| Sumario: | This study employed an interpretivist methodology to describe and analyze the interrelationships between knowledge, context and clinical nursing practice. The content of nursing continuing education programs offered 9-12 months previously was reviewed. Forty semi-structured, tape-recorded interviews were conducted with nurses from hospitals, nursing homes and home care agencies to determine their use of this new knowledge. Nurses were asked questions about their learning, their work environment, and their clinical practice. Data were analyzed using computerized data coding, concept maps and matrices. Nurses identified that knowledge became meaningful in clinical practice when it was relevant to the practice, met the needs of the client, and contained specific content that was deemed helpful. Additionally, the process of constructing a knowledge base was facilitated when the knowledge was reaffirmed, when the individual learner was revitalized, when confidence was increased, and when personal growth was sustained. Finally, nurses identified that knowledge became meaningful when they saw results, engaged in dialogue and networked with colleagues. Nurses described the structural, political, symbolic and human relations frames of the context in which they worked as having an impact on how they constructed knowledge in clinical practice. The structural frame was seen as a hurdle to be overcome. The human relations frame was seen as positive and facilitating the construction of knowledge. The political frame was used as a screen to filter out new knowledge. Finally, the symbolic frame developed from the political issues in the organization and became imbedded as operating values and assumptions. Clinical practice affected knowledge through the role that paradigm cases played in both personal and professional growth. Nurses learned to make meaning of such concepts as hope, control, vulnerability, acceptance, respect, loss, persistence, communication, caring, complexity, attachment and families through their clinical practice. Implications for nursing continuing educators, researchers and administrators were drawn.
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