The concept of phronesis is venerable and is experiencing a resurgence in contemporary discourses on professional life. Aristotle’s notion of phronesis involves reasoning and action based on ethical ideals oriented towards the human good. For Aristotle, humans possess the desire to do what is best for human flourishing, and to do so according to the application of virtues. Within health care, the pervasiveness of economic agendas, technological approaches and managerialism create conditions in which human relationships and moral reasoning are becoming (...) increasingly de‐valued. This creates a tension for nurses, and nursing leaders, as the desire to do what is morally right is often in conflict with contextual demands. In this paper, Aristotle’s writing on phronesis is examined with a focus on his classic conceptions of eudaimonia, the virtues, deliberation, judgement, and praxis. Building on Aristotle’s work, a number of contemporary views are explored with a focus on what various conceptualizations offer for the discipline of nursing. These expanded conceptions of phronesis include attention to: embodiment in practice; open‐mindedness including the capacity to stay curious and open to recognizing what we do not know; perceptiveness as a disposition towards insight and aesthetic understanding; and reflexivity as an ongoing process of interrogation and inquiry into ourselves and our actions. Drawing on these concepts, we discuss the affordances of phronesis as a morally informed guiding force to attend to modern‐day challenges in nursing practice and nursing leadership. (shrink)

The practice of nursing involves ongoing interactions between nurses' and clients' lived bodies. Despite this, several scholars have suggested that the “lived body” (Merleau‐Ponty, 1962) has not been given its due place in nursing practice, education or research (Draper, J Adv Nurs, 70, 2014, 2235). With the advent of electronic health records and increased use of technology, face‐to‐face assessment and embodied understanding of clients' lived bodies may be on the decline. Furthermore, staffing levels may not afford the time nurses need (...) to be as “present” with their clients in embodied ways. The failure to attend to the lived body may contribute to missed opportunities for care and decreased quality of life for both clients and healthcare practitioners. In this paper, we undertake an analysis of selected aspects of the work of Maurice Merleau‐Ponty. The aim is to advance understanding of the affordances this work may offer to enhancing client–nurse interactions within the practice of nursing. Merleau‐Ponty's notions of embodiment, intersubjectivity and intercorporeality as articulated in his seminal texts The Phenomenology of Perception (New York, NY: Routledge, 2012) and The Visible and the Invisible (Evanston, IL: Northwestern University Press, 1968) are examined. These three constructs are discussed as they relate to the lived body in client–nurse interactions in nursing practice and education. Finally, implications of how attention to “the lived body” could shape interactions and have the potential to foster increased quality of life of clients and nurses are considered. (shrink)

Donald Schön’s theory of reflective practice has been extensively referred to and has had enormous impact in education and related fields. Nonetheless, there continues to be tremendous conceptual and practical confusion surrounding interpretations of reflective practice and philosophical assumptions underlying the theory. In this paper, I argue that one of the original contributions of reflective practice is the theory’s attention to an embodied reflective dimension. In this regard, the influences of Michael Polanyi and Gilbert Ryle, within Donald Schön’s classic work, (...) are examined and shed light on a unique embodied reflective dimension within the theory of reflective practice. This paper suggests that the notion of an embodied mode of reflection is a useful way to conceive of the original contributions that Schön brings to understandings of reflective processes in professional education. Such understanding is crucially important to practical applications of the theory amidst widespread confusion in educational contexts. (shrink)

Reflective practice is one of the most popular theories of professional knowledge in the last 20 years and has been widely adopted by nursing, health, and social care professions. The term was coined by Donald Schön in his influential books The Reflective Practitioner , and Educating the Reflective Practitioner , and has garnered the unprecedented attention of theorists and practitioners of professional education and practice. Reflective practice has been integrated into professional preparatory programmes, continuing education programmes, and by the regulatory (...) bodies of a wide range of health and social care professions. Yet, despite its popularity and widespread adoption, a problem frequently raised in the literature concerns the lack of conceptual clarity surrounding the term reflective practice. This paper seeks to respond to this problem by offering an analysis of the epistemology of reflective practice as revealed through a critical examination of philosophical influences within the theory. The aim is to discern philosophical underpinnings of reflective practice in order to advance increasingly coherent interpretations, and to consider the implications for conceptions of professional knowledge in professional life. The paper briefly examines major philosophical underpinnings in reflective practice to explicate central themes that inform the epistemological assumptions of the theory. The study draws on the work of Donald Schön, and on texts from four philosophers: John Dewey, Nelson Goodman, Michael Polanyi, and Gilbert Ryle. Five central epistemological themes in reflective practice are illuminated: (1) a broad critique of technical rationality; (2) professional practice knowledge as artistry; (3) constructivist assumptions in the theory; (4) the significance of tacit knowledge for professional practice knowledge; and (5) overcoming mind body dualism to recognize the knowledge revealed in intelligent action. The paper reveals that the theory of reflective practice is concerned with deep epistemological questions of significance to conceptions of knowledge in health and social care professions. (shrink)

Donald Schön’s theory of reflective practice has received unprecedented attention as an approach to professional development in nursing and other health and social care professions. This paper examines technical rationality in Schön’s theory of reflective practice and argues that its critique is a broad and often overlooked epistemological underpinning in this work. This paper suggests that the popularity of Schön’s theory is tied in part to his critique of technical rationality, and to his acknowledgement of the significance of practitioner experience (...) and indeterminate zones of practice in the development of expertise. Schön tapped into a growing disillusionment with technical rationality that coincided with a crisis of knowledge across a range of disciplines. The question is raised as to whether Schön’s critique sets up a dichotomy between technical rationality and experience, or overcomes it. The conclusions suggest that Schön is not discarding research‐based professional knowledge, but rather challenging conflated views of its practical significance. In this way, it is proposed that his critique of technical rationality can be interpreted as an attempt to overcome dualistic thinking as it pertains to professional knowledge. (shrink)

Phronesis is often described as a ‘practical wisdom’ adapted to the matters of everyday human life. Phronesis enables one to judge what is at stake in a situation and what means are required to bring about a good outcome. In medicine, phronesis tends to be called upon to deal with ethical issues and to offer a critique of clinical practice as a straightforward instrumental application of scientific knowledge. There is, however, a paucity of empirical studies of phronesis, including in medicine. (...) Using a hermeneutic and phenomenological approach, this inquiry explores how phronesis is manifest in the stories of clinical practice of eleven exemplary physicians. The findings highlight five overarching themes: ethos (or character) of the physician, clinical habitus revealed in physician know-how, encountering the patient with attentiveness, modes of reasoning amidst complexity, and embodied perceptions (such as intuitions or gut feeling). The findings open a discussion about the contingent nature of clinical situations, a hermeneutic mode of clinical thinking, tacit dimensions of being and doing in clinical practice, the centrality of caring relations with patients, and the elusive quality of some aspects of practice. This study deepens understandings of the nature of phronesis within clinical settings and proposes ‘Clinical phronesis’ as a descriptor for its appearance and role in the daily practice of (exemplary) physicians. (shrink)