An understanding of the nature and development of nursing intuition can help nurse educators foster it in young nurses and give clinicians more confidence in this aspect of their knowledge, allowing them to respond with greater assurance to their intuitions. In this paper, accounts from philosophy and neurophysiology are used to argue that intuition, specifically nursing intuition, is a valid form of knowledge. The paper argues that nursing intuition, a kind of practical intuition, is composed of four distinct aspects that (...) include: embodied knowledge rather like that knowledge we have when we have learned to ride a bicycle; well‐trained sensory perceptions attentive to subtle details of complex, often rapidly changing situations; a significant store of pertinent conceptual knowledge; and a history of habitual actions intentionally directed towards achieving the best outcomes for our patients. Contemporary neurophysiology research strongly suggests that human persons experience other persons such that they directly understand the meaning of a variety of different human actions, intentions, emotions, and sensations in immediate, non‐reflective, and non‐conceptual perceptions. This research is supported by the philosophical theories of Jacques Maritain and Yves R. Simon found in their accounts of practical knowledge. Together, these accounts offer us a rich view of the reality of nursing intuition that helps us understand why we find intuitive actions in some but not all nurses and gives us some specific information about how to develop intuition in young nurses. Finally, this research shows us a path for further research. (shrink)

Research on moral judgment has been dominated by rationalist models, in which moral judgment is thought to be caused by moral reasoning. The author gives 4 reasons for considering the hypothesis that moral reasoning does not cause moral judgment; rather, moral reasoning is usually a post hoc construction, generated after a judgment has been reached. The social intuitionist model is presented as an alternative to rationalist models. The model is a social model in that it deemphasizes the private reasoning done (...) by individuals and emphasizes instead the importance of social and cultural influences. The model is an intuitionist model in that it states that moral judgment is generally the result of quick, automatic evaluations (intuitions). The model is more consistent than rationalist models with recent findings in social, cultural, evolutionary, and biological psychology, as well as in anthropology and primatology. (shrink)

In this article, we clarify and describe the nature of nursing expertise and provide a framework to guide its identification and further development. To have utility and rigour, concept‐driven research and theories of practice require underlying concepts that are robust, valid and reliable. Advancing understanding of a concept requires careful attention to explicating its knowledge, metaphors and conceptual meaning. Examining the concepts and metaphors of nursing expertise, and how they have been interpreted into the nursing discourse, we aimed to synthesise (...) definitions and similarities between concepts and elicit the defining characteristics and properties of nursing expertise. In clarifying the concept, we sought to move beyond the ambiguity that currently surrounds expertise in nursing and unravel it to make explicit the characteristics of nursing expertise from published peer‐reviewed studies and structured literature synthesis. Findings indicate a lack of clarity surrounding the use of the term expertise. Traditional reliance upon intuition as a way of explaining expert performance is slowly evolving. Emerging from the analysis is a picture of expertise as the relationship between networks of contextual reasoning, understanding and practice. Striking absences in the discourse include limited explication of ethical reasoning and theorising a broader interpretation of expertise reflective of contemporary forms of nursing. (shrink)

I examine the phenomenon of implicit learning, the process by which knowledge about the rule-governed complexities of the stimulus environment is acquired independently of conscious attempts to do so. Our research with the two seemingly disparate experimental paradigms of synthetic grammar learning and probability learning, is reviewed and integrated with other approaches to the general problem of unconscious cognition. The conclusions reached are as follows: Implicit learning produces a tacit knowledge base that is abstract and representative of the structure of (...) the environment; such knowledge is optimally acquired independently of conscious efforts to learn; and it can be used implicitly to solve problems and make accurate decisions about novel stimulus circumstances. Various epistemological issues and related problems such as intuition, neuroclinical disorders of learning and memory, and the relationship of evolutionary processes to cognitive science are also discussed. (shrink)

Psychological theory and research in ethical decision making and ethical professional practice are presently hampered by a failure to take appropriate account of an extensive background in moral philosophy. As a result, attempts to develop models of ethical decision making are left vulnerable to a number of criticisms: that they neglect the problems of meta-ethics and the variety of meta-ethical perspectives; that they fail clearly and consistently to differentiate between descriptive and prescriptive accounts; that they leave unexplicated the theoretical assumptions (...) derived from the underlying moral theories; and that they fail to accommodate the complexity and comprehensiveness of the processes involved in the making and implementing of ethical decisions. Many of these problems also have implications for the methodological domain. This paper offers an analysis of the difficulties, and makes a number of recommendations for future theory, research and practical applications, including: the need for training in moral philosophy; clarification of the status of Professional Codes in decisional models; the development of theoretically comprehensive prescriptive models; and the testing of these models in ways that do justice to their dimensional scope and theoretical complexity. (shrink)

The likelihood of nurse reflection is examined from the theoretical perspectives of Habermas' Theory of Communicative Action and Moral Action and Sumner's Moral Construct of Caring in Nursing as Communicative Action, through a critical social theory lens. The argument is made that until the nurse reaches the developmental level of post-conventional moral maturity and/or Benner's Stage 5: expert, he or she is not capable of being inwardly directed reflective on self. The three developmental levels of moral maturity and Benner's stages (...) are presented with discussion on whether or not there can be self-reflection because of an innate vulnerability that leads to self-protective behaviours. It is only when the confidence from mastery of practice has been achieved can the nurse be comfortable with reflection that enables him or her to become enlightened, emancipated, and empowered. The influences and constraints of the knowledge power between nurse and patient are acknowledged. The power hierarchy of the institution is recognized as constraining. (shrink)

In philosophy, a debate can live forever. Nowhere is this more evident than in ethics, a field that is fueled by apparently intractable dilemmas. To promote the wellbeing of many, may we sacrifice the rights of a few? If our actions are predetermined, can we be held responsible for them? Should people be judged on their intentions alone, or also by the consequences of their behavior? Is failing to prevent someone’s death as blameworthy as actively causing it? For generations, questions (...) like these have provoked passionate arguments and counterarguments, but few clear answers. Here, we offer a psychological account of why philosophical dilemmas arise, why they resist resolution, and why scientists should pay attention to them. Building on a family of recent proposals (Cushman & Young, 2009; Greene, 2008; Sinnott- Armstrong, 2008), we argue that dilemmas result from conflict between dissociable psychological processes. When two such processes yield different answers to the same question, that question becomes a “dilemma”. No matter which answer you choose, part of you walks away dissatisfied. This explanation of philosophical dilemmas has an important payoff for psychological research, and we discuss two specific cases in which it has yielded promising results. In each case, social neuroscience has played an important role in distinguishing the psychological processes responsible for producing a dilemma. This, we suggest, is no accident; cognitive neuroscientific methods are particularly well-suited to dissociating independent psychological processes (Henson, 2006). Consequently, philosophers’ dilemmas provide a reliable guide toward productive cognitive neuroscience by identifying the contours of distinct psychological process. The research we review below focuses particularly on moral dilemmas, which is our own area of expertise. The psychological processes that contribute to moral judgment are of interest in their own right, and play a central role in social cognition.. (shrink)