Knowledge development to guide evidence-informed practice is a cornerstone of nursing as a practice-based discipline. The emphasis on empirical knowledge development overshadows other ways of knowledge development—personal, aesthetic, and ethical. Technical, objective knowledge development is more dominant than knowledge development for delivering holistic, person-centered care. Personal, aesthetic, and ethical ways of knowing are essential factors in satisfying work environments, patient satisfaction, and nurse retention. Boyer's model of scholarship development defining the scholarship of discovery, teaching, application, and integration guide nurses in building programs of scholarship informing the practice of nursing in practice and academia with an aim of improving and transforming healthcare delivery and patient outcomes. The purpose of this paper is to describe the various forms of scholarship described by Boyer as priorities in knowledge development, examine how the multiple ways of knowing expand traditional empirical perspectives of knowledge development, and present the value of reflective practices that undergird knowledge generation, integration, and application for holistic person-centered safe quality care. Reflective practices have a unique contribution to forming the unique art and science of nursing as a practice-based discipline. Transforming perspectives on knowledge development incorporate reflective practices, igniting a spirit of inquiry for developing the ontology, epistemology, and praxis for delivering holistic, person-centered, safe, quality care. By developing a growth mindset for continuous improvement of their practice, nurses engage in the ongoing search for evidence informed practice.
1. Introduction
Nursing is a practice-based discipline. Knowledge development is a key foundation for guiding the science underpinning evidence-informed nursing practice. Research questions derive from practice; clinicians become partners with nurse educators in preparing nurses with the myriad skills critical for developing and cultivating knowledge guiding practice [1]. Knowledge for practice relies on a multiplicity of research perspectives in developing the unique art and science defining nursing and builds from multiple ways of knowing [2]. The emphasis on empirical knowledge development creating technical, objective evidence often overshadows aesthetic, personal, and ethical ways of knowing that emphasize holistic, person-centered care. Reflective practice provides a systematic way for nurses to ask questions about their practice that leads to better understanding and sense-making as they sift evidence for situated practice contexts [3]. Asking questions about practice can help identify gaps in knowledge. The systematic thinking of reflective practices is increasingly applied in knowledge development among the healthcare professions, including nursing [4].
The purpose of the paper is to describe the various forms of scholarship that contribute to knowledge development, examine how the multiple ways of knowing expand traditional empirical perspectives of knowledge development, and present reflective practices that undergird knowledge generation, integration, and application for holistic person-centered safe quality care forming the unique art and science of nursing as a practice-based discipline. New perspectives on knowledge development incorporate reflective practices, igniting a spirit of inquiry for continuous learning.
2. Developing knowledge for a practice-based discipline
Having a unique body of knowledge that defines the foundation of its practice is an essential characteristic of a profession, differentiating it from a technical task-oriented practice [5]. Educational programs preparing professional practitioners are built on scholarship that differentiates and underscores nursing’s unique body of knowledge. A practice-based discipline focuses on caring for humans and the circumstances that influence their health, which requires multiple sources of knowledge and relationships [2,6].
Schwind and Manankil-Rankin [7] propose that deliberate reflections on experiences give meaning to our ways of being (ontology), knowing (epistemology), and doing (praxis) that grounds holistic, person-centered care [8]. Technical rationality from empirical knowledge is critical in linear situations in which it is important for the same approach to work every time, such as in high reliability processes for improving patient safety outcomes. However, much of current clinical practice is more complex and uncertain; navigating current clinical environments and interprofessional teams requires specialized knowledge and situated interventions [9]. In recent decades, as nursing sought disciplinary status, knowledge development, and practice were more focused on the received theoretical perspective for developing empirical knowledge [7]. Yet, some questions in practice cannot be resolved from only theoretical knowledge and evidence. Nurses create knowledge arising from reflecting on experience, thus developing tacit knowledge grounded in practice experiences. Reflective practice helps nurses understand their own practice by recognizing patterns in practice and making sense of confounding dilemmas through aesthetic, personal, and ethical ways of knowing [10]. The role of clinical nurses is crucial to knowledge development, then, as they develop their own theories and collaborate with researchers in testing what works [9].
