Reflections on Emancipatory Ways of Knowing.

Abstract

A good number of years ago, as I was getting ready to start my freshman year in college, there were two books on our summer reading list that we were to read before setting foot on campus: The Autobiography of Malcolm X (Haley and X, 1968Haley A. X M The autobiography of. Bantam Doubleday Dell Publishing Group, Malcolm X. Chicago, IL1968Google Scholar) and Roszak's (Roszak, 1969Roszak T. The making of a counter culture: Reflections on the technocratic society and its youthful opposition. Anchor Books, Garden City, NY1969Google Scholar) The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. (Yes, this was in the 70s.) I had a chance to recently look again into Roszak's work (he passed away in May 2021), now some 50 years later, and have a new appreciation for this book as it represents a call for a new way of knowing.When it was published in 1969 during the Vietnam War, Roszak's work appealed to the youth and older generations who were trying to make sense of a rapidly changing country. He argued that the pursuit of progress through science and technology might also lead to an abuse of power or a “technocracy” that appeals solely to scientific forms of knowledge. Roszak maintained that if we want to change society, we must also look for meaningful, alternative forms of logic and learn to reframe “the known” such that objection or criticism becomes possible. He believed that the American culture, at that time, had too much data, technical expertise, and scientific knowledge but not enough ideas. According to Roszak, some of the most personal aspects of life (such as childrearing, mental health, and sexuality) were becoming overly subject to the influence of “experts” within a technocracy that offers only one form of knowing. So, part of the counterculture movement of that time encompassed youth and others searching for alternatives to the status quo and meaningful ways of refocusing our attention on human actions.Following my trajectory, fast forward then, a few decades to when I became acquainted with Carper's (Carper, 1978Carper B.A. Fundamental patterns of knowing in nursing.Advances in Nursing Science. 1978; 1: 13-23Google Scholar) classic article on fundamental ways of knowing in nursing. To read and reflect on the personal, ethical, and esthetic (in addition to the traditional empirical) ways in which nurses and others learn and know was tremendously eye-opening for me as if Carper was describing processes with which I felt so familiar through my early clinical work in pediatric intensive care but could also now name. Carper's typology might also be seen as a rebuttal against purely empirically derived knowledge, but rather I think it offers tools to understand the wholeness as well as the unique aspects of a human experience, particularly in health care in which the range of personal, moral, and ethical choices will certainly vary.This now brings me to the present, as I delve into Chinn, Kramer, and Sitzman's (Chinn et al., 2021Chinn P.L. Kramer M.K. Sitzman K. Knowledge development in nursing e-book: Theory and process.11th ed. Elsevier Health Sciences, New York, NY2021Google Scholar) latest edition of Knowledge Development in Nursing E-book: Theory and Process. Building on Carper's original work and incorporating Bickford's (Bickford, 2014Bickford D. Postcolonial theory, nursing knowledge, and the development of emancipatory knowing.Advances in Nursing Science. 2014; 37: 213-223Google Scholar) work on postcolonial theory, emancipatory ways of knowing are also described as key to the knowledge and processes of nursing. Emancipatory knowing involves critically examining those social, political, and institutional structures which have led to social injustices and inequities. The need to identify these structures and disrupt the status quo has become even more apparent during the pandemic and Black Lives Matter movement, as inequities in access to and outcomes of health care have become even more apparent. By positioning emancipatory ways of knowing as central to the five patterns, Chinn and colleagues offer important clarity to how each of the five ways of knowing relate to each other and can be applied in effective nursing care. In so doing, Chinn and colleagues have effectively described and critiqued various symbolic interpretations of meaning—a process that Roszak once described as meaningful resistance.This past fall, I had a chance to speak to our master's students (as part of a core course in primary care issues) about ways of knowing. Much of this was a new approach for them, and when we moved to the topic of emancipatory ways of knowing, I could feel the attention in the room become more focused. Students sat a little more forward in their chairs, and for some, it seemed as if the lightbulbs started to shine. In our further discussions, many acknowledged that this was exactly what they had been looking for in their very early careers, and they were energized by the move away from defined, static, and self-limited theories to a framework that is all-encompassing, flexible, and more meaningful to their values and goals.I am not sure I can fully make the connection between students’ thoughts and actions on a small, liberal college campus in Ohio back in 1971, and now what our students these days are trying to tell us and what needs to be heard. However, I feel that a renewed focus on emancipatory ways of knowing and practicing may help us as faculty, clinicians, and students find our common ground and move forward to develop a more socially conscious, judicious, and equitable health care system. A good number of years ago, as I was getting ready to start