Patricia Benner: From Novice to Expert

• Born on August 1942; Hampton Virginia, United States.
• BA in Nursing - Pasadena College/Point Loma College (1964)
• MS in Med/Surg nursing from the University of California at San Francisco (1970)
• PhD - 1982 from University of California at Berkeley
• Published 9 books and numerous articles
• Published ‘Novice to Expert Theory in 1982
• Received Book of the Year from AJN in 1984,1990,1996, 2000

\
FOUR METAPARADIGMS IN NURSING
Nursing
• Nursing is described as a caring relationship, an “enabling condition of connection and concern.”
• is viewed as a caring practice whose science is guided by the moral art and ethics of care and responsibility.
• Dr. Benner understands that nursing practice as the care and study of the lived experience of health, illness, and disease and the relationships among the three elements.

Person

“The person is a self-interpreting being, that is the person does not come into the world predefined but gets defined in the course of living a life.”- Dr. Benner

\

Major aspects of understanding that the person must deal as:

1.The role of the situation
2.The role of the body
3.The role of personal concerns
4.The role of temporality

\
Health
• focuses on the lived experience of being healthy and being ill.
• Health is defined as what can be assessed, whereas wellbeing is the human experience of health or wholeness.
• Wellbeing and being ill are understood as distinct ways of being in the world.

Environment
• Benner uses situation rather than environment because situation conveys a social environment with social definition and meaningfulness
• “To be situated implies that one has a past, present, and future and that all of these aspects….influence the current situation.”- Dr. Benner
•

From Novice to Expert

• Patricia Benner developed a concept known as “From Novice to Expert.” This concept explains that nurses develop skills and an understanding of patient care over time from a combination of a strong educational foundation and personal experiences.
• Dr Benner proposed that a nurse could gain knowledge and skills without actually learning a theory. She describes this as a nurse “knowing how” without “knowing that.” She further explains that the development of knowledge in fields such as nursing is made up of the extension of knowledge through research and understanding through clinical experience.

\

Levels of Nursing Experience

• The theory identifies five levels of nursing experience: novice, advanced beginner, competent, proficient, and expert.

1. Novice
   • Beginner with no experience
   • Taught general rules to help perform tasks
   • Rules are: context – free, independent of specific cases and applied universally
   • Rule-governed behavior is limited and inflexible
   • Exs: “Tell me what I need to do and I’ll do it
2. Advanced Beginner
   • Demonstrates acceptable performance
   • Has gained prior experience in actual situations to recognize recurring meaningful components
   • Principles, based on experiences begin to be formulated to guide actions
3. Competent
   • Typically, a nurse with 2-3 years experiences on the job in the same area or in similar day-to-day situations
   • More aware of long-term goals
   • Gains perspective from planning own actions based on conscious abstract and analytical thinking and helps to achieve greater efficiency and organization
4. Proficient
   • Perceives and understands situations as whole parts
   • More holistic understanding improves decision-making
   • Learns from experiences what to expect in certain situations and how to modify plans
5. Expert
   • No longer relies on principles, rules, or guidelines to connect situations and determine actions
   • Much more background of experience
   • Has intuitive grasp of clinical situations
   • Performance is now fluid, flexible and highly-proficient

\
Different levels of skills reflect changes in 3 aspects of skilled performance

• Movement from relying on abstract principles to using past concrete experiences to guide actions
• Change in learner's perception of situations as whole parts rather than in separate pieces
• Passage from a detached observer to an involved performer, no longer outside the situation but now actively engaged in participation

\
Conclusion

Benner’s model has been used in the nursing profession to make innovative changes in how knowledge is acquired and developed, continuing education’s rationale, and serve as a foundation for how nurses build and improve skills based on acquiring experience.

Benner’s concept of reflection can be used to bridge the gap between theory and actual skill. This can be appropriate for nurses and patient families performing a return demonstration, further proving they have the knowledge and know how when faced with a situation or task (1984). Deeper meaning and skill can be enhanced by reflection in practice, leadership, and education (Benner,1984).