Theory based interventions form the basis for developing evidence-based nursing practice interventions. Lindell [11], however, voiced concerns that the expansion and structuring of nursing knowledge and efforts to articulate our disciplinary perspective contributed to a prevailing theory practice gap. Reflection can be the bridge connecting theory and practice. By engaging in reflective practice, nurses connect knowing (epistemology), doing (praxis), and being (ontology). Reflective practice is more than just thinking about what one is doing and adding personal knowledge. Reflective practice at its highest levels involves critical discourse that synthesizes what one is learning from doing nursing practice with what one knows about practice, informing actions that define being and doing, connecting theory with practice, and leading to evidence generation [12].
The concentration on developing knowledge for knowing, doing, anticipating, and addressing patient care needs requires developing scholars grounded in philosophical, conceptual, and theoretical dimensions [1]. Balancing these dimensions is important in preparing stewards of the discipline who develop theory-based core disciplinary knowledge addressing the needs of society [5]. Goulet et al. [13] underscores the theory practice gap concerns, proposing two primary purposes of reflective practice: bridging theory and practice and contributing to knowledge development, research methodology, and social change.
Nursing scholarship is the systematic search for understanding our world and developing evidence for improving lives through the practice of nursing [14]. Scholarship, a core domain in nursing education requirements in the United States (USA), embraces an expansive scope of generating, synthesizing, translating, applying, and disseminating knowledge for improving health and transforming healthcare delivery [15]. Through scholarly inquiry, nurses come to understand different approaches to evidence-informed practice and teaching, apply theoretical frameworks, and evaluate the outcomes of their practice [16].
2.1. Nursing scholarship: Building an evidence-base
Nurses often focus their work in a particular scholarship domain by setting priorities for knowledge development and application that befits a practice-based discipline. These were defined by Boyer [17] as teaching, discovery, integration, and application. The American Association of Colleges of Nursing (AACN) in the USA issued a new position statement describing Boyer’s four research domains relevant to the discipline of nursing [15]. Each brings a unique but essential contribution to nursing knowledge development emanating from varied research paradigms for examining ways nurses can improve, innovate, and transform healthcare delivery and patient outcomes driven through education and practice. Transformative approaches to scholarship can position nurses to lead evidence-informed teaching, practice, and policy for universal access to safe, quality healthcare.
2.1.1. Scholarship of discovery
The scholarship of discovery generates the knowledge needed to guide nursing as a practice-based discipline. Clinical questions are systematically evaluated and tested using a range of research paradigms to develop disciplinary knowledge translatable into practice, providing the evidence to support culturally sensitive interventions [15].
2.1.2. Scholarship of application
The scholarship of application or practice interprets and implements new insights to and from research that bridge the theory to practice gap [17]. Practice scholars apply and integrate evidence to and from clinical practice, translate evidence, and lead quality improvement methodologies for improving care processes.
2.1.3. Scholarship of teaching
The scholarship of teaching focuses on the transmission, transformation, and extension of knowledge in developing new generations of nurses [15]. The teaching scholar produces evidence-based approaches that support learners’ understanding and application of the science and art of nursing and incorporates scholarship into their teaching.
2.1.4. Scholarship of integration
The scholarship of integration collaborates across the professions to illuminate data in a more meaningful way, connects research with the real world, advocates for informed health policies, and innovates new paradigms for understanding social determinants of health [17].
Scholarship culminates in disseminating outcomes across the breadth of nursing and healthcare to inform education, policy, and practice. Individual scholarship is measured through cumulative impact visible in evidence-informed practice and theory generation, citations of publications and presentations in strategic venues, and transformative education.
2.2. Multiple ways of knowing: Expanding knowledge development
Developing scholarship through generating and applying knowledge for practice and education requires more than an empirical, hard science approach. A spirit of inquiry emerges from asking the questions necessary for developing evidence to assure safe, quality nursing practice. The knowledge base required to guide a practice-based discipline comes from multiple ways of knowing first described by Carper [2], further explicated by Johns [10], restated in 2012 in Sherwood & Horton Deutsch [18] and reconsidered by Thorne [19]. Holistic nursing practice is both an art and a science requiring knowledge that develops through these four ways of knowing [2] and addresses praxis, epistemology, and ontology:
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Empirical: Factual, verifiable, descriptive with theoretical explanations
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Aesthetic: The creative, expressive process of discovery within the empirical
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Personal: Knowing, encountering, standing in relationship to another
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Ethical: Moral component of personal choices within the complexity of healthcare
In reviewing Carper’s historical explanation of how nursing knowledge emerges from multiple ways of knowing, Thorne [19] highlights the importance of disciplinary knowledge, citing the disciplinary lens of nursing practice as “a strong and enduring set of core values and principles” (p. 1) that can be known and taught. The personal way of knowing is emphasized as discovering the self-and-other through reflective practices combined with the empirical, aesthetic, and ethical ways of knowing to synthesize perceptions and connect with what is known for engaging with one’s practice. Litchfield and Jónsdóttir [6] describe knowledge as “personal and participatory, evolving in the here-and-now of health systems” (p. 79), giving every nurse a responsibility for participating in various stages of research, whether by integrating discovery, application, or teaching. Advancing practice comes from new ways of examining what is and what is not known to guide scholarship development; through reflection, research reveals what has not been seen or known.
