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Patricia Benner is a theorist whose works are deeply grounded on research. According to Dinç (2015), part of Benner’s career started in the 1970s as a postgraduate scholar in nursing in California. Further, Strickler et al. (2016) explain that the theorist worked as a staff nurse with specialty in areas such as emergency room, medical-surgical, ICU, coronary and home care. On the other hand, Tiew et al. (2017) explain that Benner delved into nursing ethics and intensive care unit as her major areas of research. According to Dinç (2015), Benner attributes her scholarly and professional success to the inspirations of Virginia Henderson. Benner’s involvement in the research project referred to as Achieving Methods of Intra-professional Consensus, Assessment, and Evaluation (AMICAE) is considered by Strickler et al. (2016) as the driving force to the inception of the famous text From Novice to Expert: Excellence and Power in Clinical Nursing Practice. According to Tiew et al. (2017), Patricia Benner realized the importance of clinical practice in availing professional knowledge. The AMICAE research initiative led to the establishment of two major discoveries: corroboration and elucidation of the Dreyfus model that gives guidance in the processes of acquiring skills and knowledge among nurses; and the description of the diverse fields and proficiencies of nursing as a field of practice Dinç (2015). On the other hand, Strickler et al. (2016) explain that the Dreyfus model of acquisition and development of skills was acclimatized by Patricia Benner as a source of guidance in nursing. Dinç (2015) reveals that Benner used the model as a benchmark of identifying and distinguishing the stages of nursing from novice to connoisseur.
According to Strickler et al. (2016), Benner’s scholarly works that ranged from interviews and surveys in actual practice and situations led to the emergence of the seven spheres of nursing practice. Dinç (2015) enumerates these dominions as: “the helping role, the teaching-coaching function, the diagnostic and patient-monitoring function, effective management of rapidly changing situations, administering and monitoring therapeutic interventions and regimens, monitoring and ensuring the quality of health care practices, and organizational work-role competencies”. The current study undertakes a critical analysis of Patricia Benner’s novice to expert theory by reviewing the concepts, nursing paradigms and the major views of the model.
Concepts of the Theory
Benner’s model underscores the roles played by experience in fostering the development of expertise among nurses. For instance, a new graduate nurse greatly relies on the book knowledge acquired at school. However, field experience is gradually gained as the practitioner moves through the developmental stages with time. To develop the novice and expertise theory, Patricia Benner borrows heavily from Dreyfus’ model of skill acquisition in nursing as a field of practice. According to Benner, nurses undergo five key levels of competence: novice, advanced beginner, competent, proficient and expert as described below:
According to Benner, nurses in the novice stage lack professional experience in the day to day tasks assigned. Tiew et al. (2017) explain that nurses in the novice stage have no background proficiency of the situations in which they are encompassed. Dinç (2015) attributes lack of know how to lower levels of confidence, resulting into minimal demonstration of confidence required to foster safe practice. Strickler et al. (2016) reveal that nurses in the novice phase need to be taken through programs aimed at strengthening their physical and verbal prompts. On the other hand, Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015) explain that professionals in this stage rely on prolonged practice; an aspect that limits their abilities to exploit discretionary judgment.
Advanced beginner stage
The advanced beginner stage develops when the practicing nurse shows the ability to demonstrate marginally acceptable expertise. Tiew et al. (2017) explain that professionals in this phase have already coped up with the real career situations to explain the meaningful conditions of the circumstances based on the prior experience gained. According to Strickler et al. (2016), advanced beginners are both skillful and effective in the aspects of professionalism in need of periodically supportive nods.
Competence is exhibited by nurses who have been practicing for two to three years tackling situations with similarity. According to Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015), competent caregivers have the ability to demonstrate professional coordination and conviction in their actions. On the other hand, Tiew et al. (2017) reveal that nurses with competence adopt plans to drive their perspectives. Further, Strickler et al. (2016) explain that the plans of practice used by nurses in this category to contemplate on problems are based on abstract, analytical and consciousness. Dinç (2015) reveal that the holistic understanding enjoyed by practitioners in the competent category goes a long way in improving their decision making abilities.
The expert stage
The expert level is attained when the nursing practitioner is no longer dependent on analytical processes and procedures to link a situation to the desired courses of action. According to Benner, an expert nurse function from a profound understanding of the issues presented based on the fluid and highly efficient modes of operation he/she adopts.
Nursing Metaparadigms in Patricia Benner’s Novice to Expert Theory
Benner’s theory is based on Dreyfus model to nursing. According to Tiew et al. (2017), Benner established a relationship between two crucial aspects of practice that bring the distinction in the levels of progression among nurses. First, nurses in their levels of practice must have the ability to recognize and respond to varying situations and needs for action. Second, Benner notes that any practicing nurse must develop agency. According to Dinç (2015), agency among clinicians stirs the senses of responsibility towards patients as they periodically evolve to become fully functional members of the healthcare delivery team. Strickler et al. (2016) explain that the two relationships fostered go a long way in connecting the four metaparadigms of nursing as highlighted below:
According to Tiew et al. (2017), Patricia Benner looks at nursing as the “enabling condition of connection and concern”. In this case, nursing is described as the detailed attention offered by nurses to their patients to ensure that assistance is offered based on decency, ethics and responsibilities of the profession. According to Dinç (2015), Benner’s theory gives a deep understanding of the nursing profession as an aspect of care and a field that advances through practice, experience, and the relationship existing between illnesses, health and diseases.
