Expertise in nursing practice : caring, clinical judgment - Springer ...

Chapter 1 The Relationship of Theory and Practice in the Acquisition of Skill 3
piety—angrily rejecting Euthyphro’s appeal toexamples and his own special
intuition.
Descartes (1641/1960) and Kant (1963) completed the Socratic account
of theory by adding two more requirements: (4) Discreteness. A
theory must be statedinterms of elements free of context, whichwe now
call features,factors, attributes, data points,cues, and soforth—isolable
elements that make no reference to human interests, traditions, institutions,
and such. (5) Systematicity. Atheory must be anewwhole in which
decontextualized elements are related toeach otherbyrules or laws.
Plato expressed all five characteristics inthe myth of the cave: The
theorist must remove his object of knowledge from theeveryday, perceptual,
social world in order to see the universal relations between the
explicit and abstract elements—in this case, the ideas. Freed from all
context, the elements form a system of their own—all Plato’s ideas are
organized bythe idea of the Good. Plato saw that while everyday understanding
is implicit, concrete, local, holistic, and partial, theories, by
contrast, are explicit, abstract, universal, and range over elements organized
into anew total whole.
Another question being asked was what do these new theoretical
disciplines have to do with everyday practice. In answering this question,
thefavoriteexample was medicine. Unlike physics, astronomy, and
geometry, which were purely abstract, Hippocrates claimed to have a
theory that told physicians what to do.For this reason, Socrates admired
Hippocrates and held up the newmedicine as a model of knowledgefor
philosophers to study. Hippocratesreturnedthecompliment by remarking
that “a philosophical physician resembles agod.” The question for
Socrates thus became, Howisatheory-based craft like medicine different
from skills based on rules of thumb like stonecutting and cooking? His
answer, which still has serious consequences for our current lives, grew
out of two observations. Both were true observations about medicine,
but, like agood philosopher, Socrates overgeneralizedthem. He saw that
physicians claimed to be able to explain why they did what they did and
that their explanations were based on principles from whichthe behavior
in question could be seen tofollow rationally. Generalizing these observations,
Socrates claims in Gorgias (Plato, 1937) that any craft must have
“principles of action and reason” (p. 501a).
Theclaim that a craft or techne must be based onatheory that could
be articulatedbythe practitioners ledSocratesto ruleout of account all
forms of intuitiveexpertise that do notseemto be based on any principles
at all. Cooking, for example, unlike medicine, is “unable to render any