaling, and clinical supervision. An example from a practitioner's diary demonstrates how Carper's model informs reflection on an interaction with a patient with newly diagnosed cancer.