From Novice to Expert

Patricia Benner

I. Objectives of the Theory

1. This theory aims to describe the characteristics and factors that ensure successful evolution from the novice to expert level.

2. This theory aims to present the concept that expert nurses develop skills and understanding of patient care over time through a sound educational base as well as a multitude of experiences.

II. Conceptual Framework and Definition of Concepts

Expert Proficient Competent

Advanced Beginner

Novice

From Novice to Expert

Definition:

1. Novice A novice is a beginner with no experience. She is taught general rules to help perform tasks. To her, rules are: context-free, independent of specific cases, and applied universally. The nurses rule-governed behavior is limited and inflexible.

2. Advanced Beginner An advanced beginner is a nurse who demonstrates acceptable performance and has gained prior experience in actual situations to recognize recurring meaningful components. Her principles, based on experiences, begin to be formulated to guide actions

3. Competent A competent nurse is typically a nurse with 2-3 years experience on the job in the same area or in similar day-to-day situations. She is more aware of longterm goals and gains perspective from planning own actions based on conscious, abstract, and analytical thinking and helps to achieve greater efficiency and organization.

4. Proficient A proficient nurse perceives and understands situations as whole parts. She exhibits more holistic understanding that improves decision-making. She learns from experiences about what to expect in certain situations and how to modify plans.

5. Expert An expert nurse is someone who no longer relies on principles, rules, or guidelines to connect situations and determine actions. She has a much more background of experience and possesses intuitive grasp of clinical situations. The nurses performance is now fluid, flexible, and highly-proficient.

III. Explanation of Concepts The theory from Novice to Expert postulates that in the acquisition and development of a skill, a student passes through five levels of proficiency: novice, advanced beginner, competent, proficient, and expert. These different levels reflect changes in three general aspects of skilled performance:

1. One is a movement from reliance on abstract principles to the use of past concrete experience as paradigms.

2. The second is a change in the learner's perception of the demand situation, in which the situation is seen less and less as a compilation of equally relevant bits, and more and more as a complete whole in which only certain parts are relevant.

3. The third is a passage from detached observation to involved performer. The performer no longer stands outside the situation but is now engaged in the situation.

The overlapping and growing circles in the conceptual framework represents the growth experienced by the nurse as she progresses through the different levels of proficiency, from being a novice to finally becoming an expert.

IV. Application of Theory

a. Nursing Practice The theory is greatly essential in ensuring a quality nursing care in clinical practice. It is important to identify the proficiency level of nurses and pair up a lower level of proficiency to a higher one. The role of the guide at the side is critical to moving from novice to expert. It is impossible to teach the myriad circumstances and conditions that a clinician might face daily in a clinical area. For example, inexperienced ICU nurses must deal with a wide variety of complex situations and conditions, many of which they are seeing for the first time. However, the expert nurse has a solid technical foundation

and the critical thinking skills to adapt to the unique condition of each patient. Thus, Preceptors/Expert Nurses help by intervening in this potentially lethal situation and give new a nurse confidence while carefully monitoring their actions.

b. Nursing Administration The theory From Novice to Expert may be used as a framework for professional development and advancement model in various hospitals in recognizing the clinical expertise of nurses who provide direct patient care. This would serve to promote reflective practice, recognize nursing expertise, create a peer review system, and provide monetary rewards based on a nurse's level of expertise.

c. Nursing Education The theory serves as a guide for an educator in creating a teaching plan. The level of nursing expertise informs the educator's teaching strategies. Nurses who practice at the novice and advanced beginner levels rely heavily on policy and procedure, have difficulty with ill-defined problems, and have little experience with a variety of clinical situations on which to base decisions. The educator must create highly structured learning activities for nurses at different levels of professional development.

d. Nursing Research The theory From Novice to Expert can be used as a theoretical framework to advance reflective practice and transformative learning experiences not just based on any kind of experience. The experience must be the right type of experiencea transformative learning experience to develop the knowledge and skills of a truly expert nurse.

Bibliography Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Menlo Park: Addison-Wesley, pp. 13-34. http://nursingtheories.info/patricia-benner-nursing-theory-from-noviceto-expert/