my freshman year in college, there were two books on our summer reading list that we were to read before setting foot on campus: The Autobiography of Malcolm X (Haley and X, 1968Haley A. X M The autobiography of. Bantam Doubleday Dell Publishing Group, Malcolm X. Chicago, IL1968Google Scholar) and Roszak's (Roszak, 1969Roszak T. The making of a counter culture: Reflections on the technocratic society and its youthful opposition. Anchor Books, Garden City, NY1969Google Scholar) The Making of a Counter Culture: Reflections on the Technocratic Society and Its Youthful Opposition. (Yes, this was in the 70s.) I had a chance to recently look again into Roszak's work (he passed away in May 2021), now some 50 years later, and have a new appreciation for this book as it represents a call for a new way of knowing. When it was published in 1969 during the Vietnam War, Roszak's work appealed to the youth and older generations who were trying to make sense of a rapidly changing country. He argued that the pursuit of progress through science and technology might also lead to an abuse of power or a “technocracy” that appeals solely to scientific forms of knowledge. Roszak maintained that if we want to change society, we must also look for meaningful, alternative forms of logic and learn to reframe “the known” such that objection or criticism becomes possible. He believed that the American culture, at that time, had too much data, technical expertise, and scientific knowledge but not enough ideas. According to Roszak, some of the most personal aspects of life (such as childrearing, mental health, and sexuality) were becoming overly subject to the influence of “experts” within a technocracy that offers only one form of knowing. So, part of the counterculture movement of that time encompassed youth and others searching for alternatives to the status quo and meaningful ways of refocusing our attention on human actions. Following my trajectory, fast forward then, a few decades to when I became acquainted with Carper's (Carper, 1978Carper B.A. Fundamental patterns of knowing in nursing.Advances in Nursing Science. 1978; 1: 13-23Google Scholar) classic article on fundamental ways of knowing in nursing. To read and reflect on the personal, ethical, and esthetic (in addition to the traditional empirical) ways in which nurses and others learn and know was tremendously eye-opening for me as if Carper was describing processes with which I felt so familiar through my early clinical work in pediatric intensive care but could also now name. Carper's typology might also be seen as a rebuttal against purely empirically derived knowledge, but rather I think it offers tools to understand the wholeness as well as the unique aspects of a human experience, particularly in health care in which the range of personal, moral, and ethical choices will certainly vary. This now brings me to the present, as I delve into Chinn, Kramer, and Sitzman's (Chinn et al., 2021Chinn P.L. Kramer M.K. Sitzman K. Knowledge development in nursing e-book: Theory and process.11th ed. Elsevier Health Sciences, New York, NY2021Google Scholar) latest edition of Knowledge Development in Nursing E-book: Theory and Process. Building on Carper's original work and incorporating Bickford's (Bickford, 2014Bickford D. Postcolonial theory, nursing knowledge, and the development of emancipatory knowing.Advances in Nursing Science. 2014; 37: 213-223Google Scholar) work on postcolonial theory, emancipatory ways of knowing are also described as key to the knowledge and processes of nursing. Emancipatory knowing involves critically examining those social, political, and institutional structures which have led to social injustices and inequities. The need to identify these structures and disrupt the status quo has become even more apparent during the pandemic and Black Lives Matter movement, as inequities in access to and outcomes of health care have become even more apparent. By positioning emancipatory ways of knowing as central to the five patterns, Chinn and colleagues offer important clarity to how each of the five ways of knowing relate to each other and can be applied in effective nursing care. In so doing, Chinn and colleagues have effectively described and critiqued various symbolic interpretations of meaning—a process that Roszak once described as meaningful resistance. This past fall, I had a chance to speak to our master's students (as part of a core course in primary care issues) about ways of knowing. Much of this was a new approach for them, and when we moved to the topic of emancipatory ways of knowing, I could feel the attention in the room become more focused. Students sat a little more forward in their chairs, and for some, it seemed as if the lightbulbs started to shine. In our further discussions, many acknowledged that this was exactly what they had been looking for in their very early careers, and they were energized by the move away from defined, static, and self-limited theories to a framework that is all-encompassing, flexible, and more meaningful to their values and goals. I am not sure I can fully make the connection between students’ thoughts and actions on a small, liberal college campus in Ohio back in 1971, and now what our students these days are trying to tell us and what needs to be heard. However, I feel that a renewed focus on emancipatory ways of knowing and practicing may help us as faculty, clinicians, and students find our common ground and move forward to develop a more socially conscious, judicious, and equitable health care system. Martha K. Swartz, PhD, APRN, CPNP, FAAN, Professor and Program Chair, Yale School of Nursing, Yale University, West Haven, CT.