Patricia Benner’s Novice to Expert theory gives the description of a person as “a self –interpreting being that is, the person does not come into the world predefined, but becomes defined in the course of living a life. A person also has an effortless and non-reflective understanding of self in the world” (Strickler et al., 2016). In this case, Benner implies that human beings are empty slates as they are born, and they are molded into the right states by the experiences they are exposed to by life. According to Dinç (2015), Benner looks at the person as a key partaker of common meanings. On the other hand, the theorist brings forth four critical mechanisms that constitute a person: the situation; the body; personal concerns; and temporality. Tiew et al. (2017) reveal that these elements go a long way in reaffirming the fact that an individual should not only be described by the physical self since the body and the mind operate in unity. According to Strickler et al. (2016) the field of nursing emphasizes on treating the patient in entirety and not the physical body alone.
While Patricia Benner’s theory fails to incorporate the word “environment” as a way of describing the surroundings in which the patient lives, she gives a description of “situations”. According to Tiew et al. (2017), the use of the term situation gives an implication of the engagement of the person in an environment that is both social and interactive. Benner adopts expressions such as situated meaning and being situated to explain people’s engagements based on interactions, modes of interpretation, and comprehension of circumstances (Dinç, 2015). Therefore, the experiences and perspectives adopted by human beings go a long way in affecting their environments of operation.
Benner’s theory looks at the concept of health in two perspectives. In the first dimension, the theorist describes health as “what can be assessed” based on objective pieces of information. Second, the novice to expert theory addresses health as the state of wellbeing of an individual (Strickler et al., 2016). According to Tiew et al. (2017) the two facets of health brought forth by Benner give the implications of wholeness in the patient’s state of wellness. For instance, a patient diagnosed of prostate cancer may not feel the effects of the condition based on the stage and state of the disease at that moment.
Description of a Peer Reviewed Research Study Associated with Benner’s Theory
Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015) in their article “How to become an expert educator: a qualitative study on the view of health professionals with experience in patient education” reveal the roles played by competent health professionals in fostering the environments required to nurture novice practitioners as they transit their expertise. Based on their presentation, the researchers contend that competent health practitioners have the skills needed to ensure that high quality patient education is availed. In this case, novice health professionals need to be exposed to environments that allow for motivation and engagement as an aspect of expanding their skills. On the other hand, Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015) explain that provision of conditions that support learning among practitioners in the novice stage goes a long way in stirring knowledge seeking and facilitation of development of competency.
Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015) explain that practicing nurses need to build professional experiences by cultivating their skills of experiential training and observation as a way of ensuring that they evolve from novices to experts. According to the researchers, caregivers gain proficiency through the invaluable experiences they receive while undertaking their chores. In this case, the scholars caution novice practitioners from avoiding their patients due to insecurity and unpredictable circumstances in new situations. Novices must learn through observation of their expert counterparts as a way of ensuring that they enhance their levels of awareness on the most appropriate skills of operation. Further, the researchers explain that nurses with minimal experience must come up with proper mechanisms of assessing their performances by concentrating on their strengths and weaknesses.
To move from a novice to an expert practitioner, nurses need to be exposed to supportive programs that are based on supervision. According to Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015), can be formal or informal. The researchers explain that informal supervision entails guidance from multiple educators while formal guardianship comes from experts. On the other hand, supervisors need to embrace structured mentoring initiatives as a way of allowing the mentor to gain awareness of the novice’s processes of learning and capabilities. Further, the researchers explain that highly experienced practitioners need to emphasize the role played by constructive critical reflection while encouraging those who are less experienced to ask questions in the process of learning. Svavarsdóttir, Sigurðardóttir, and Steinsbekk (2015) reveal that such practices go a long way in stimulating the processes of learning and acquisition of good practices.
Patricia Benner’s novice to expert theory plays a significant role in giving a unique description of how practicing nurses behave based on their levels of professional expertise. A critical analysis of the theory reveals the universal perspective as it lacks restrictions based on the patient’s health status, age, and the place of nursing practice. Benner’s model can be adopted as a platform of fostering patient evaluation and nursing practices. Based on the analysis established, nurses in practice need to be taken through continuous mentoring and training to ensure that their transition from the novice to the expert stage is effective. Therefore, Benner’s Novice o Expert model plays a crucial role in giving insight into the modalities through which healthcare practitioners should approach patient care. While a novice is tied to the strict rules of operation acquired in school, he/she needs to emulate the experts in assessing patients.
Dinç, L. (2015). How does nursing student internship clear up nursing problems?. Nursing Practice Today, 1(4), 173-175.
Svavarsdóttir, M. H., Sigurðardóttir, Á. K., & Steinsbekk, A. (2015). How to become an expert educator: a qualitative study on the view of health professionals with experience in patient education. BMC medical education, 15(1), 87.
Strickler, J., Bohling, S., Kneis, C., O'Connor, M., & Yee, P. L. (2016). Developing nurse leaders from within. Nursing2017, 46(5), 49-51.
Tiew, L. H., Koh, C. S., Creedy, D. K., & Tam, W. S. W. (2017). Graduate nurses' evaluation of mentorship: Development of a new tool. Nurse education today, 54, 77-82.
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