Exemplar case.

An exemplar case is a description or depiction of a situation, experience, or event that satisfies the following statement: “If this is not x, then nothing is.” The case can be drawn from nursing practice, literature, art, film, or any other source in which the concept is represented or symbolized. If the case is depicted as an object or in some form of media, many rich aspects of the phenomenon can be conveyed by displaying the media for others to experience. Regardless of the format used for presentation, the case is selected because it represents the concept to the best of your present understanding. For concrete concepts such as cup, an exemplar case is relatively easy. An ordinary teacup, for example, can be presented for others to see and hold. The people who examine the object can then verify, “If this is not a cup, then nothing is.” To demonstrate the concept red (a property), a model case is more difficult. You can physically present to the group something that you perceive as being red in color and find out whether the group agrees that this is what its members would also perceive as being red. However, a more precise and consistent identification of red would result from measurement with the use of a spectrophotometer.

When you deal with highly abstract concepts, the task of constructing and selecting exemplar cases is even more difficult, and often these concepts can only be measured indirectly. Many such measurements depend on scales that rely on self-report. For example, the concepts of anxiety and pain are typically measured by self-report rating scales. Usually, exemplar cases of abstract concepts involve experiences and circumstances that are described in words. Exemplar cases may be created from your own experience, or you may find cases in the literature that have been constructed or described by others. For example, to demonstrate an abstract concept such as sorrow, a scenario from a novel or film or a rich description of an experience from your practice can be shared with others who respond to the scenario as a representation of the phenomenon of sorrow.

If you create your own exemplar case, work with your ideas and revise your description until you are satisfied that the case fully represents your concept. For a concept such as mothering, your exemplar case might describe the following event: an infant cries, and an adult picks up the infant. The event is a start, but when you share your case with others, they might object, saying that this description represents only the physical act of picking up a crying child and does not necessarily demonstrate mothering. Your exemplar case develops until there is enough substance that people respond to the case by forming a mental image of mothering. As you build on the scenario of an adult picking up an infant to represent mothering, you could include various circumstances, behaviors, motives, attitudes, and feelings that surround the act of picking up the infant. You paint a picture or tell a story so that people can confirm that this is indeed mothering. As this and other exemplar cases are created, you can compare various meanings in the experience and define what is common and what is different about the various cases that you consider.

It often is useful to alternatively include and exclude various features of exemplar cases to reflect on how central each feature is to the meaning you are creating. In the exemplar case of mothering, the adult initially might be portrayed as female. Later, you might portray a male in the same case. In the absence of any evidence one way or the other, you might tentatively decide that the idea of mothering that you are creating will be deliberately limited to instances that involve women. Because your decision is tentative, you can change your construction for another purpose or circumstance. You can acknowledge the fact that some men mother but that, for your purpose, your idea deliberately includes the experience of women.

While you are working with exemplar cases, pose the following question: What makes this an instance of this concept? The responses to this question form the basis for a tentative list of criteria. During the early stages, the criteria may be quite detailed, and they may be the essential characteristics associated with the concept, given the meanings that you deliberately decide to include. The criteria are designed to make it possible to recognize the concept when it occurs and to differentiate this concept from related concepts. For example, in the case of mothering, you would want to be able to recognize mothering when it happens and distinguish mothering from related phenomena such as caring, nurturing, or helping.

Impressions regarding the criteria begin to form as you work with your exemplar case. You develop ideas about which features are essential for your purposes and why as well as their qualitative characteristics. These ideas become the criteria for the concept. Sometimes exemplar cases are presented after clarification is complete. In these instances, the exemplar case is similar to a definitional form for the concept. Here we use exemplar cases as a way to create meaning rather than to represent it.

Definitions.

Two sources that provide information about conceptual meaning are definitions and word usages of the concept you are exploring. Existing definitions are often circular and do not give a complete sense of meaning for the concept, but they do help to clarify common usages and ideas associated with the concept. Existing definitions often help to identify core elements of objects, perceptions, or feelings that can be represented by a word. They are also useful for tracing the origins of words, which provides clues about core meaning.

Dictionary definitions provide synonyms and antonyms and convey commonly accepted ways in which words are used. They are not designed to explain the full range of perceptions associated with a word, particularly a word that has a unique use within a discipline or that represents a relatively abstract concept.

Existing theories provide a source of definitions that sometimes extend beyond the limits of common linguistic usage. Theoretic definitions and ways that concepts are used in the context of the theory convey meanings that pertain to the domain of the discipline from which the theory comes.

Visual images.

Popular and classical literature.