3. Reflective practice: creating a spirit of inquiry
Knowledge development to create evidence is more than the process of generating psychometrics through rigorous measurements. Scholarship is predicated on a mindset of asking questions about why nurses do things the way they do. Inquiry, reflecting on asking critical questions, is the first step in knowledge development, whether through research or quality improvement processes that identify gaps in knowledge and care outcomes. Reflective practice can provide a guide for asking critical questions about variability in outcomes, which is fundamental to understanding underlying issues in practice. Reflective practice helps separate what one knows and what one assumes to be true. Systematic reflection guides us to describe, examine, and reconsider situations from multiple viewpoints to realize ways to improve or explore the unknown through research. Reflection helps to integrate knowledge and experience in developing tacit knowledge derived from examining experience in light of what one knows [20].
Bogumil [21] applied reflective practices in professional education as a systematic model for thinking deeply about practice to consider values, beliefs, and priorities that influence choices that nurses make in applying knowledge, skills, and attitudes in caring for patients [3]. Reflective practice provides access to the full range of knowing and analysis of experience, tapping into the objective, the emotional, and multiple perspectives of a situation [10]. Engaged nurses cultivate curiosity about the evidence informing nursing practice, giving rise to a spirit of inquiry that guides the ways nurses filter evidence informing optimal care. Reflective practice can have a role in knowledge development by cultivating a spirit of inquiry that asks clarifying questions about practice. Every nurse has a responsibility to develop knowledge, translate evidence into practice, evaluate outcomes, and implement best practices across standards and professional practice models.
Reflection develops professional growth through fuller awareness of self, others, and contextual factors to be able to reconsider choices, sift through what one knows, and arrive at new ways of thinking and acting. In developing a spirit of inquiry, nurses seek to improve their work, critically analyze experience in developing clinical judgment, and grow from novice to expert [22]. Reflecting on confounding experiences, unfolding case studies, or personal narratives helps grasp the whole of a situation, make sense of circumstances, and reconcile contradictions in practice or research results [21].
Reflective practices guide deeper insights for analyzing experiences that reveal new meanings, drive improvement, and help identify knowledge gaps, all of which catalyze new thinking and responses, contributing to continuous knowledge improvement. Meaningful reflective practice develops a growth mindset enacted through mindful presence, asking questions, and taking action. Mindfulness is the cornerstone of reflective practice and focuses on being attentive, present, intentional, and open to learning and melding knowledge and experience. Reflection permeates from mindful thinking about one’s practice, research, and professional service, integrating the multiple ways of knowing that expand knowledge development beyond the empirical [10] and integrating the spirit of inquiry that defines the various ways of scholarship development [16].
3.1. A spirit of inquiry: Asking questions to promote knowledge development
A spirit of inquiry establishes a habit of the mind for constantly questioning what we know and don’t know. How do nurses recognize the need for research? What is the reflective space within the research process? How does reflection help lead to the development of evidence informed practice? These questions help advance nursing research by supporting a spirit of inquiry as a professional hallmark; nurses grounded in evidence-informed practice are constantly raising questions about practice by reflecting on experience to consider [21]:
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What questions do I have about my practice?
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What evidence supports my decisions?
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How do I compare the actual care in my setting against best practices?
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How do I search for evidence when I am uncertain?
In developing a growth mindset, nurses might apply a set of questions adapted from Socratic questions to stimulate inquiry and critical thinking, as noted in Table 1 [23]. These questions can also aid reflective analysis and interpretation of research results.
Table 1.
