436 ■ III: ROLE FUNCTIONS OF DOCTORAL ADVANCED NURSING PRACTICE
■ PARADIGM WARS?
The dominant discourse or paradigm in nursing has been, and remains, the natural sci-
ence approach of evidence- based practice and the randomized controlled trial. So long
as this positivist worldview dominates contemporary science, it will probably continue
to hold sway in nursing. Yet, the profession would be enriched if it could also accommo-
date the human science tradition. Mitchell and Cody (1992) summarized their overview
of human science with the assertion that the
Lived experience, the world as experience, meaning, and understanding
are all aspects of a unitary process of human life and cannot be adequately
described, explained, or analyzed through objectification, measurement, or
reduction. (Mitchell and Cody, 1992, p. 55)Watson (1999a) has identified similar philosophical and conceptual foundations for hu-
man science, adding that human science epistemology “allows not only for empirics,
but for advancement of esthetics, ethical values, intuition, and process of discovery”
(p. 16). Essentially, human science aims at knowledge development that enhances un-
derstanding of the multidimensional meanings inherent in human existence, rather
than that which seeks to explain, predict, and control human phenomena, as in the nat-
ural science tradition.
Nurse scholars such as Newman (1986), Paterson and Zderad (1988), Parse
(1981, 1998), and others have promoted human science perspectives in the interests
of humanistic nursing. Can we combine nursing science with the artistry of nursing?
Self- awareness and mindful reflection can be the way forward to producing thoughtful,
innovative, and critical practice. It is when the nurse is in this place of personal wisdom,
gaining new and deeper insights, that a caring moment becomes more possible (Watson,
1979, 1999b).
■ SUMMARY
Reflective practice is something more than thoughtful practice. It is that form of practice
that seeks to problematize many situations of professional performance, so that they can
become potential learning situations and you, as a doctoral advanced NP, can continue
to learn, grow, and develop in and through your practice. As you journey through your
doctoral program, you will be developing the qualities related to this level of study—
critical thinking and reflexive self- awareness— in addition to extensive specialist knowl-
edge, practical research skills, and scholarship. Doctoral study involves mastering
procedures not only for generating knowledge, but also for becoming aware of different
ways of knowing and of the limits of knowledge. It means tolerating uncertainty and
realizing that all knowledge is provisional, and that we can be certain of nothing in sci-
ence (Popper, 1969). It is this shift in the breadth and depth of intellectual perspective
that distinguishes master’s from doctoral- level study, from MSN- prepared APN to the
doctoral DNP or DrNP graduate.
The reflective skill set of the doctorally prepared APN includes challenging
assumptions about evidence, learning to think and write reflexively, developing your
own characteristic voice, and producing practice- based knowledge. Your professional
identity and self- awareness will be transformed through your doctoral journey, and
both your practice and research will be underpinned by sensitive and insightful reflec-
tion. By developing both praxis (mindful action) and phronesis (practical wisdom), you