exercise, you should be able to identify the criteria you used in making a decision about what theory to use.
Over a 30-year span of teaching, I have asked students, faculty, clinicians, and administrators in the United States, as well as in many other countries, the questions outlined in the preceding text. In reviewing the answers and analyzing their content, I noticed the emergence of a number of criteria for selection and use of theory. Now, compare your criteria with those identified in Box 10-1.
CHAPTER 10 A Model for Evaluation of Theories: Description, Analysis, Critique, Testing, and Support 181 true to the theory’s premises and propositions, and the converse is also true. Using a particular theory to describe components of care or to provide an explanation of the use of a particular vari- able in research is different from testing, refuting, or supporting theories (Norman, 2004).
The objective evaluation and critique of theories is as complex as the subjective evaluation.
To simplify any evaluation, we must break it down into components. For example, when a research project is critiqued, the analysis is done along structural criteria, such as the introduction, conceptual framework, research questions and hypotheses, methodology, results, discussion, con- clusions, and limitations. The critique is then completed by looking for clarity, significance, time- liness, and documentation, among other criteria. To analyze and critique theories objectively, numerous criteria have been recommended by a number of authors. In fact, analysis and critique of theories have preoccupied many nurse metatheorists over a period that even preceded diligent theory development efforts.
Two disciplines have profoundly influenced the evaluation of nursing theory: sociology and psychology. The result has been a synthesis of criteria from these disciplines––at times too empir- ically based and at other times too critical of the theories that were developed by nurses––and those driven by our own nursing phenomena. When we adhered to some of these criteria, we tended to discount nursing theories, relegating them to the category of individual subjective philo- sophical expositions. Although some of these criteria are appropriate for the discipline of nursing, many were not and did not reflect the nature of nursing and the goals of our discipline. Others have emerged that directly relate to and represent nursing. The rationale for developing a different set of criteria is embedded in the nature of nursing care, the assumptions on which the discipline of nursing is built, and the quality of its scientific and humanistic bases. The domain of nursing encompasses human experiences and interactions, and deals with complex sets of contextual vari- ables; therefore, the criteria for theory evaluation must consider ways by which its theories reflect and represent these contexts.
Each one of the evaluation models offered in nursing literature addressed one aspect of a the- ory to the exclusion of others. For example, Johnson (1974) focused on a congruence of theory mission with goals relegated by society to nurses (social congruence, utility, and significance).
Earlier, in an unpublished manuscript on requirements of an effective model, Johnson (1970) offered a set of requirements that focused on the mission of nursing practice: goals of action, patience, the actor’s place and role, source of difficulty, intervention focus, and mode and conse- quences of care. Although Johnson also addressed the necessity of explicit and consistent struc- ture (assumption and values) and content (nursing’s unique goal, ability to be generalized, restrictiveness, continuity, and specificity), other utility criteria were not included, such as research utility and potential for theoretical propositions. Johnson pioneered the development of a set of objective requirements for effective models in nursing and the use of internal and external requirements. Her evaluation model was not published, however, and was therefore limited in exposure and refinement.
Barnum (1998) suggested that passing judgment on theories happens both subjectively and objectively. Judgment may be “simply a matter of personal taste” (p. 171), just as is judgment of art that is based on personal taste, and/or it could be based on clear criteria. The criteria selected by Barnum (1998) are both internal and external. These evaluative criteria are appropriate for internal criticism (internal construction of theory) and external criticism (which considers theory in its relationships to human beings, nursing, and health). The criteria for internal criticism are clarity, consistency, adequacy, logical development, and level of theory development. The criteria for external criticism are reality conversion, utility, significance, discrimination, scope of theory, and complexity (Barnum, 1998, pp. 171–185). These criteria represent one framework for cri- tiquing theories that could be used independently or in conjunction with the descriptive and ana- lytical criteria offered in the model proposed in this chapter.
A similar framework was offered by Ellis (1968), whose insights endure and transcend time, and who delineated seven criteria for what she considered significant theories. Significant theo- ries, according to Ellis, have a broad scope, are sufficiently complex to consider different proposi- tions reflecting the wide scope, and contain propositions that are testable and useful. Significant
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theories are also those that have explicit values and in which implicit values are carefully delin- eated. These theories must have well-defined and meaningful terminology, and they provide opportunities for further generation of information (Ellis, 1968). Hardy (1974) borrowing heavily from the discipline of sociology, organizing her criteria around the concept of “adequacy”: mean- ing, logic, operationalization, empirical evidence, and pragmatism. She also believed that ade- quate theories should have the ability to be generalized, should contribute to understanding, and should be able to predict. It is indeed a challenge to find theories in any discipline to meet all these criteria simultaneously; however, these criteria provide serious theory developers with milestones toward which they should strive.
Lest theory developers become discouraged by the rigorous criteria, Duffey and Muhlenkamp (1974, p. 571) offered the following modest set of questions by which theories can be evaluated:
• Does the theory generate testable hypotheses?
• Does the theory guide practice?
• How complete is its subject matter?
• Did the theorist make her biases explicit?
• Does the theory have propositions and are relationships explicit?
• Is the theory parsimonious?
Chinn and Kramer (2004, pp. 91–119) offer a set of questions that should guide the evalua- tion of integrated knowledge that incorporates theories. These sets of questions are driven by their definition of theory as “a creative and rigorous structuring of ideas that projects a tentative, purposeful, and systematic view of phenomena” (p. 91). They use a series of questions to guide the reviewer toward describing a theory, and then another set of questions to guide the reviewer on a journey of critical reflection of theory. To review and describe a theory, they propose these questions:
• What is the purpose of this theory?
