Academic journal article Creative Nursing

A Midrange Theory of Empowered Holistic Nursing Education: A Pedagogy for a Student-Centered Classroom

Academic journal article Creative Nursing

A Midrange Theory of Empowered Holistic Nursing Education: A Pedagogy for a Student-Centered Classroom

Article excerpt

The purpose of this article is to propose Empowered Holistic Nursing Education (EHNE) as a midrange theory-developed through induction, explication, deduction, and retroduction-to help nurse educators teach holistically and create a student-centered classroom, to establish a theoretical basis for a nursing pedagogy reflecting nursing's foundational principles, and to guide future research. The model's 5 core concepts, how to use the model as a pedagogy for practice, and its application to research will be presented. Holistic nursing will be defined, and traditional holistic nursing, holistic pedagogy, and emancipatory pedagogy will each be described.

Keywords: empowered; holistic; nursing pedagogy; cocreating; emancipatory; prior knowledge; contextual; interconnectedness; self-care

For more than 30 years, authors have appealed for changes in nursing education (Bevis, 1988; Bevis & Watson, 1989; Moccia, 1988; Spence, 1994), asking for a shift away from behaviorist learning theories and authoritarian power structures in the classroom to an empowered learning culture that focuses on seeking social justice and developing the student as a whole person (Randall, Tate, & Lougheed, 2007; Yorks & Sharoff, 2001). Holistic nursing provides the tools to achieve these goals.

This article introduces a midrange theory of EHNE that approaches nursing pedagogy from a holistic perspective. This new theory is based on the premise that students are mind-body-spirit beings who deserve to experience a holistic learning environment, and that this environment extends beyond wellness modalities to include empowered learning in which students create their own knowledge, take responsibility for their education, expect to be treated as whole beings, and gain awareness of socially constructed circumstances that prevent empowerment, growth, and healing (Freire, 1970; Hooks, 1994).

Holistic nursing rejects the compartmentalization of physical care, mental care, and spiritual care. Rather, it focuses on disease prevention, health promotion, therapeutic presence, and interconnectedness. However, holistic principles and practices are not usually brought into the classroom except to teach students how to approach patients holistically or how to integrate complementary and alternative modalities (CAM). The midrange theory of EHNE synthesizes the existing holism literature and expands the concept to include empowerment and emancipatory pedagogies. Integrating holism in the classroom is crucial because educational practices are guided by the assumptions of the nurse educator, which can lead to classrooms hostile to multiculturalism and to biases in content (Bryne, 2001; Love, 2010; Tarca, 2005). The same principles that support patient-centered care can be applied to student-centered classrooms. Using the EHNE framework, the nurse educator is guided in creating a learning environment consistent with the principles of holistic nursing.


Meleis (2007) supports the development of midrange theories in nursing scholarship at this point because they focus on practice aspects of nursing and reflect the substantiated grand theories of the discipline. A midrange theory generally brings together two or more concepts, and although such theories have limited scope, they improve researchers' ability to test hypotheses, utility, and feasibility. A midrange theory of EHNE allows nurse educators to define and guide nursing pedagogy and to focus research on measurable outcomes, allowing for rigorous, systematic research.


A midrange theory is strongest when it synthesizes several different approaches (Kolcaba, 2001; Marriner-Tomey & Alligood, 2006). The EHNE theory was developed using inductive explication, deduction, and retroduction. A concept analysis of interconnectedness, one of the theory's previously undefined components, was explored as a necessary step in developing new conceptual l inkages. …

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