Ethical Knowing in the Classroom and the Care of Underserved Populations

Thursday, 25 July 2013: 3:15 PM

Marcianna Nosek, CNM, MPH, PhD
School of Nursing and Health Professions, University of San Francisco, San Francisco, CA

Learning Objective 1: Describe the importance of ethical knowing in the care of underserved populations.

Learning Objective 2: Apply concepts of Gadamer's hermeneutic philosophy to developing ethical knowing in nursing education.

Purpose: The purspose of this study was to examine how ethical knowing is created in the setting of graduate level nursing education regarding the care of undersered and marginalized populations. Gadamer’s writing of phronesis and hermeneutic philosophy provide the philosophical foundation and framework for the study.  Specific aims include: to create opportunities for ethical knowing or phronetic experience in the classroom; to bring together two diverse groups with different life experiences and prospectives, i.e., nursing students and formerly incarcerated adults together in a dialectic and dialogic way; to develop new meanings and understandings about ethical knowing or phronesis as it relates to nursing care generally and to caring for specific groups, like formerly incarcerated adults.

Methods: This qualitative study incorporated the use of focus groups of both students and the previously incarcerated panelists before and after a class in which formerly incarcerated adults presented about their life experiences as the authorities on poverty, stigma, drug addiction, hope, recovery, and change.

Results: Findings articulated participants’ pre-class expectations which included fear, curiosity, skeptism and excitement, and they described a phronesis in action as transformations of prior understandings of the subject matter.  The effect of the class continued to influence understanding of caring for, and being cared for, by both students and panelists.

Conclusion: These initial findings suggest that through the use of dialogic exchange, ethical knowing, or phronesis, can be created in the classroom.  In this initial exchange both students and formerly incarcerated panelists’ assumptions about one another were challenged and they developed different meanings of each other, of themselves, and what it means for nurses to care for this population in a way that is imbued with phronesis.