Patterns of knowing: review, critique, and update.

Carper's patterns of knowing in nursing have been consistently cited in the nursing literature since they appeared in 1978. The degree to which they represent nursing knowledge in the mid-1990s is explored, and a major modification is suggested--the addition of a fifth pattern, sociopolitical knowing. The article also suggests modifications to the model for nursing knowledge put forward by Jacobs-Kramer and Chinn to enable this model to be used more effectively as a framework for exploring processes of inquiry into nursing knowledge and practice.