A variety of literature resources can provide information about conceptual meaning. Literature reflects meanings that arise from the culture and provides rich sources of exemplar cases for concepts. Classical prose and poetry are often good sources of meaning for concepts that are used in nursing. For example, images of love and longing may be found in the poetic works of Emily Dickinson. Louisa May Alcott’s classic book Little Women provides information about the nature of intimacy and caring. The popular current literature is also a source of valuable data about conceptual meaning. Popular self-help books on topics such as overcoming negative thinking and codependency often can clarify commonly understood (or misunderstood) conceptual meanings. Fairy tales, myths, fables, and stories provide relevant insights, depending on the concept that you are exploring. Usages for words that are expressed in popular jargon and cartoons may highlight borderline meanings. For example, when a 5-year-old child jumps up and down and exclaims, “I’m so anxious for my birthday to be here!” the meaning of anxious is not the same meaning that concerns nurses. What the child’s usage does convey is the physical agitation that accompanies the experience of anxiety within the context of nursing practice.

Music and poetry.

The imagery of music or poetry may be useful for the creation of conceptual meaning. You can find music or poetry by seeking out lyrics or titles that name the concept under consideration. The music itself or the metaphoric images in the title or lyrics may reasonably suggest the concept. Music and poetry can effectively convey meanings through rhythm, tones, lyrical or linguistic forms and metaphors, or musical moods that reflect experiences in life events with which nurses deal. For example, the Shaker folk tune “Simple Gifts” suggests criteria for concepts of authenticity, genuineness, centeredness, and community. The tune itself conveys a sense of inner happiness and peace; the lyrics reflect relationships between inner peace and the ability to build strong relationships. The popular Cole Porter song “Don’t Fence Me In” conveys through its musical mood, rhythm, and lyrics what it feels like to be confined emotionally and projects a yearning to be free.

Professional literature.

The meanings of concepts can be explored from within the context of the professional literature. This literature often provides meanings that are pertinent to the practice of nursing. For example, philosophers as well as nurses have written about the concept of presence as a way of being with another. When the work of a scholar in another discipline coincides with your experience as a nurse, the work of other scholars can augment your conceptual meaning. When you find contradictions with your experience as a nurse, the contradictions prompt you to clarify your own insights about the phenomenon.

Anecdotal accounts and opinions.

Peers, coworkers, hospitalized individuals, other professional workers, and people who are not connected to nursing can provide valuable information about the meaning of a concept. It may be useful to seek others’ opinions about the meaning of a concept, particularly if your direct experience with the concept is limited. Nurses who work with the concept daily may be able to shed light on nuances of meaning that will markedly affect how meaning is integrated into your theory. For example, a nurse who works with people whose lung function is severely compromised might observe that anxiety, although usually characterized by increased activity, evokes a different reaction in these patients. Rather than random activity, anxiety may be accompanied by a deliberate quieting of behavior to conserve energy. Asking others to share their ideas about a concept is an informal exploration that is different from standard research procedures that might investigate conceptual meaning. Rather, it is an exploration of the opinions and understandings of others to ground your meaning in everyday perception or to test your professional meanings in the light of everyday assumptions about a phenomenon.

Contrary cases.

Contrary cases are those cases that are certainly not instances of the concept. They may be similar in some respects, but they represent something that most observers would easily recognize as significantly different from the concept you are considering. For more concrete concepts, contrary cases are relatively easy. A saucer or a spoon can be presented, and most observers in Western cultures would agree that these things are not cups. A spoon may hold liquids that people sip, but it is not a cup; a saucer that a cup sits on is also clearly not a cup. A contrary case for the color red might be the color green. For the concept of restlessness, calmness could be presented as a contrary case.

As you consider contrary cases, ask the following: What makes this instance different from the concept that I have selected? By comparing the differences between exemplar and contrary cases, you will begin to revise, add to, or delete from the tentative criteria that are emerging. If your purpose includes designing an exemplar case for your concept, you also might use this information to refine the exemplar case. For example, one of the traits that distinguishes a cup from a saucer or a spoon is the shape of the cup. You may already discern that this feature is essential by looking only at the cup. When you see the spoon and saucer, however, the shape stands out in sharp contrast, and your description of essential features of the shape of the cup can be more complete and precise. As you compare the objects, you may also decide that the volume of liquid that a cup holds is an important distinguishing characteristic. Later, when you consider miniature teacups as cases, you might decide that volume is not an essential quality, especially if your other criteria are sufficient to distinguish which objects can be considered cups, which is your purpose.

Sometimes, when creating narrative contrary cases, the tendency is to simply reverse the situation depicted in the exemplar case. Usually this does not add new information of significance for creating conceptual meaning. If you are having difficulty with constructing a negative case, ask someone else to suggest a contrary case or something that is definitely not what you are trying to describe. Sometimes you can locate a contrary case in the literature. Contrary cases that contribute to meaning often reveal important aspects of the exemplar case that are hidden in assumptions that you may be making about the concept.

Related cases.