Questions guiding reflection and analysis to promote scholarship and knowledge development
| Reflective stance | Being with the data | Questions to ponder |
|---|---|---|
| Challenging assumptions | Am I free of bias? | Is this always the case? What assumptions am I making? |
| Evidence base | Where would this data be useful? | What evidence applies here? Is there reason to doubt this evidence? |
| Alternative views and perspectives | What else can it be? | What is the counter-argument? Does anyone see this another way? |
| Implications and consequences | All actions have consequences. What are the possible outcomes? | If this … happened, what else would result? How does this affect that? What else can it be? |
| Question the question | Am I asking the appropriate questions? | Why is this question important? Why am I asking? How did this change my thinking? What else did I learn? |
Nurse scholars engaged in practice contribute in a meaningful way to clinical knowledge as they investigate evidence informed, expert consensus in caring for individuals, families, communities, and populations. Nurses seek learning for practice within situated contexts, that is, learning that guides actions—knowledge for use—versus knowledge only for content acquisition. The double helix of research and learning for practice is visible in the questions that arise in practice and return as evidence informed practice guiding what nurses do. Data results are incomplete without reflection on how the evidence can be applied to specific situations in practice, thus situated context; therefore, knowledge development is incomplete without translation to apply in practice [24].
The scholarship of application, as presented in Boyer’s model of scholarship [2], encourages questions about nursing actions and interventions, the search for practice improvements, and the engagement in reflective learning from experience. Rather than assume evidence supports their routine actions in practice, engaged nurses consider what evidence supports their interventions, leading to the conclusion that evidence supporting their actions is lacking. Knowledge gaps lead to research questions that need to be answered to produce the evidence needed for directing practice. Evidence informed nursing care aims to provide the best possible evidence while reflecting to consider patient values and preferences in shared decision-making in implementation. Evidence informed practice begins with searching systematically through valid databases and analyzing the research available. The process involves setting a review protocol, asking answerable questions, finding the evidence, appraising the evidence, and reflecting on the applicability of the evidence using a set of criteria [24].
3.2. Reflective practice transforming research: learning for practice
Research uncovers other views of reality by revealing elements, patterns, and cues not visible without systematic examination and reflection on the meaning; new information can change perspectives by understanding previously hidden elements. Research, like reflective practice, makes things more obvious so that evidence is uncovered to guide ways to improve outcomes. Reflection helps define and convey the nuances of the phenomenon of interest in moving beyond only technical rationality to experience deeper meanings. Through reflective practice, clinicians engage in knowledge development through systematic reasoning and interpretation of what happened in specific circumstances and what lessons are learned for next time [24]. Freshwater went further in applying the reflective practice to evaluate the experience of the participants themselves in the research.
Taylor [25] declared reflection is fundamental to research because thinking is fundamental to inquiry and necessary in applying knowledge to deliver safe, quality, informed practice. Reflection as a way of thinking and habit of the mind is fundamental to change and improvement; both are hallmarks of lifelong learning and professional identity formation. Reflection and research are inextricably linked through ways of thinking and knowing in the reflective process as nurses review and contrast ideas and construct systematic approaches to inquiry and application [24].
There are myriad ways of incorporating reflective practice into research using both quantitative and qualitative approaches. Freshwater [24] described reflective practice within an evidence-based approach to clinical practice. Johns [10] proposed a questioning approach expanding the examination of Carper’s ways of knowing. Taylor [25] examined reflexivity as essential to objectivity in research to avoid bias and assumptions. Reflective practice is particularly evident in narrative inquiry [7,26] involving storytelling and oral history, action research, feminisms, and other postmodern approaches described by Holloway and Freshwater [26], as well as critical reflective inquiry described by Bolg et al. [27].
Through these examples of various research methodologies, reflective practice becomes a part of transforming perspectives on nursing knowledge that embraces knowing, doing, and being. By explicating the role of reflective practice to reframe knowledge generation, application, and integration, nurses reframe for a growth mindset, stimulating continuous improvement in their practice. Regardless of the research method, the ways the researcher and the research team live with the data require an essential skill of reflective practice. With the myriads of methodologies, researchers grapple with data generated to analyze, interpret, and put into meaningful terms with theoretical frameworks. Much is written and studied about the ways of positioning data, but the role of reflective practice skills is rarely acknowledged [26]. Data analysis in both quantitative and qualitative paradigms involves interpretation, standing in the space between the data itself and what to do with the data. Within the scholarship and knowledge development space, reflective practice as a habit of the mind leads researchers into deeper thinking about the subject under study. It is here researchers must deal with the evolving social organization of knowledge and practice to make sense of what has been uncovered in the discovery phase [26].
