In the premiere issue ofAdvances in Nursing Science(October, 1978), Barbara Carper detailed a typology of nursing knowledge. Carper’s ideas have been appreciated and commented upon extensively in the nursing literature, with little extension of her work. This article describes a model of nursing knowledge that builds from Carper’s initial formulation. The model begins with an interpretation of Carper’s four original knowledge patterns: empirics, ethics, esthetics, and personal. Each pattern is considered in relation to: (1) developmental processes and product outcomes associated with its creation; (2) expressions of the pattern; and (3) process context for assessing credibility of knowledge associated with the pattern. The position taken is that all knowledge patterns must be integrated to enable deliberate clinical choices. A failure to integrate knowledge patterns impedes choice and produces negative care outcomes.