The conceptual framework for graduate programs at the University of Washington School of Nursing affirms the faculty's perspective on the nature of nursing knowledge and its relationship to professional practice and graduate education. The framework stems from a two-fold source: a) the overall mission of the University of Washington to foster the generation, dissemination, and utilization of systematic knowledge garnered through scholarship and research; and b) the nursing profession's mission to foster knowledge-based nursing services that promote, maintain, and restore the well-being and health of individual human beings, families, and populations in the community. The components of the framework were chosen on the assumption that the discipline of nursing, i.e., the body of systematic nursing knowledge, derives from a combination of humanitarian and scientific perspectives on the meaning of health, human nature, and caregiving as a social activity (Donaldson and Crowley, 1978; Ellis, 1983). Three concepts were identified as central to the framework for graduate programs: a) professional foundations, b) nursing science, and c) modes of systematic inquiry.
As a profession, nursing carries responsibility for providing a service in keeping with societal needs for assistance with health care problems involving individuals, groups, and communities. Professional foundations as a domain of knowledge comes from inquiry into the nature of professional nursing, the value-orientations of the profession, the nature of clinical practice, historical influences on current practices and delivery modes, and the philosophic underpinnings of both professional and clinical practice (Donaldson and Crowley, 1978).
This area of nursing knowledge incorporates salient conceptualizations of professional nursing including the American Nurses' Association's (1981) definition of nursing as the diagnosis and treatment of human responses to health problems. The concept of professional nursing consists of the categories of direct and indirect services. The former is concerned with goal-directed activities performed in relation to and collaboration with the recipient of services (individual, group, or community) to promote and maintain recovery, rehabilitation, and well-being of the recipient. The latter refers to measures that support and facilitate the delivery of direct services and includes but is not limited to administration, coordination, supervision, instruction, evaluation, and consultation.
Professional foundations incorporates different theoretical perspectives on the central mission of nursing and its goals, methods, and desired outcomes. It includes consideration of the relationship of salient values to statements of nursing philosophy, the functions and limits of professional codes of ethics as guidelines for practice, and the influence of context on the nature of nursing problems. Conceptualizations on the principles and nature of nursing practice include examination of the types and nature of clinical problems, the nature of clinical interventions, and ethical issues and problems to be considered.
Professional services that assist individuals, groups, or populations towards the achievement of health and health-directed behaviors need to be based on scientific knowledge about the responses of human beings in interaction with their life situations. Nursing science is defined as the study of individual and group adaptations to health and illness in relation to environments and therapeutic change. The functions of nursing science are: a) to extend knowledge of the various circumstances, therapeutic actions, and environments that influence and alter the health of individuals, groups, and populations, and b) to incorporate knowledge of theories that identify the conditions necessary and sufficient for the promotion, maintenance, and restoration of health. Operationally the faculty has conceptualized the substantive content of nursing science within five fields study.
Individual Adaptations to Wellness and Illness consists of study of responses an d/or behaviors of individuals in states of wellness and illness. Focus is on identifying effective and noneffective means used by individuals for promoting health, preventing disease and disability, fostering recovery from illness and rehabilitation to optimal functioning.
Family Adaptations to Wellness and Illness consists of study of coping patterns of families in health and illness changes. Focus is on small group adaptations to usual and ordinary transitions in living as well as to critical changes produced by death, major illness, and other unusual events.
Environments: Supporting and Non-supporting is the study of physical, biological, psychological, and sociocultural environments or systems as complex multidimensional sets of forces and elements affecting the development and maintenance of health and unhealthy states in human beings. Particular attention is given to identifying the characteristics of internal and external environments that promote, maintain, and support states of health.
*Clinical therapeutics: Interpersonal consists of the study of social intervention and interpersonal actions which assist patients and families in coping with physical, psychological, interpersonal, and social effects of illness and in promoting health and health-related behaviors. Focus is on the characteristics and outcomes of these interventions and the psychosocial circumstances under which they take place.
*Clinical Therapeutics: Physical is the study of physical interventions and therapeutics measures which assist patients and families in reducing the physical effects of illness and in improving or promoting health. Focus is on the mechanism of action of these interventions as they affect underlying physiological and pathophysiological processes. *Clinical Therapeutics: Interpersonal and Physical were combined as a single field of study 1978.
The uniqueness of nursing science lies primarily in (a) the conceptual orientation of the human being to his/her environment and (b) the need for research design that includes and extends beyond traditional laboratory and research settings. The scientific study of human subjects in relation to their usual circumstances of living of necessity must be conducted in a variety of settings and circumstances.
Modes of systematic inquiry
Because the knowledge comprising the discipline of nursing derives from both humanitarian and scientific perspectives, its creation makes use of several modes of systematic inquiry. In the case of nursing science the predominant mode of inquiry is the scientific method toward the goal of creating descriptive and predictive theories based on the study of empirical phenomena. The knowledge defined as professional foundations serves as the basis for action in professional and clinical practice and derives from the use of other modes of systematic inquiry including but not limited to philosophic, historical, and clinical methods. The ultimate goal of these inquiries is the creation of prescriptive theories having relevance for the meaning and implementation of direct and indirect nursing services.
Goals of graduate education
As members of a professional school, the faculty carry dual responsibility for preparing (a) practitioners whose focus is the use of nursing and related knowledge for the delivery and evaluation of effective health care services to individuals groups, and communities and (b) nurse scholars and scientists whose focus is the generation and validation of new forms of nursing knowledge. The conceptual framework highlights the need for two kinds of graduate programs in nursing, one emphasizing education for professional nursing practice and the other emphasizing education for academic scholarship and research. Both types of graduate education are built around the knowledge domains of professional foundations, nursing science, and modes of systematic inquiry and draw on knowledge of related fields. They differ in terms of outcome goals, substantive emphasis, major modes of inquiry, and specific programs of study.
Approved by UW Seattle Graduate Faculty in 1986 (revised 2000) and by UW Tacoma faculty in 2000.
American Nurses' Association. Nursing, A Policy Statement. Kansas City, Missouri: American Nurses' Association, 1981.
Sue K. Donaldson and Dorothy M. Crowley. The Discipline of Nursing. Nursing Outlook, 26:112-120, 1978.
Rosemary Ellis, Philosophic Inquiry. H. Werley and J. Fitzpatrick (Eds.), Annual Review of Nursing Research (Vol.1) New York: Spring Publishing Company, 1983, pp. 211-228.