Analyzing data requires reflective thinking to interpret meaning and implications for useability. While numbers do tell a story, it is the reflection on the numbers that sheds light on their meaning, therefore telling a more complete story. To interpret research findings, the research team must engage in discussions and reflections, considering relevant theories and findings from other studies and seeking meaning in their own study.
Reflective practice is specifically linked with qualitative research through the common value of learning from human experience. Qualitative inquiry asks about the changing nature of knowledge within the context of people, places, times, and conditions relative to a particular phenomenon.
Reflection as a research strategy focuses on purpose and engagement, asking questions about why nurses do what they do, how they make decisions, and how they learn from experiences. Reflective interpretation and analysis is a part of developing evidence informed practice to promote a coherent view of knowledge arising from narratives, beliefs, and practice rather than relying only on an objective, prescriptive knowledge generation. Evidence informed practice and reflective practice are not opposites but rather can work together to create the best evidence informed practice. The understanding that emerges from reflecting and interacting with the data rather than receiving from the data [24] informs practice.
While research seeks to learn through systematically and rigorously controlled situations, reflection can be a means for practitioners to learn systematically about their own practice from experience. Reflective practice recognizes paradigms that shape thinking and action, assumptions, frameworks, and patterns of thoughts and behaviors to explore broader questions. Reflection provides a systematic synthesis of what we know in light of retrospectively examining what happened. By engaging in scholarship development, we can understand hidden elements that are before us to see another view of reality, making things more obvious and changing our view of things.
3.3. Reflexivity: Reflective practices for objectivity in interpreting results
A reflective mindset is grounded in presence and engagement in the moment-to-moment occurrences in one’s work. Reflective practice as a habit of the mind defines professional development, leading to one’s science of practice and knowledge development as one applies theoretical knowledge and evidence sifted through multiple ways of knowing. Knowledge development and knowledge acquisition become inseparable; reflection illuminates theory in practice by throwing light on one’s understanding. It becomes a part of who we are as nurses and is fundamental to scholarly development; reflection becomes a core part of interpreting data and applying knowledge in practice [10].
Framing practice for learning derives from reflective questions. Examples include:
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Asking questions: What stands out in this experience? What cues or assumptions are recognizable?
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Interpreting: What is the most concerning part? Why is that? What else could it be? Why? What knowledge, beliefs, assumptions, values, and beliefs influence this situation?
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Analyzing: What do you already know that helps in this situation? What will be the consequences of possible actions?
Reflexivity refers to the ways nurse researchers reach higher levels of awareness and change strategies from the topic of study or concern. It is a tool for researching and improving practice, a way to find and validate knowledge [25]. “In quantitative research, the researcher is compelled to create and maintain objectivity within the project to ensure prejudices, emotions, and intentions do not affect data collection and analysis to assure the validity of the results. By contrast, qualitative researchers value the subjectivity of the process, and the people involved in the research remain self-aware to ensure their prejudices, emotions, and intentions are not imposed on participants’ narratives. Reflexivity allows researchers to use systematic questioning and appraisal to assure research validity, reaching higher levels of awareness [25]. Reflexivity is a means of remaining objective, raising questions about how knowledge is generated and validated through epistemology. Objectivity is a constant principle within research. In qualitative methods, researchers lay aside their own perspectives, using bracketing, to maintain an objective stance [26]. It brings awareness of the interpretive and contextual nature of human knowledge.
Reflective practices review and contrast ideas and construct systematic approaches to human inquiry. Taylor [26] stated that " … forms of thinking, such as reflecting on experiences, problem solving, inducing, deducing, synthesizing, interpreting, and conceptualizing, are linked inextricably to planning, doing, evaluating and disseminating research(p 25–26).” Reflection is attentive consideration to making sense of experiences to be able to make changes; therefore, it is both a rational and intuitive process.
4. Translating research to practice: Evidence-informed practice
The scholarship model described by Boyer [17] is critical in developing a science of practice, that is, professional development that is based on reflexive methods or knowledge based on evidence and theoretical knowledge. Reflection brings theory to practice when one reflects on an experience in light of what one knows or needs to know [26].