• What are the concepts of this theory?
• What are the relationships in this theory?
• What is the structure of this theory?
• What are the assumptions of this theory?
To reflect and critique the theory, they pose a series of whys? In each of the preceding points, the major ideas to consider are clarity, simplicity, generalizability, and accessibility.
Fawcett (2005a, 2005b), dissatisfied with previously developed evaluation criteria because of the seeming overlap between criteria for evaluating theories and those more appropriate for evalu- ating conceptual frameworks, offered, and continued to update, one analytical and evaluative framework for conceptual models, and a separate one for theories. Fawcett’s framework for con- ceptual models separates questions for analysis from those intended for evaluation. For analysis, Fawcett proposed a consideration of the historical evolution of the model, and the unique focus of the nursing model and the context of the model. For the evaluation, she proposed evaluation (judg- ment based on criteria) of the origins of the model, the degree of comprehensiveness of content, the logical congruence of its internal structure, the ability of the model to generate and test theo- ries, the degree to which it is credible as demonstrated in its social utility (use, implementation), social congruency, and significance to society. A final criterion for evaluating nursing models is in terms of its contributions to the discipline of nursing (Fawcett, 2005a, pp. 51–59). Although these were proposed as criteria for evaluating conceptual models, the same criteria could be used in ana- lyzing and evaluating theories. However, Fawcett (2005a, pp. 441–450) proposed another set of criteria for theory critique that she believed to be more congruent with her definition of theory.
Critique of theories was also divided into analysis and evaluation. For theory analysis, she pro- posed criteria to similar to those of other metatheorists, such as consideration of the scope of the theory, the context of theory, and its attention and consideration of major concepts in nursing and the content of the theory. Fawcett also proposes an evaluation of theories to complement the
CHAPTER 10 A Model for Evaluation of Theories: Description, Analysis, Critique, Testing, and Support 183 analysis described in the preceding text. The content of theories, she says, could be evaluated in terms of the congruency of its significance, internal consistency, the extent to which the theory is stated clearly and concisely (parsimony), and the potential testability of its propositions. Theories must also be evaluated through the adequacy of their empirical evidence and their utility for prac- tice (pragmatic adequacy) (Fawcett, 2005a, pp. 441–450).
Fawcett also differentiates between the evaluation of grand and middle-range theories and provides similarities and differences in the types and level of questions to ask of the two levels of theories. The levels of theories may be differentiated by the kind of methods used, tests per- formed, measurements utilized, and their empirical adequacy. For grand theories, Fawcett (2005b) believes that questions should focus on congruency between methods and philosophical claims, and on the adequacy of the inductive descriptions of data and its congruency with the concepts and propositions of the theory. For middle-range theories, the questions focus more on the observability of concepts, potential for measurement, and the congruency between the theo- retical assertions and the empirical evidence. Fawcett (2005b) provides a strong convincing argu- ment against differentiating criteria that are based on whether theories used quantitative or qualitative data. I would further propose that theories that withstand the tests of time and repeated research findings could neither be classified based on the type of data nor differentiated only by research data. This argument will become even more apparent as you review the evalua- tions of the theories offered in the next few chapters and as you review and study strategies for theory development in Part Five.
Whall (2005) defines theory as a “group of concepts interrelated via propositional statements which are based upon a group of underlying assumptions” (p. 5). As such, she proposes that analy- sis and evaluation use three major criteria: (a) critical review of basic considerations of theory, in which adequacy is examined; (b) internal analysis and evaluation, in which review of complete- ness, consistency, and assumptions are examined; and (c) external analysis and evaluation, in which the connection between theory, research, practice, and education are carefully examined and reviewed (pp. 11–13). Whall also differentiates between the separate review and analysis of each theory level (micropractice, middle-range, and grand nursing models). Each level drives a different set of questions that the reviewer must use. However, analysis and evaluation of all levels of theory must address basic structure, internal analysis and evaluation, and external analysis (Whall, 2005, pp. 5–20).
Table 10-1 compares and contrasts the criteria for evaluating theories, as proposed by four metatheorists. I encourage you to review as many of these proposals for evaluation as possible. As you can see in Table 10-1, there are some similarities and some differences in how each metatheo- rist conceptualized the criteria of analysis and evaluation of theories. The criteria reflect the level and sophistication of our knowledge at different stages of the development of nursing as a scien- tific discipline. In reviewing the different criteria, several trends emerge:
• Theories are described, analyzed, and tested.
• Internal and external criteria exist for evaluating theories.
• The internal descriptive criteria include assumptions, concepts, relationships, and defini- tions.
• The internal critical criteria include some areas of agreement, such as consistency, clarity, and logical development.
• Evaluation criteria consider the fit between the theory and external criteria (human beings, society, prevailing paradigms) and not only the intrinsic criteria.
• A more accepting attitude has evolved, shifting away from the rigor of empiricism to the more realistic rigor of potential for testability.
• There is wider acknowledgment of the complexity of evaluation criteria (the two sides of simplicity, the many meanings of complexity, etc.) and, therefore, wider acceptance of multiple criteria.
• There is less prejudice toward descriptive theories.
Common themes in description and analysis are presented in Table 10-2.
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