patricia benner - from novice to expert concept

St. Paul University Philippines

Tuguegarao City, Cagayan Valley 3500

ACT 200: Advanced Critical Thinking in Nursing and Clinical Teaching

PATRICIA BENNER: FROM NOVICE TO EXPERT CONCEPT

SCHOOL OF HEALTH SCIENCES

MASTER OF SCIENCE IN NURSING

GROUP 2 MEMBERS: Aira Katrina S. Caberoy, RN

Elrey Joseph Calitis, RN

David Brian A. Perez, RN

Patricia E. Benner

From Novice to Expert Concept

Biography and Career of Patricia Benner

Benner earned her Bachelor of Arts degree in nursing from Pasadena College in

1964.

She was given a Master of Science in Medical-Surgical Nursing from the

University of California at San Francisco in 1970, and a Ph.D. from the University

of California at Berkeley in 1982.





In the late 1960s, Benner worked in the nursing field. This included working as a

Head Nurse of the Coronary Care Unit at the Kansas City General Hospital and

an Intensive Care Staff Nurse at the Stanford University Hospital and Medical

Center.

From 1970 until 1975, she was a Research Associate at the University of

California at San Francisco School of Nursing. Following that, she was a Research

Assistant to Richard S. Lazarus at the University of California at Berkeley.

From 1979 until 1981, she was the Project Director at the San Francisco

Consortium/University of San Francisco for a project achieving methods of

intraprofessional consensus, assessment, and evaluation.

Since 1982, Benner has been working in research and teaching at the University

of California at San Francisco School of Nursing.

Benner has published nine books, including From Novice to Expert, Nursing

Pathways for Patient Safety, and The Primacy of Caring. She has also published

many articles.

In 1995, she was awarded the 15th Helen Nahm Research Lecture Award from

the University of California at San Francisco School of Nursing.

She is currently a professor emerita in the Department of Physiological Nursing

at the University of California at San Francisco School of Nursing.

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Four Domains of Nursing Paradigm

Client/ 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

Health

Dr. Benner focuses on the lived experience of being healthy and being ill.

Health is defined as what can be assessed, whereas well being is the human

experience of health or wholeness.

Well being and being ill are understood as distinct ways of being in the world

Environment/ Situation

Benner uses situation rather than environment because situation conveys a

social environment with social definition and meanifulness.

“To be situated implies that one has a past, present, and future and that all of

these aspects….influence the current situation.”- Dr. Benner

Nursing

Nursing is described as a caring relationship, an “enabling condition of

connection and concern.” -Dr. Benner

“Caring is primary because caring sets up the possibility of giving and receiving

help.”

Nursing is viewed as a caring practice whose science is guided by the moral art

and ethics of care and responsibility.





Patricia Benner Nursing Theory: From Novice to Expert

The Patricia Benner nursing theory of Skill Acquisition in Nursing or the “from Novice to

Expert model” developed based on the study of the acquisition and development of

skills by chess players and airline pilots in emergency situations. As the individual

progress through these levels, they demonstrate changes using concrete experiences.

Second, they move from analytic, rule based thinking to intuition. Third, the learner’s

perception changes from a situation composed of equally relevant parts to a complex

whole in which certain parts are more relevant than others. Fourth, they move from a

detached observer to an actively involved performer.

Levels of Nursing Experience

Stage 1: Novice

Beginners have had no experience of the situations in which they are expected to

perform. Novices are taught rules to help them perform. The rules are context-free and

independent of specific cases; hence the rules tend to be applied universally. The rule-





governed behavior typical of the novice is extremely limited and inflexible. As such,

novices have no “life experience” in the application of rules.

“Just tell me what I need to do and I’ll do it”

Stage 2: Advanced Beginner

Advanced Beginner is those who can demonstrate marginally acceptable performance,

those who have coped with enough real situations to note, or to have pointed out to

them by a mentor, the recurring meaningful situational components. These components

require prior experience in actual situations for recognition. Principles to guide actions

begin to be formulated. The principles are based on experience.

Stage 3: Competent

Competence, typified by the nurse who has been on the job in the same or similar

situations two or three years, develops when the nurse begins to see his or her actions

in terms of long-range goals or plans of which he or she is consciously aware. For the

competent nurse, a plan establishes a perspective, and the plan is based on

considerable conscious, abstract, analytic, contemplation of the problem, The

Conscious, deliberate planning that is characteristic of this skill levels help achieve

efficiency and organization. The competent nurse lacks the speed and flexibility of the

proficient nurse but does have a feeling of mastery and the ability to cope with and

manage the many contingencies of clinical nursing. The competent person does not yet

have enough experience to recognize a situation in terms of an overall picture or in

terms of which aspects are most salient, most important.

Stage 4: Proficient

The proficient performer perceives situations as whole rather than in terms of chopped

up parts or aspects, and performance is guided by maxims. Proficient nurses understand





a situation as a whole because they perceive its meaning in terms of long term goals.

The proficient nurse learns from experience what typical events to expect in a given

situation and how plans need to be modified in response to these events. The proficient

nurse can now recognize when the expected normal picture does not materialize. The

holistic understanding improves the proficient nurse’s decision making; it becomes less

labored because the nurse now has a perspective on which of the many existing

attributes and aspects in the present situation are the important ones.

Stage 5: The Expert

The expert performer no longer relies on an analytic principle (rule, guideline, and

maxim) to connect her or his understanding of the situation to an appropriate action.

The expert nurse, with an enormous background of experience, now has an intuitive

grasp of each situation and zeroes in the accurate region of the problem without

wasteful consideration of a large range of unfruitful, alternative diagnosis and solutions.

The expert operates from a deep understanding of the total situation.

patricia benner - from novice to expert concept

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