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Dr. Patricia Benner

by Lisa Ewart

March 2019

Figure 1.

Dr. Patricia Benner

1942 - present

Dr. Patricia Benner

Figure 2.

Nursing Theorist, author and academic

History

  • 1964 - Bachelor's Degree in Nursing
  • 1970 - Master's Degree in Nursing
  • 1984 - Developed "From Novice to Expert: Excellence and Power in Clinical Nursing Practice" book
  • 1989 - "The primacy of caring" book
  • 1996 - "Expertise in Nursing Practice" book

Background

Award

In 2011, Patricia Benner was named "Living Legend of the American Academy of Nursing"

Nursing Theory

Why theories

Purpose of Theories

  • Theoretical ideas provide the foundation for personal philosophy and guides each individual nurses’ practice and helps form nursing knowledge

Novice to Expert Theory

Figure 3.

Novice to Expert Theory

Theory Explained

  • Benner (1982) proposes that nurses develop expert skills of patient care over time.
  • This is developed through a diverse educational background and experiences.
  • The theory focuses on how nurses acquire expertise, not how to become a nurse.

Dreyfus Model of Skill Aquisition

The Dreyfus Model of Skill Aquistion

  • Dr. Benner used the Dreyfus model of Skill Acquisition as the basis to her theory.

  • The Dreyfus model takes into account changes in skill performance based on education and experience. The model consider experiential and situation-based learning.

  • Benner’s model applies to nursing knowledge development as well as ethical development of nurses.

  • There are five stages of clinical competence and depending on where each nurse is in their career path, it changes.

5 Stages of Clinical Competence

Figure 4.

Novice

Novice

  • Nursing student or first year of clinical experience
  • No experience in nursing situations
  • Lacks confidence
  • Requires verbal and physical cues for safe practice

Advanced Beginner

  • Prior experience in clinical situations
  • Ability to recognize meaningful components of a situation
  • Inability to prioritize

Competent

  • Have some mastery, can rely on advanced planning
  • Good organizational skills
  • Understands actions, situations and long-term goals
  • Care for patients is complete and within appropriate time frame

Proficient

  • Nurses are capable to see situations as a whole
  • Learn from experience and are able to modify plans related to patient situations
  • Good understanding of long-term goals
  • Holistic patient understanding

Expert

  • Recognizes demands and needed resources
  • Intuitive grasp on situations, problems, alternative diagnosis and solutions
  • Highly skilled, analytical ability within situations of no previous experience

Implications for Benner's Nursing Theory

Nursing Theory Implications

Benner (2009) states that nursing practice is complex, varied and clinicians must adapt to changes in clinical situations.

The significance of Benner's Novice to Expert theory shows a movement from abstract concepts to concrete experiences.

  • Good practice requires nurses to develop skillful, ethical and clinical judgement.

  • Nursing competence is developed over time, experience and practice using experiential learning, perceptual acuity and logic of reasoning.

  • Benner's theory has changed how expert nursing is perceived; a nurse who provides exquiste nursing care.

Applying theory to practice

Application to practice

Application in Clinical Nursing practice:

  • Describes the importance of intuition and intuition-based decision making in nursing practice
  • Provides a strong basis for developing and improving nursing career in practice
  • Promote reflective thinking and the determination of nursing expertise

Education and research

Application to education and research

Application in nursing education:

  • Ability to expand practical knowledge and skills through actual experiences.
  • Use of effective training tools like simulation to increase self-confidence, provide exposure to various clinical conditions and allow nurses to rely on skills and knowledge.
  • Nursing educators can use simulation to facilitate the progress from nursing student to expert by gaining clinical competence in complex situations through education.

Application in simulation education:

  • Provides a conceptual structure to guide simulation facilitator development
  • Uses the five stages of development to guide development of resources, educational programs, and simulation infrastructure

Application in nursing research:

  • Research uses main concepts of Benner’s theory such as competency, proficiency and intuition
  • Development and use of self-reporting competency tool for nurses

Assumptions

  • Benner's model emphasizes nursing care in the clinical setting, which does not consider contexts outside of the unit environment.

  • The theory assumes that all nurses reach a specific competency level at predetermined time in a nurses career and does not take into consideration adaptations that may occur.

  • Expertise is described but not defined.

  • Intuition is considered an aspect of expertise, however intuition is ambiguous.

References

Benner, P. (1982). From novice to expert. American Journal of

Nursing, 402-407.

Benner, P., Tanner, C., & Chesla, C. (2009). Expertise in nursing

practice: Caring, clinical judgement and ethics (2nd Ed.). New York, New York: Springer Publishing Company.

English, I. (1993). Intuition as a function of the expert nurse: a

critique of Benner’s novice to expert model. Journal of Advanced Nursing, 18, 387-393

Figure 1. (n.d.). Picture of Patricia Benner. Retrieved from

https://www.educatingnurses.com/biography-of-patricia-benner/

References Continued

References Continued

Figure 2. (n.d.). Picture of Patricia Benner. Retrieved from https://alchetron.com/Patricia-Benner

Figure 3. (n.d). Picture of Novice to Expert Theory. Retrieved from http://cjni.net/journal/?p=967

Figure 4. (n.d.). Picture of Novice to Expert Theory. Retrieved from http://

novicetoxpertnursingtheory.blogspot.com/2017/08/theory-reference.html

Haag-Heitman, B. (1999). Clinical practice development using novice to expert theory. Gaithersburg, Maryland: Aspen

Publishers, Inc.

Oshvandi, K., Moghadam, A., Khatiban, M., Cheraghi, F., Borzu, R. (2016). On the application of novice to expert theory in

nursing; A systematic review. Journal of Chemical and Pharmaceutical Sciences, 9(4), 3014-3020.

Patricia Benner. (n.d.). In Wikipedia. Retrieved March 3, 2019 from https://en.wikipedia.org/wiki/Patricia_Benner

Thomas, C.M. and Kellgren, M. (2017). Benner’s novice to expert model: An application for simulation facilitators.

Nursing Science Quarterly, 3(30), 227-234.

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