Information resources reflect their creators’ expertise and credibility. Authority is constructed in that nursing, like other disciplines, may recognize different types and sources of authority. It is contextual in that the information need may help to determine the level of authority required. Nurses exercise their own authority in delivering and improving care on an individual, local, regional or national basis.
Authority is a type of influence recognized or exerted within a community. Authority directly relates to the credibility and trust that members of a community place in people or organizations as information sources. Although authority may be traditionally associated with the author of a published work, it can relate to a broader context, such as authors’ affiliations and other considerations. When seeking information, nurses can ask relevant questions about the origins, context, and suitability of their particular information needs. Nursing, like other disciplines, constructs authority by deeming some information sources generally more credible than others, relying on nursing associations, government health entities, nurse scientists, researchers, and others to create and disseminate health-related information. Nurses may trust a particular source as having authority, yet they also realize the necessity to critically appraise information.
Nurses themselves exert authority within communities, and the level of their authority depends on the communities in which they are acting and the context of an information need. For example, a nurse sharing basic health information with their family members is likely to be seen as having greater authority than when sharing that same information among other nurses.
Entry-level nurses recognize who or what the nursing profession has deemed credible as information sources. They may rely on basic indicators of authority, such as the type of publication or author credentials. Depending on their information needs, they learn how to identify authoritative voices and also understand that less recognized or credentialed voices can be authoritative. Entry-level nurses demonstrate an awareness that not all sources of authority are valid. For example, they are aware that people and organizations can use authority to share misinformation and disinformation related to health and medical information. Entry-level nurses also begin to exert their own authority to improve health at an individual level, such as by assessing and teaching patients, promoting healthy behaviors, and advocating for policies that enhance wellbeing.
Advanced-level nurses view authority with an attitude of informed skepticism and openness to new perspectives, additional voices, and the evolution of evidence based on research and practice. They understand the need to determine the validity of the information created by different authorities. They acknowledge biases that affect sources and authority, especially regarding others’ worldviews, gender, race, sexual orientation, cultural orientations, and other factors. They recognize the potential for bias, including how the nursing profession constructs authority. They recognize that expertise, whether it be that of the author or researcher, journal editors, or peer reviewers, is insufficient to guarantee the quality of evidence or research design or appropriateness for the information need. Advanced-level nurses regularly exercise their authority to improve care, such as by leading interprofessional teams and authoring healthcare policies.
Evidence of the Frame in Action
A nurse looking for information uses the 6S evidence pyramid and consciously starts at the top of the pyramid before moving down.
A group of nurses working on updating a practice guideline uses the SORT evidence grading system to evaluate the strength of the evidence on their given topic, which takes into consideration patient-oriented outcomes.
A nurse researcher working on a community-based participatory research project recognizes the importance of including stakeholders and the people who will use and benefit from the results of the research in the research process.
Competencies
Nurses who are developing their information literacy abilities:
Describe different types of authority, such as discipline subject expertise (e.g., scholarship), degree or licensing, societal position (e.g., public office or title), or special experience (e.g., participating in a historic event or living with a disease or condition) [Remembering];
Recognize the value of diverse ideas and worldviews and maintain an open mind when encountering varied and sometimes conflicting evidence or perspectives attributing authority accordingly [Understanding];
Appraise evidence using an appropriate tool such as JBI Critical Appraisal Tools or Yale Research Appraisal Tool [Appraise];
Select an appropriate study type (Systematic Reviews/Scoping reviews, RCT, qualitative study) to answer different types of questions (For example, PICOT , or therapy/prevention, prognosis, etiology, meaning, etc.) [Applying];
Analyze and base decisions on evidence derived from various formats including print, electronic or multimedia, formal or informal as appropriate [Analyzing];
Use research tools and indicators of authority to determine the credibility of sources, understanding the elements that might temper this credibility [Analyzing];
Review the editorial policies of point of care tools and clinical practice guidelines in order to ensure that a robust synthesis and critical appraisal process has been used to assess the strength of evidence for practice recommendation [Evaluating];
Incorporate evidence from the top of the 6s evidence pyramid, moving down the pyramid until the question has been answered in order to inform patient care with the highest level of evidence possible [Evaluating]; and
Incorporate the input of patients, caregivers, and community members in the research and evidence-based practice processes, recognizing their knowledge and expertise [Creating].