Related cases are instances that represent a different but similar concept. Related cases usually share several criteria with the concept of interest, but one or more criteria will be particularly associated with the model cases to distinguish them from the related cases. A different word is generally used to label the related instances. If you find that one word is typically used to refer to essentially different phenomena, you may need to select language for your concept that differentiates it from the related meanings. For example, if you were focusing on the concept of love between a parent and child, you may need to use the word label parental love to signify that you see essential differences between this experience of love and other related experiences of love.

In the case of a cup, you might consider a drinking glass. For the concept of red, you might consider a red-orange hue or magenta. For the concept of mothering, you could design a case of child tending that would be similar to the exemplar case. You might make a childcare worker the adult or substitute an elderly person for the infant. Again, you consider differences and similarities between the exemplar and the related cases and revise the tentative criteria to reflect your new insights.

Borderline cases.

A borderline case is usually an instance of metaphoric or pseudo applications of the word. A borderline case is found when the same word is used in a different context. For example, if you are examining the concept of fatigue in chronic illness, a useful borderline case of the use of the term fatigue would be “military fatigue clothing.” Poetry and lyrics to music provide rich sources of metaphoric uses of words. In the evolution of language, the metaphoric meanings of words carry powerful messages that often persist as new usages emerge and thus illuminate the core meaning. The metaphoric meanings for the concept of red are excellent examples. Red as a word and as a color has become, in Western culture, a metaphoric symbol for communism, violence, passion, and anger. To give a “cup of cheer” is an exemplary borderline usage of the term cup. This highlights the feature of cups as being capable of holding something.

Slang terms and terms that are used to describe technologic operations or features are rich sources of borderline cases when they are first entering the language. After they become well accepted, they are no longer borderline; they move to more central conceptual meanings, and they sometimes even become exemplary cases. Slang, which can develop from a quirky application of a word, provides rich sources of borderline cases. The language that emerges to refer to new technology is also a rich source of borderline cases. During the early 1990s, the word web probably would have prompted a mental image of something that a spider creates, and a reference to the Internet would have been considered a borderline case. By the end of the 1990s, the word web was so fully associated with the Internet that it might have become a model case of web.

For the concept of mothering, a borderline case might be a computer motherboard, because this term and its related concept are not part of the typical computer user’s conceptual realm and remain primarily technical. You might choose this borderline usage to help clarify features of the concept of mother that can be seen as foundational to the concept of mothering. These features could include the central importance of the mother in some cultures for defining the scope of relationships or structuring the energy of all relationships within the system. Ask what happens to your meaning if you perceive mothering as a process that structures and directs the nature of relationships in a system.

Paradoxic cases are variants of borderline cases that are useful to highlight the central meanings of concepts. Paradoxically, these cases embody elements of both exemplar and contrary cases. For example, when exploring the meaning of dignity, you might create a case in which actions that violate dignity occur to preserve a central feature of dignity. Your case might be the emergency cardiopulmonary resuscitation of a person in a public space to preserve the life of that person. Such a case is paradoxic in that it violates some criteria for dignity but highlights the importance of a central criterion for discerning the concept.

You will probably invent other varieties of cases during the process of creating conceptual meaning. How the cases are classified is not critical. Rather, their important function is to assist you with discerning the full range of possible meaning so that you can design a meaning that is useful for your purpose. Although creating conceptual meaning is a rigorous and thoughtful process, cases are somewhat arbitrary, and they are historically and culturally situated. What you call them is not essential to the process; what is important is the meaning that you derive from the conceptual exploration and the investigation.

Exploring contexts and values.

Social contexts within which experience and the values that grow out of experience occur provide important cultural meanings that influence the mental representations of that experience. For example, consider the concept of judgment if you are a student taking an examination, a real estate agent assessing a home for sale, an official scoring a gymnastics meet, or a magistrate preparing to impose a sentence. When you explore the various meanings acquired by virtue of the context, you probably will become aware of meanings that you previously had not considered.

One way to imagine various contexts is to place your exemplar cases in different contexts and ask the following: What would happen in a different situation? You mentally imagine the practical outcomes of your conceptual meaning in its context. For example, if you place your exemplar case of the color red in the context of a magazine advertisement, what symbolic meaning is conveyed? What advertising results does the advertiser intend? If the color red is placed in the context of traffic signs and symbols, what meaning does the color now convey? What behavioral responses do you now expect? What about a woman who is wearing a red suit in a boardroom where everyone else is dressed in dark suits? As you consider various possible combinations of context, you will clarify how meanings are influenced by context.

Placing the concept in a subtly differing context also reveals values. The concept of mothering has a relatively positive connotation for most people. Most people agree that humans require “good” mothering to grow and develop adequately. However, people differ widely with regard to what they consider to be good mothering; these differences often have to do with the cultural context. For example, there probably would be considerable disagreement regarding whether what happens in a schoolroom, in a hospital, or in counseling can be considered mothering. What is considered mothering reflects deeply embedded cultural values. When you consider your exemplar case being placed in several different social contexts, you create an avenue for perceiving important values and making deliberate choices about them.