Health Care and Nursing and Hermeneutics
Hermeneutics, Importance of Hermeneutics, Heidegger’s fore structure,Interpretive Phenomenon,Nature of Hermeneutical Scholarship,Analysis of Hermeneutical Researchers,Understanding Interpretation and Critique and Benner Study
What is Hermeneutics
Historically,
hermeneutics described the art or theory of interpretation (predominantly that
of texts) and was prevalent in disciplines such as theology and law.
German
philosopher Wilhelm Dilthey’s (1833-1911) redefined hermeneutics as a science
of historical understanding and sought a method for deriving objectively valid
interpretations.
Martin Hei degger (1889-1976) recast hermeneutics from being
based on the interpretation of historical consciousness to revealing the
temporality of self-understandings (Palmer, R., 1969).
Importance of Hermeneutics
Hermeneutics
is an approach to scholarship that acknowledges the temporal situatedness of
both the researcher and the participants. Time as it advances, or
time as lived, is central to the work of hermeneutics.
The centrality of time
is what differentiates hermeneutics from traditional forms of Henselian
phenomenology. The hermeneutic scholar works to uncover how humans are
“always already” given as time.
Hermeneutics has no beginning or end
that can be concretely defined but is a continuing experience for all who
participate.
Heidegger’s fore structure
Interpretation
presupposes a threefold structure of understanding, which Heidegger called the
fore structure. The premise of the fore structure is that all interpretations
are based on background practices that grant us practical familiarity with
phenomena. Heidegger called this sense of phenomena fore-having.
Our background
practices also form the perspective from which we approach understanding. Our
interpretive lens, termed fore-sight, is constituted by background practices.
Fore-conception describes our anticipated sense of what our interpreting will
reveal. This too is shaped and framed by our background practices.
Understanding is circular, and humans as self-interpreting being share always
already within this interpretive (hermeneutic) circle of understanding. Thus,
“interpretation is never a presuppositionless grasping of something
previously given” (Heidegger, 1927/1996, p. 141).
Hermeneutic researchers
do not attempt to isolate or “bracket” their presuppositions, but
rather to make them explicit. Hans Georg Gadamer (1989), a student of
Heidegger’s, has extended hermeneutical research in this area.
The essence of
hermeneutics lies not in some kind of mystic relativism but in an attitude of
respect for the impossibility of bringing the understanding of
“Being” to some kind of final or ultimate closure. The way of
hermeneutics is to allow oneself to be drawn into the complexity of the simple
and overlooked (Heidegger, 1977/1993).
Interpretive Phenomenon
The
work of interpretive phenomenologists moves beyond traditional logical
structures to reveal and explicate otherwise hidden relationships. Calling
attention to human practices and experiences, hermeneutics is closely related
to critical social theory, feminism, and postmodernism.
Unlike them, however,
hermeneutics does not posit politically or psychologically determined
frameworks as the modus operandi of the method, nor does the interpretive
phenomenologist attempt to posit, explain, or reconcile an underlying cause of
a particular experience.
Rather, the description of the common practices and
shared meanings is intended to reveal, enhance, or extend understandings of the
human situation as it is lived.
Nature of Hermeneutical Scholarship
The
thinking that accompanies hermeneutical scholarship is reflective, reflexive, and
circular in nature. However, describing the process of hermeneutical research
may suggest a linearity and structure that believed the seamless, fluid nature
of this approach to inquiry.
On the other hand, not describing the process
implies a thoughtless or haphazard approach that does not reflect the
scholarliness of hermeneutical research. Therefore, al- though a brief summary
of hermeneutical analysis is given here, the reader is referred to several
authors (Benner, 1994; Gadamer, 1960, 1989; Grondin, 1995; Palmer, 1969) who
discuss hermeneutical methodology in more detail.
Analysis of Hermeneutical Researchers
Commonly,
hermeneutical researchers work in teams and study areas of personal interest
and expertise. Each interview, as text analogue, is read by team members to
obtain an overall understanding.
Members of the research team identify common
themes within each interview and share their written interpretations, including
excerpts from each interview, with the team.
Dialogue among team members
clarifies the analyses. As the team analyzes subsequent interviews, they read
each text against those that preceded it. This enables new themes to emerge and
previous themes to be continuously refined, expanded, or overcome. Team members
clarify any discrepancies in their interpretations by referring to the
interview text or reinterviewing participants.
This is not to say that
hermeneutic researchers reduce phenomena to differences or similarities.
Rather, through dialogue, the team members explicate the practices of
identifying the seemingly simple and overlooked.
Team
members identify and explore themes that cut across interview texts. They
reread and study interpretations generated previously to see if similar or
contradictory interpretations are present in the various interviews.
Though an
underlying assumption of hermeneutical analysis is that no single correct
interpretation exists, the team’s continuous examination of the whole and the
parts of the texts with constant reference to the participants ensures that
interpretations are focused and reflected in the text.
Whenever conflicts arise
among the various interpretations of the interviews, team members provide
extensive documentation to support their interpretations.
Understanding Interpretation and Critique and Benner Study
Reading
across post positivist, feminist, critical, and postmodern texts, team members
hold open and problematic the identification and interpretation of common
practices. Team members read across all texts and write critiques of the
interpretations.
The purpose is to conduct critical scholarship using other
interpretive approaches to extend, support, or overcome the themes and patterns
identified by hermeneutics. In this way analysis proceeds in “cycles of
understanding, interpretation, and critique” (Benner, 1994, p. 116).
Like
the hermeneutic circle, interpretations are complete but never ending. During
the interpretive sessions, patterns may emerge. A pattern is constitutive,
present in all the interviews, and expresses the relationships of the themes.
Patterns are the highest level of hermeneutical analysis. The hermeneutic
approach provides an opportunity for team members and researchers not on the
team to review the entire analysis for plausibility, coherence, and
comprehensiveness.
In addition, participants in the study may be asked to read
interpretations of their interviews as well as the interviews of other
participants to confirm, extend, or challenge the analysis.
Others, not
included in the analysis but likely to be readers of this study, may review the
written interpretations. This review process exposes unsubstantiated and
unwarranted interpretations that are not supported by the texts. The purpose of
the research report is to provide a wide range of explicated text so that the
reader can recognize common practices and shared experiences.
The researcher
writes the final report using sufficient excerpts from the interviews to allow
the reader to participate in the analysis. Hermeneutical research that draws on
interpretive phenomenology was introduced to nursing by Patricia Benner in
Expertise in Nursing Practice: Caring, Clinical Judgment, and Ethics.
This
study revealed nursing as an interpretive practice with skills, expertise, and
practical knowledge (Benner, Panner, & Chesla, 1996). Viewing nursing as a
practice rather than as an applied science presents a new approach to
understanding that has implications for practice, research, and education.
Hermeneutics deconstructs the corresponding relationship between theory and
practice and reveals the practical knowledge and expertise that evolves over
time.
the Benner study, hermeneutics emerged as a significant area of scholarship in
nursing. Christine Tanner, through hermeneutical analyzes of the narratives of
nurses, has recast clinical judgment making and clinical thinking as
interpretive practices.
Nancy Dickel man is utilizing hermeneutics to describe
the concertful practices of teaching and learning. These shared practices of
students, teachers, and clinicians offer a view of schooling, teaching, and
learning as interpretive practices to transform conventional nursing education.