Effective communication is a staple of our healthcare culture. Working with patients, peers, and interprofessional teams requires that nurses manage information and evidence toward influencing safe and positive patient outcomes.Please address the following:Describe caring attributes of the culture where you currently practice. Which attributes stand out as having significant influence on patients, nurses, and other healthcare professionals?How do you see effective communication relating to patient outcomes in this setting? What is the evidence for this?

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Using the text and online resources in this module, respond to one of the following focused questions in at least 500 words. (Be sure to cite online sources by author or title and date as well as Web address/URL.) In your original responses, be sure to cite primary source quotations in the words of the philosophers in addition to secondary source information about their ideas.Examples:Primary source: Descartes reached the conclusion, "cogito ergo sum" (Descartes).Secondary source: Descartes methodological doubt led to the certainty of the mind or thinking subject. (Morgan)Focused Questions:Compare and contrast the rationalist and empiricist approaches to epistemology. How are these two differing approaches to knowledge, unified in Kant's Critique of Pure Reason? (Use primary source quotations in your response in addition to secondary sources.)Examine the Feminist perspectives on Epistemology in Perry's Women's Ways of Knowing. Describe the stages of knowledge that lead to communication and social engagement. How are these alternative ways of knowing different than traditional approaches to epistemology explored in previous philosophers? (Use primary source quotations in your response in addition to secondary sources.)Resources : Survey the following resources to use in Discussions. You are not expected to read/view all of these, but you should be able to cite some of these in your Discussion postings.The Empiricist Approach to EpistemologyFind out about the origins of Ancient Greek Skepticism.See this introduction to Empiricism.Review these notes on the British Empiricists.John LockeFind out about Locke's Origin of Ideas.Find out more about Locke's contribution to British Empiricism.Video: Watch this video on Locke's philosophy on cognition. (6:52)David HumeSee how Hume Shifts the Burden of Proof in Epistemology.See this detailed overview of Hume from Stanford.Read about how Hume's Empiricism leads to Positivism.Video: Watch this video lecture on Hume's Epistemology. (4:33)George BerkeleyFind out about the philosophy of Berkeley from Stanford.Video: Watch this crash course on Locke, Berkeley and Empiricism. (9:51)(Learning Objectives Supported: 1b, 2a, 3b, 4a, 4bReading Material : Chapter 6Text Notes: What is Real? What is True?In the previous chapter we explored the metaphysics and epistemology of Plato, Aristotle and Descartes. While the rationalists, Plato and Descartes believed that genuine knowledge of reality is discovered through reason, Aristotle departed from his teacher, Plato and in shifting genuine knowledge to the examination of material reality, which combined reason and observation of the natural world. While neither Plato nor Aristotle ever doubted the existence of the external world, Descartes introduced the question, "How do I know the external world exists independently of my thinking about it?" Descartes method of radical doubt introduced a new and modern gap between the thinking subject and the external world, as one can only be certain of the one's own thoughts. His "cogito ergo sum" introduced an uncertainty about external reality, independent of our thought and senses about it. Empiricist philosophers such as Locke, Berkeley and Hume all entertained the possibility that external reality may not be known or proven, independently of our experiences.The 20th century British philosopher, Bertrand Russell (1872-1970) stated that "the distinction between appearance and reality between what things seem to be and what they are" is the source of philosophical debate in epistemology and metaphysics or the nature of knowledge and external reality following Descartes quest for certainty. While Locke introduces the empirical focus of our knowledge of the world through sense-data, George Berkeley further extended Locke's empirical certainty to deny the existence of matter as existing independently from our sensations or perceptions as nothing can be real or certain outside of minds and their ideas of things. Hume also introduces a skepticism that denies many of the common sense notions of external reality as well as our unfounded beliefs about the nature of reality and the mind.Locke (1632-1704) was critical of Plato and Descartes rationalist views that we enter the world with innate knowledge as well as rational intuition independent of sense experience. In his An Essay Concerning Human Understanding, Locke views the mind as a tabula rasa or blank slate which is latter filled with sensory experience. Locke's theory of knowledge is based on perception and was contemporary with the new and emerging world-view of Isaac Newton's mechanistic universe of physical bodies and the related forces of particles as mass in motion.Leibniz (1646-1716) disagreed with Locke, making a case for a modern notion of innate ideas as inclinations, dispositions, tendencies and natural potentials that are activated to help form ideas and gradually evolve through the mind's interaction with experience. The rationalist concept innate knowledge that is independent of experience according to Leibniz included general principles such as causality, as well as pure mathematics, logic, ethics and natural theology. Although empiricists acknowledge the certainty of some of these fields, they continued to focus on the primary role of sense experience to account for the primary basis of knowledge of the world.Locke began his Essay Concerning Human Understanding on the primacy of objects in the world as the basis for sensation, resulting in sense data from our sensory impression from objects. He further characterized ideas as they are constructed from sense data and the mind's reflections in constructing knowledge about the world. Locke further distinguishes between primary qualities and secondary qualities of objects. The primary qualities reside in the object and can be measurable, such as size, shape and weight. Secondary qualities reflect our perceptions of objects, such as color, smell, texture, and taste. Of the two qualities, only the primary qualities really exist in the objects as our ideas are described as resemblances and reside in our perceptions, rather than the objects themselves. Locke's theory of knowledge is based in the causal force exerted by objects on our senses, but the connection between our perceptions and the immediate objects becomes less certain in the construction of ideas and reflections leaving a gap between perception and real existence. Locke attempted to use common sense and then resorted to God, like Descartes in the assurance of the external