Translating research to nursing practice is essential for solving healthcare problems and improving the quality of care. Knowledge workers apply knowledge to assess and validate patient care outcomes, measure quality of life indicators, develop and refine practice protocols/strategies, evaluate systems of care, and analyze innovative health care delivery models. Knowledge workers develop the artistry of nursing by accessing and integrating knowledge and information to improve practice outcomes.
Reflective practice facilitates theory development to guide practice and generate knowledge, integrate theory into practice, and expand the knowledge base for practitioners to encourage a holistic, individualized approach to practice [26]. Reflective practice helps nurses make sense of practice through the nurse’s ability to access, critically analyze and learn from an experience to achieve a more desirable, effective, and satisfying practice [10].
5. Implications
In one sense, nursing research is in its infancy as measured by the establishment of the first national agency for nursing research in the USA, the National Center for Nursing Research, established in 1986; in 1993, it was elevated to the National Institute for Nursing Research (NINR) (Accessed December 21, 2023; https://www.ninr.nih.gov/aboutninr/history). The visibility and credibility given to nursing by this important agency have encouraged collaborative research, application, and integration, promoting nursing science. Research is firmly embedded in the discipline, as evidenced by the emphasis on nursing research in every country and the commitment of nurses for evidence informed practice.
Nurses inherently want to make a difference and experience satisfaction in practicing beyond the status quo, tradition, and tasks. Incorporating a habit of inquiry, nurses see the outcomes of their work with a sense of purpose and fulfillment. Joy in work comes from engaging in quality work that excels beyond simply coming to work to complete a series of tasks without seeing the meaning and relevance of one’s actions. Instilling a mindset of continuous improvement honed through reflective practice skills helps nurses refocus on the difference nursing as a discipline makes in society and the world. Reframing knowledge development through the lens of reflective practice is part of creating evidence supporting practice and education and drives the synergistic connection between practice and academia through knowledge development, acquisition and application.
Research requires clear, measurable definitions of concepts to examine gaps in existing mental models, test concepts, and identify intervening variables to investigate what else may be going on, given the unpredictability of human responses [26]. Both research and quality improvement are important in developing the scholarship guiding nursing practice. Knowledge development is concerned with controlling variables, describing, and prescribing; quality improvement is concerned with knowledge translation into evidence informed processes. The improvement process applies what we know from evidence to improve practice. It begins with measuring what is (outcomes measured in real practice) against a standard or benchmark, assessing outcomes, applying supporting evidence, and establishing a process for achieving the desired benchmarks. When evidence to guide nursing practice is lacking, it is the moment to turn to research as the next step.
Research methodologies are ever evolving. Qualitative methods have slowly been adopted, and other forms are emerging to advance scholarship. An evidence-informed approach to practice blends knowledge from research, practice, and the people experiencing the practice. Understanding the strengths and limitations of research can facilitate its effective use in an evidence-informed approach to practice. It is helpful for practitioners to be familiar with the common types of research evidence to be able to critically assess the appropriateness of their work.
In fulfilling dual responsibilities for scholarship, educators have multiple roles and responsibilities in preparing future generations of nurses with reflective practice skills melded into the competency domains that encompass varied approaches to scholarship, exploring multiple ways of knowing for a holistic, equitable, inclusive, and evidence-informed practice. Yet, the skills of reflective practice are often applied in more superficial levels than proposed in this paper. Professionals engaged in the habit of ongoing self-reflection demonstrate commitment to personal and professional growth that helps nurses derive meaning and purpose from their work.
6. Conclusions
Nursing as a discipline is built from the unique body of knowledge developed by nurse scientists, which is conveyed in a systematic education process advanced by research [27]. Knowledge development is the cornerstone of nursing as a practice-based discipline. Multiple research paradigms and multiple ways of knowing help guide knowledge development for holistic, person-centered, safe, quality care, forming the unique art and science of nursing as a practice-based discipline. Integrating reflective practices can transform traditional research focused on empirical, technical, objective linear perspectives of knowledge development to knowledge incorporating praxis, ontology, and epistemology for rethinking knowledge generation, application, and integration. Transforming perspectives on knowledge development from the integration of reflective practices ignites a spirit of inquiry, a growth mindset for continuous improvement of their practice, and an ongoing search for evidence to guide safe, quality healthcare.
Conflict of interest statement
The author declared no conflict of interest or any potential competing interest.
Data availability statement
No data were generated or analyzed relative to this manuscript.
Footnotes
Peer review under responsibility of Chinese Nursing Association.
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