The Science and Art of Theory Development and Evaluation

In the nursing field, theory development and evaluation are among the most critical components that distinguish the nursing discipline from medicine and related sciences. Therefore, this component aids in developing and understanding healthcare principles, allowing for the effective formulation of theory-based practices. For a theory to be effective, it must be relevant to the clinical practice. In addition, evaluation helps analyze a theory's effectiveness in patient outcomes, aiding medical practitioners in determining the most appropriate theory for nursing research, education, administration, and practice. While a theory needs to be relevant in clinical practice to be effective, it can only be relevant if it produces the desired outcomes. This paper will examine the art and science of theory development and evaluation, outlining the process of theory development and the importance of theory evaluation in nursing practice.

The development of nursing theories derives from conceptual models with clearly identified nursing metaparadigm phenomena. In most cases, the fundamental concepts that form the metaparadigm for nursing are person, environment, health, and nursing. The conceptual model consists of abstract propositions and concepts melded into a relevant configuration to help describe nursing phenomena and their interrelationships in abstract terms (Fawcett, 2011). As a result, this conceptual model forms a forerunner of nursing theory as it helps in deriving concepts and their definitions and propositions of the nursing theory. In addition, these models used in the development of a theory also aid theory developers in depicting the beliefs in their theory, explaining to the nursing community how the theory works and how one can interpret it into nursing practice.

Once a theory developer proposes a nursing theory addressing a given phenomenon of interest, the theory has to be analyzed for various considerations, including its logic and completeness, correspondence with empirical findings, internal consistency, and operational definition for testing. This analysis results in various changes to the theory, helping make improvements and eliminate any inconsistencies. The theory then undergoes repeated rigorous research to help accumulate scientifically proven evidence to help support the assertions of the proposed theory and make extensions or alterations to the theory.

The development of nursing theories is a continuous and systematic process as more scholars continue with research on the existing theories and the development of new theories, making this field vital for the future of nursing. However, despite this systematic process, the approaches in the development of theories tend to differ. Therefore nursing theories can emerge from various types of reasoning: retroductive (abductive), inductive, or deductive (Behfar & Okhuysen, 2018). Retroductive reasoning selects the likeliest possible explanation from a set of incomplete observations. While deductive reasoning starts from a married and specific clinical area and observations, inductive reasoning is much broader, focusing on general observations (Behfar & Okhuysen, 2018). After devising and developing the theory, a nursing theorist should then publish their theory to the nursing community to allow for another significant process of theory evaluation.

Theory evaluation is the assessment and systematic examination of a theory to determine the origins, meaning, usefulness, logical adequacy, testability, and generalizability of these theories. After publishing a theory, the nursing community then reviews, debates, and critiques the theory with reference to the relevant practice field and the research findings. Theory evaluation is vital in nursing practice as it helps provide additional information about the theory’s soundness and determine the theoretical relationships supported by the research. In addition, evaluation helps in the development of intervention guidelines and helps determine the efficacy of these interventions. Their evaluation is also vital in research by helping researchers determine the relevance of the theory's content being tested (Fawcett, 2011). Theory evaluation varies depending on the relevant field of research as multiple evaluation criteria exist. However, the four main criteria in theory evaluation include examining the theory's definitions, significance, internal consistency, parsimony and testability (Fawcett, 2011).

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