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From Novice to Expert, Patricia Benner. By Lisa Nutt Jackie Savage Amy Scanlon. From Novice to Expert- Theory Development. Source of Theory

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From Novice to Expert, Patricia Benner

By

Lisa Nutt

Jackie Savage

Amy Scanlon


From Novice to Expert- Theory Development

  • Source of Theory

    • Early 1980’s University of California, Berkley, Benner’s qualitative research related to the Dreyfus & Dreyfus Five Stage Model of Mental Activities Skill Acquisition

    • 1984 Benner publishes From Novice to Expert: Excellence and Power in Clinical Nursing Practice

    • Theory defines skill levels in nursing and establishes best practices for nursing education (Frisch, 2009)


From Novice to Expert- Theory Development

  • Description of Theory- Five Stages of Skill Acquisition in Nursing

    • Stage I- Novice

      • Beginner to profession or nurse changing area of practice (Frisch, 2009)

      • Explicit rule based knowledge and behavior (Altmann, 2007)

    • Stage II- Advanced Beginner

      • Nurse begins to incorporate real-life experiences in practice into knowledge base (Frisch, 2009)

      • Still requires mentor or experienced nurse to assist with defining situations, to set priorities, and to integrate practical knowledge (English, 1993)


From Novice to Expert-Description of Theory

  • Stage III-Competent

    • After two to three years in the same area of nursing the nurse moves into the Competent Stage of skill acquisition

    • The nurse still relies on conscious planning, efficiency, and organization skills

  • Stage IV- Proficient

    • After three to five years in the same area of nursing the nurse moves into the Proficient Stage

    • The nurse possesses a deep understanding of situations as they occur, less conscious planning is necessary, critical thinking and decision-making skills have developed (Frisch, 2009)


From Novice to Expert-Description of Theory

  • Stage V- Expert

    • This stage occurs after five years or greater in the same area of nursing (experienced nurses changing areas of nursing practice may progress more quickly through the five stages)

    • The nurse develops an intuitive grasp of situations and experiences

    • The expert nurse operates from a deep, holistic understanding of the situation or experience (Frisch, 2009)

    • According to Altmann (as cited in Carper, 1978) the expert incorporates the ways of knowing, empiric knowledge, moral/ethical knowledge, personal knowledge, and aesthetics into their practice of nursing


Benner’s Original Research

  • Goal:

    • Compare Novice & Expert Nurse’s descriptions and responses to the same clinical situations

  • Participants:

    • 21 nurse preceptors & 21 new graduate nurses

    • 51 experienced nurses

    • 11 newly graduated nurses

    • 5 senior nursing students

  • Collection of Research:

    • Interviews with narrative accounts of situations

    • Observation of behaviors in clinical settings (Benner, 1984)


Nursing Education Incorporates Benner’s Theory

  • Goal:

    • Identify if simulating unstable patient scenarios by providing interactive teaching will transition nursing students to higher levels of expertise

  • Participants:

    • 190 Adult Health Nursing Students

  • Collection of Research:

    • Observation of students in simulated patient rooms with manikins providing clues to clinical scenarios

  • Conclusion:

    • Development of nursing competency requires practice and clinical simulation provides a safe, structured learning experience (Larew, Lessans, Spunt, Foster, and Covington, 2006)


Nursing Application of Benner’s Theory

  • Nursing applies Benner’s Theory through:

  • Nursing school curriculum

  • Building clinical ladders for nurses (Frisch, 2009)

  • Developing mentorship programs

    • Preceptors for student nurses

    • Mentors for newly graduated nurses (Dracup and Bryan- Brown, 2004)

  • Development of the Clinical Simulation Protocol (Larew et al., 2006)


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