Nursing Epistemology

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Epistemology is the study of the nature of knowledge and truth, and is focused on what is considered justified knowledge (Stanford Encyclopedia of Philosophy, 2020). According to Chinn and Kramer (2015), epistemology is the “how to” of knowledge development (p. 3). In nursing, our epistemology includes our epistemological views or isms and our patterns of knowing.

Epistemological Views, also referred to as isms or philosophies of science, relate to how problems of a study are conceptualized while supporting the underlying methods of research and the development of theory (Reed, 2018).

Currently, there is only one ism developed from and for the discipline of nursing named Intermodernism. Developed by Dr. Pamela Reed (1995, 2006a, 2006b, 2019), and originally titled neomodernism, Intermodernism is a philosophy of nursing science and practice, where science and practice work interdependently to build knowledge (Reed, 2018). To learn more about intermodernism, please click here

Patterns of knowing are the different ways in which we know, what we know, as nurses. Originally, patterns of knowing were proposed by Dr. Barbara Carper in 1978. In this foundational work, four different patterns of knowing were proposed: empirics or the science of nursing, ethics or the moral knowledge of nursing, personal knowing of the self and interpersonal relationships, and aesthetics or the art of nursing (Chinn & Kramer, 2015). Since Carpers work, a variety of nursing scholars have proposed other ways of knowing, including sociopolitical knowing (White, 1995), emancipatory knowing (Chinn & Kramer, 2015), unknowing (Munhall, 1993), and unitary knowing (Cowling, 1993). Please see the below table for a substantive reference to these different patterns of knowing. 

Table 1.
Substantive patterns of knowing references

Author(s) and YearTitlePattern of Knowing
Carper (1978)Fundamental patterns of knowing in nursingEmpirical, Ethical, Personal, and Aesthetics
Cowling (1993)Unitary knowing in nursing practiceUnitary
Chinn and Kramer (2015)Chapter 3: Emancipatory knowledge developmentEmancipatory
Munhall (1993) ‘Unknowing’: Toward another pattern of knowing in nursingUnknowing
White (1995)Patterns of knowing: review, critique, and updateSociopolitical


Carper, B. (1978). Fundamental patterns of knowing in nursing. Advances in Nursing Science, 1(1), 13-23. Retrieved from

Chinn, P. L., & Kramer, M. K. (2015). Knowledge development in nursing: Theory and process (9th ed.). Elsevier Mosby.

Cowling, R. W. (1993). Unitary knowing in nursing practice. Nursing Science Quarterly, 6(4), 201-207.

Munhall, P. L. (1993). Unknowing: Toward another pattern of knowing in nursing. Nursing Outlook, 41(3), 125-128. Retrieved from

Reed, P. G. (1995). A treatise on nursing knowledge development for the 21st century: beyond postmodernism. Advances in Nursing Science, 17(3), 70-84. Retrieved from

Reed, P. G. (2006a). The practice turn in nursing epistemology. Nursing Science Quarterly, 19(1), 36-38.

Reed, P. G. (2006b). Commentary on neomodernism and evidence-based nursing: implications for the production of nursing knowledge. Nursing Outlook, 54(1), 36-38.

Reed, P. G. (2018). A philosophy of nursing science and practice: Intermodernism. In P. G. Reed & N. B. C. Shearer (Eds.), Nursing knowledge and theory innovation: Advancing the science of practice (2nd ed., pp. 21-46). Springer Publishing Company.

Reed, P. G. (2019). Intermodernism: A philosophical perspective for development of scientific nursing theory. Advances in Nursing Science, 42(1), 17-27.

Stanford Encyclopedia of Philosophy. (2020). Epistemology. Retrieved from

White, J. (1995). Patterns of knowing: review, critique, and update. Advances in Nursing Science, 17(4), 73-86. Retrieved from

Page updated August 24th, 2020