The loudest demand heard in healthcare research is for findings that can be applied in practice. This call, however, oversimplifies a very complex process. Even the findings of an exceptionally rigorous and successful research project do not and cannot have direct application in practice. Rather, each individual project supports or suggests modifications in the knowledge base about an issue. It is the full knowledge base (theory), as extended by the specific project, that should be used to guide practice. However, this route is rarely visible in the published literature, and readers must often tease out or guess at the underlying theory.

Nurse researchers in training are challenged by a lack of examples of knowledge development in published nursing research. One great privilege of mentoring doctoral students is helping them develop the theory (knowledge base) that will guide their research. The required steps are to first determine the current knowledge in an area, then determine the gaps in the knowledge, and finally plan a project that will provide the needed new knowledge. Knowledge comes from the understanding we have of the relationships and explanations for the facts and experiences as well as the facts and findings of previous studies. Theory organizes this knowledge by identifying important concepts, their interrelationships, and the scope and context of those relationships. Theory building consumes students once they progress beyond the inherent suspicion of theory in an applied profession.

Budding researchers must first step away from their concrete applied world of nursing practice and begin to see the more abstract and uncertain world of supposition and conjecture that is the shaky foundation for practice. Once this uncertainty is appreciated, skeptical minds open, and the larger questions of what we do not know emerge. This developmental process is facilitated and made overt by organizing their thinking into a theory. The theories that emerge from this process are comprehensive and reflect complex real-world phenomena. If done well, a theory gives birth to a series of propositions that can be tested with empirical research. Each student soon realizes that the dissertation research project cannot possibly test that theory as a whole. Any one project can only address portions of a theory. And, a single project that tests only a portion of a theory cannot drive practice either; practice must be based on the whole knowledge base.

How can we assist in the process of developing knowledge rather than just reporting the findings of individual research projects? First, we must model this process by making overt the theory underlying and guiding the projects we conduct and interpret the findings in light of that knowledge base. Too often, authors are encouraged to reduce background and theory in a manuscript to a paragraph or two; fortunately, this is not the pattern in Nursing Research and other leading nursing research journals. Second, we must work to improve the translation of our growing knowledge base to practice, remembering that it is the whole knowledge base, not individual project results, that guide our practice.

Mary A. Blegen, PhD, RN, FAAN

Associate Editor

[email protected]