world. He further argued that putting one's hand over a flame, could further prove the existence of external reality through our sense perception in pain resulting from the reality of fire. Locke finally admits that we can have no clear and distinct idea of substances we can never directly experience.George Berkeley (1685-1763) took Locke's ideas on perception to a logical conclusion in his philosophy which became known as subjective idealism. While Berkeley accepts Locke's premise that all knowledge comes from sense experience or observing our own reflective processes in the mind as ideas. Berkeley however rejects Locke's distinction between primary and secondary qualities because all we can ever know are the ideas presented to our own conscious minds, rather than an independent material world outside of our minds. Because reality depends on perception, the only things that can be said to exist with certainty are the ideas themselves as Berkeley states, "To be is to be perceived" in his epistemology that has come to be known as subjective idealism. We can never really know with certainty the existence of reality outside our perceptions. To the age-old question, "if a tree falls in the forest, does it make a sound?" would be rejected by Berkeley, if no one was there to hear it. In fact the reality of the trees and forest could not exist independently of a human mind. All we can know from our ideas are the phenomena we describe as trees and the concept we have of a forest. We can never know with any certainty the reality of the objects in themselves outside of our perceptions or ideas.The evolution of doubt about the nature of knowledge, which can be seen in Descartes, Locke, and Berkeley, reaches an even higher level in the skepticism of David Hume (1711-1776) Hume's skeptical approach to epistemology raises serious questions about achieving genuine knowledge over belief. Most of what we take for knowledge falls into the category of unexamined belief when applying Hume's skeptical test for knowledge, known as Hume's fork. For Hume all objects of human knowledge can naturally be divided into either "Relations of Ideas" or "Matters of Fact". The first kind of knowledge includes laws of geometry, algebra, and arithmetic, which can be demonstrated as certain. The latter or matters of fact must be confirmed or rejected based on empirical measurement from observation. Hume states that empirical experience and observation is required to make inferences concerning real existence and matters of fact. He goes on to demonstrate that there is nothing in experience to support many of our beliefs, such as the principle of cause and effect because every causal event is independent of every other causal event. After failing both tests, principles such as causality and induction fall into the category of custom and habitual belief but cannot count as genuine knowledge. Hume's skeptical test for knowledge, leaves most metaphysical beliefs in philosophy as empirically unjustifiable. Hume contends that most of what we claim to know in philosophy remains unjustifiable custom and belief when put under closer scrutiny.Immanuel Kant (1724-1804), thought by many to be the greatest thinker of the Enlightenment, took Hume's critique of knowledge as a serious challenge in the construction of a new direction in his epistemology, which became known as transcendental idealism. Kant begins his investigation in his Critique of Pure Reason by investigating how the human mind constructs a knowable world. He begins with scientific knowledge as a model of how the mind actively works to construct reality as an active, not passive process. For Kant, perception is an active process in which the mind selects, organizes and interprets experience to construct a unified view of the world. While acknowledging the empiricist philosophy that "all our knowledge begins in experience", he points out that "it does not follow that all knowledge arises out of experience." Our minds play an active role in creating a picture in the activity of mental processing. He describes the synthetic process of reason as having apriori qualities or categories that structure the interpretation of the raw data of experience in an orderly and intelligible picture of reality. In essence, the mind imposes an order and structure on the chaotic images and sensations of the world into a unified conscious whole. Latter psychologists such as Piaget (1896-1980) have identified this process in which children construct reality through the gradual development of concepts such as objects, space, time and causality in schema for organizing there interaction with experience to construct a meaningful world. These mental forms, categories, or schemata are present in all rational adults. Kant's transcendental idealism can be further understood in the distinction between noumenal realityand phenomenal reality. The world as we experience it is phenomenal or interpreted through the synthesis of our mental processes on the external world. Noumenal reality is real world of objects and things beyond our perceptions and the regulative structures of our minds. As the human mind shapes the sensor data of the noumenal world into organized perceptions they become selected, organized and finally interpreted as phenomena which is already understood in a unified of reality. In this sense we use reason to actively construct a meaningful world of aposteriori experience, which is unique for each of us, but also universal in the aprior hardwiring inherent in reason in all functioning humans.Kant's influence on epistemology in the construction of knowledge has had a significant influence in our modern and post-modern views of constructed knowledge, resulting in the view of knowledge as a constant process of construction. The constructive view of knowledge has also lead to a multiplicity of beliefs over reliance on authorities and simplified pursuit of the truth. Contemporary views of knowledge favor relativism, which recognizes that truth is not absolute but relative to a particular context. Rather than relying on external authorities, subjective knowledge recognizes the self as its own center of authority. Feminist perspectives on epistemology have transcended the reliance on reason alone in the construction of knowledge for other ways of knowing which include empathy, care, and commitment, resulting in new frameworks and paradigms of interconnected knowledge improving the quality of life of others in social action and environmental protection. New perspectives on contextualized knowledge have moved away from theories of truth in the realization in the real world is more complex than simplified theories in the world views we can create. Both collectively and individually, our construction of knowledge can be characterized as a continual quest to better understand the complex nature of the real world in the pursuit of better models that can only approximate the changing and complex world we live in. In conclusion, knowledge is always a work in progress.Chaffee, John. The Philosophers Way: Thinking Critically about Profound Ideas. Boston Mass. Pearson, 2016