ArticleFundamental Patterns of Knowing in Nursing The Challenge of Evidence-Based PracticePorter, Sam PhD, RN Author Information School of Nursing and Midwifery, Queen's University Belfast, Northern Ireland, United Kingdom. Corresponding Author: Sam Porter, PhD, RN, School of Nursing and Midwifery, Queen's University Belfast, 10 Malone Rd, Belfast BT9 5BN, Northern Ireland, United Kingdom ([email protected]). Advances in Nursing Science: January 2010 - Volume 33 - Issue 1 - p 3-14 doi: 10.1097/ANS.0b013e3181c9d5eb Buy Metrics Abstract This article reconsiders the fundamental patterns of knowing in nursing in light of the challenge of narrow empirics in the form of evidence-based practice. Objections to the dominance of evidence-based practice are reviewed, and the reasons for it are examined. It is argued that it is partially the result of weaknesses in the alternative patterns of ethical, personal, and esthetic knowing, the ineffability of which compromises accountability. This ineffability can be countered only by introducing a wider form of empirics than countenanced by evidence-based practice into all patterns of knowing, to demonstrate their salience and to make their use in practice transparent. © 2010 Lippincott Williams & Wilkins, Inc.