Topics covered in this chapter

Trish Butler, a research-oriented practice nurse who runs a smoking cessation clinic, explores a variety of sources of knowledge of values as she tackles the clinical, training and research problems raised by her patient, 68-year-old Sandy Fraser, who continues to smoke despite the fact that both he and his wife, Ivy, have severe smoking-related disorders (chronic obstructive pulmonary disease and a stroke, respectively). Other topics include:

• Stuck points and how we learn

• Explicit and tacit knowledge

• Motivational interviewing

• PUNs and DENs in clinical learning

• Values literature retrieval: clinical purposes

• Values literature retrieval: training and research purposes

• A variety of values research methods

• Knowledge of values from research and unique individuals.

Take-away message for practice

A wide variety of methods (including retrieval of research evidence from electronic databases) can be used to learn about the values likely to be in play and influencing a given clinical situation – but the individual is always unique.

This chapter is different. The story line is still narrative in form – we follow an experienced nurse practitioner, Trish Butler, as she tries to understand why one of her patients, Sandy Fraser, refuses to give up smoking. But Trish Butler in addition to her clinical concerns has also a particular interest in training and research. Hence, if your interests are mainly clinical, you may want to “skim and skip” some of the more technical detail in this chapter and concentrate on the clinical sections.