theory model in nursing

1. From Novice to Expert
P a t r i c i a E. B e n n e r
This page w as last updated on September 9, 2013
Introduction
 Dr Patricia Benner introduced the concept that expert nurses develop skills and understanding of patient
care over time through a sound educational base as w ell as a multitude of experiences.
 She proposed that one could gain know ledge and skills ("know ing how ") w ithout ever learning the
theory ("know ing that").
 She further explains that the development of know ledge in applied disciplines such as medicine and
nursing is composed of the extension of practical know ledge (know how ) through research and the
characterization and understanding of the "know how " of clinical experience.
 She coneptualizes in her w riting about nursing skills as experience is a prerequisite for becoming an
expert.
ABOUT THE THEORIST
 Patricia E. Benner, R.N., Ph.D., FAAN is a Professor Emerita at the University of California, San
Francisco.
 BA in Nursing - Pasadena College/Point Loma College
 MS in Med/Surg nursing from UCSF
 PhD -1982 from UC Berkeley
 1970s - Research at UCSF and UC Berkeley
 Has taught and done research at UCSF since 1979
 Published 9 books and numerous articles
 Published ‘Novice to Expert Theory’ in 1982
 Received Book of the Year from AJN in 1984,1990,1996, 2000
 Her w eb address is at: http://w w w.PatriciaBenner.com
 Her profile can be obtained at http://nursew eb.ucsf.edu/w ww/ix-fd.shtml
LEVELS OF NURSING EXPERIENCE
She described 5 levels of nursing experience as;
1. Novice
2. Advanced beginner
3. Competent
4. Proficient
5. Expert
Novice

2.  Beginner w ith no experience
 Taught general rules to help perform tasks
 Rules are: context-free, independent of specific cases, and applied universally
 Rule-governed behavior is limited and inflexible
 Ex. “Tell me w hat I need to do and I’ll do it.”
Advanced Beginner
 Demonstrates acceptable performance
 Has gained prior experience in actual situations to recognize recurring meaningful components
 Principles, based on experiences, begin to be formulated to guide actions
Competent
 Typically a nurse w ith 2-3 years experience on the job in the same area or in similar day-to-day
situations
 More aw are of long-term goals
 Gains perspective from planning ow n actions based on conscious, abstract, and analytical thinking and
helps to achieve greater efficiency and organization
Proficient
 Perceives and understands situations as w hole parts
 More holistic understanding improves decision-making
 Learns from experiences w hat to expect in certain situations and how to modify plans
Expert
 No longer relies on principles, rules, or guidelines to connect situations and determine actions
 Much more background of experience
 Has intuitive grasp of clinical situations
 Performance is now fluid, flexible, and highly-proficient
Different levels of skills reflect changes in 3 aspects of skilled performance:
1. Movement from relying on abstract principles to using past concrete experiences to guide actions
2. Change in learner’s perception of situations as w hole parts rather than in separate pieces
3. Passage from a detached observer to an involved performer, no longer outside the situation but now
actively engaged in participation
SIGNIFICANCE OF THE THEORY
 These levels reflect movement from reliance on past abstract principles to the use of past concrete
experience as paradigms and change in perception of situation as a complete w hole in w hich certain

3. parts are relevant
 Each step builds on the previous one as abstract principles are refined and expanded by experience
and the learner gains clinical expertise.
 This theory changed the profession's understanding of w hat it means to be an expert, placing this
designation not on the nurse w ith the most highly paid or most prestigious position, but on the nurse
w ho provided "the most exquisite nursing care.
 It recognized that nursing w as poorly served by the paradigm that called for all of nursing theory to be
developed by researchers and scholars, but rather introduced the revolutionary notion that the practice
itself could and should inform theory.
CONCLUSION
 Nursing practice guided by the human becoming theory live the processes of the Parse practice
methodology illuminating meaning, synchronizing rhythms, and mobilizing transcendence
 Research guided by the human becoming theory sheds light on the meaning of universal humanly lived
experiences such as hope, taking life day-by-day, grieving, suffering, and time passing
RESEARCH ON BENNER'S THEORY
1. Tow ards an alternative to Benner's theory of expert intuition in nursing: a discussion paper
2. An evaluation of the seminal w orkof Patricia Benner: theory or philosophy?
3. A response by P. Benner to K. Cash, "Benner and expertise in nursing: a critique"
4. Benner and expertise in nursing: a critique
5. Intuition as a function of the expert nurse: a critique of Benner's novice to expert model
REFERENCES
1. Dracup and Bryan-Brow n. From Novice to Expert to Mentor Shaping the Future - American Journal of
Critical Care. 2004;13: 448-450.
2. Jane Corrigan Wandel. The Institute for Nursing Healthcare Leadership Conference: Reflections on the
Impact of Patricia Benner's Work. Medscape Nurses. 2003;5(2). Accessed on 5-04-2010
fromhttp://w w w .medscape.com/view article/462607
BIBILIOGRAPHY
1. Benner, P. (1982). From novice to expert.American Journal of Nursing, 82(3), 402-407
2. Benner, P., & Wrubel, J. (1982a). Skilled clinical know ledge: The value of perceptual aw areness. Part
1.Journal of Nursing Administration, 12(5), 11-14.
3. Benner, P., & Wrubel, J. (1982b). Skilled clinical know ledge: The value of perceptualaw areness. Part
2.Journal of Nursing Administration, 12(6), 28-33.
4. Benner, P. (1984). From novice to expert: Excellence and pow er in clinical nursingpractice. Menlo Park,
CA: Addison-Wesley.