Paradigm Shift in Nursing?

The current ANS featured article, available for free download, is titled “Implications for Paradigm Shift in Nursing A Critical Analysis of Thomas Kuhn’s Revolutionary Science and Its Relevance to Nursing” by Ahtisham Younas, MN, BSN and Karen Parsons, PhD, RN. I join the authors in inviting you to download this article, read it and share your thoughts below!  Here is a message from Mr. Younas about this work:

Ahtisham Younas

I am excited to have the article published in ANS. The impetus of this paper dates to the time when I taught nursing theories and models to undergraduate nursing students in Pakistan. The students mostly commented that these theories and models are so complex, and they questioned the relevance of these models for actual nursing practice. At that time, I used case studies to demonstrate the application of these theories and encouraged students to develop nursing care plans using theories of their choice during their clinical. Later, during my master’s program, I studied various nursing paradigms that serve as the foundations of these nursing theories and models. I became curious to learn about the motivation of nursing scholars to develop these paradigms. I was finally able to satisfy my curiosity in my doctoral program when I studied Thomas Kuhn’s work in the nursing philosophy course. I found out that nursing scholars developed nursing paradigms based on Kuhn’s concepts.

   The first time I read Kuhn’s book “The Structure of Scientific Revolutions,” I was blown away and mumbled to myself, “Should I take it seriously?”. I had these feelings because I found some of Kuhn’s arguments quite strange and controversial, particularly the discussion about the paradigm shift. Therefore, I reread the whole book and decided I should analyze this work, explore its relevance for nursing science, and outline the positive and negative implications. I wrote this paper for the nursing philosophy course but later made substantial changes before submitting it to ANS.

   Kuhn has been one of the most cited scholars across various scientific disciplines with over one hundred and three thousand citations. His revolutionary science includes different stages, starting from normal science to paradigm shift. Simply Kuhn argues that a scientific discipline practice under a certain paradigm, but when all the discipline-specific problems cannot be solved under the paradigm, a new paradigm is generated that replaces the older paradigm. The major issues with Kuhn’s science were; the vagueness of ideas, multiple interpretations of the word “paradigm,” inconclusiveness of ideas, issue of incommensurability of paradigms, and the use of case studies from physical sciences to support his arguments.

   Based on the analysis, we noted that Kuhn’s paradigm thinking could be useful to advance the body of nursing knowledge. However, Kuhn’s science was developed for physical and laboratory sciences, and he argued that a single paradigm is adequate to guide a discipline. Hence, we concluded that Kuhn’s science is not robust enough to guide sciences such as nursing because nursing deals with multifaceted human universal health phenomena which change and transform continuously. We proposed that instead of developing more nursing paradigms, it is better to develop middle range and situation specific theories. Such theories are more practical and can help nurses guide their actions in different situations by considering the contextual factors influencing those situations.

   One of my future works is to explore and develop an approach that can help bring various nursing paradigms together to inform nursing practice and knowledge development. The approach does not entail developing a single paradigm, rather it focuses on utilizing the useful aspects of each paradigm to guide research inquires. I would end this message with a question, “Do you think nursing can be conformed under a single paradigm as Kuhn’s envisioned for other physical sciences?”

   I am hopeful that you all read this article and please share your answers, comments, and critiques.