Running head: EVALUATION OF BENNER'S NOVICE TO EXPERT THEORY
Evaluation of Benner's Novice to Expert Theory
Tamika Missouri
Coppin State University
Theoretical Foundation of Nursing
NURS 620
Dr. Dorsey
January 20, 2014
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EVALUATION OF BENNER'S NOVICE TO EXPERT THEORY
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Evaluation of Benner's Novice to Expert Theory
Introduction
Historically, nursing’s clinical practice has made great strides in the 21st century. The
“nursing basics” (Rosdahl, 2008), the foundation of knowledge that the discipline was built upon
still exists; however, considerable advancements have been made to progress nursing towards a
professional practice. Advancements in education give nurses the greatest opportunity to impact
patients and promote quality outcomes. Variations in education platforms have prepared nurses
to meet professional standards of care, while practicing in a clinical setting provides the basis for
effective clinical decision making. Patricia Brenner’s theory, novice to expert, best reflects this
concept. Brenner’s theory depicts the characteristic changes that are witnessed as nurses develop
within the practice (Benner, Tanner, & Chesla, 2009).
Theory Description
Brenner’s theory focuses on the evolution of nurses as they acquire knowledge. She
asserts that nurses progress through the nursing discipline in developmental stages. Benner
describes the importance of acquired knowledge as it relates to nursing practice. As nurses grow
within the profession and become more experienced, their knowledge in the field broadens.
They begin to master the profession over time, through repetitive skill and reoccurring
experiences. Brenner references Stuart and Hubert Dreyfus’ Model of Skill Acquisition and
Development to describe the stages in five steps. They are as follows: (1) novice, (2) advanced
beginner, (3) competent, (4) proficient, (5) expert.
Novice
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The novice nurse is a newcomer to the profession that has no experience. Clinical
experiences are unfamiliar, leading to strict and rigid practice. It’s difficult for the beginner nurse
to see the entire clinical situation; they are generally concrete thinkers. Measurable data is
referenced to directly correlate with the patient’s well being. Novice nurses need guidance, seek
reassurance from experienced staff when performing tasks, and follow the blueprint of practice
exactly how it’s outlined.
Advanced Beginner
Advanced beginner nurses are the next stage of development. According to Brenner,
familiar clinical situations impact the characteristics of the advanced beginner. Different patient
experiences have shaped the advanced beginner’s perception and expanded their foundation of
knowledge. They are learning to take in and process information based on recurring clinical
situations. The performance of the advanced beginner starts to guide practice.
Competent
Nurses at the level of competence move away from concrete thinkers toward an
analytical, abstract reasoning. This level of skill is not achieved by the amount of time of being a
nurse, but practicing in the same clinical area over a period of time. Benner proposes about two
years. Greater efficiency is attained by gaining a better perspective of the collective needs of the
patient. This allows for better planning to achieve goals and desirable outcomes.
Proficient
Nurses considered proficient have a better understanding of the clinical picture. Practice
is reflective of analytical perception of clinical situations (Stuart, 2013). This level of function
allows the nurse to individualize care, based on specificity of the patient’s needs. Proficient
nurses critically think and make sound decisions based on the combination of skill and intuition.
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Expert
Benner regards the expert stage as the highest level a nurse can achieve in clinical practice
development. Benner’s interpretation at the expert phase, describes the nurse as deeply
connected with the clinical situation. Practice is intuitively driven, reflecting a high level of
proficiency. Information is processed, critical data is considered according to hierarchy, and
interventions implemented based on a strong foundation of knowledge from years of experience.
The expert nurse is unique to the nursing discipline, accounting for variables in clinical situations
and exercising flexibility while providing care.
Major Assumptions
Benner based her assumptions on metaparadigms of nursing, person, health, and situation.
The different phases of nursing development all intertwine at a level of caring. This component
is essential to the progression of nurses through the developmental stages. Caring is embedded
within the profession of nursing and is significant in guiding patient care. Benner asserts that
“knowledge is a prerequisite for expertise”. Exposure to similar situations, builds on the last
experience, empowering skill confidence. She describes the importance of acquired knowledge
as it relates to nursing practice.
Context for use
Generally, Benner’s novice to expert theory can be utilized in education to form preceptor
guidelines for students and new nurses. The theory seeks to define the role and sets realistic
expectations of new staff nurses. Using Brenner’s theory as a framework gives preceptors insight
of what to expect from orientees, and allows the educator to set goals accordingly. Brenner’s
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thoughts are also helpful in designing education and training programs for professional staff
development in clinical institutions . Strengthening knowledge and clinical practice, profoundly
impacts the growth of nursing. Training staff with the most current evidence based practices is
beneficial to nursing professionals. Awareness of staff nurses’ educational needs and the
development of competencies based on that need, carries considerable weight when an institution
is developing staff.
Theory Analysis
Benner’s concept proposal focuses on the “knowing that” versus the” knowing how”
phenomena. She references Polyani (site), when she suggests that “knowing how are the skills
acquired without knowing that.”The concepts in Brenner’s theory are very well defined, both
theoretically and operationally. She qualitatively classifies nurses on a scale that depicts their
skill level at different levels of practice. The theoretical, descriptive stage of the skill level
versus the operational, measurable classification, asserts this in her theory. There’s a clear
correlation between the theoretical and operational linkages. Brenner effectively communicates
the relationship between increased nursing experiences as it correlates to propelling growth
within the profession. Brenner used interviews, experience, and observations to identify and
measure performance characteristics of nurses in clinical settings. She also measures skill set and
psychosocial parameters of the nurse as it relates to practice at these stages. Brenner’s theory
predictions use Dreyfus’ model of skill acquisition as it relates to nursing practice (Alligood &
Tomey, 2010). Dreyfus’ Model of Skill Acquisition was based on studying chess masters and
pilots in emergency situations. It served as a situational model that measures performance at
different levels by exposure to familiar situations. The model embodies the concepts that
Brenner portrays in her theory.
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Theory Evaluation
As the discipline of nursing continues to change, Benner’s novice to expert theory
provides a theoretical framework for clinical institutions. Current nursing standards incorporate
evidence based practice to give quality patient centered care. Benner’s theory directly impacts
standards of practice and performance by laying the educational framework for nurse
development in a clinical setting. The foundation of Benner’s theory is used in educational
advancements. Teaching-learning experience in simulation labs, offer a reflective learning
experience that assists in practice and knowing growth for nurses (Bambini, 2009). It also has
been referenced in practice in relation to sound decision making and clinical judgment when
caring for patients in a clinical setting. It is noted that expert nurses collect more relevant data,
grasp a bigger clinical picture when caring for patients in comparison to novice nurses (Hoffman,
2009). Evidence also references Benner model when defining leadership roles among nurses on
the unit. Excellent organizational skill, not just task accomplishment, establishes leadership roles
in clinical settings (Cummings, 2010).
In addition, the philosophy of Benner’s theory aligns
with the role of advanced nursing practice, by setting the same foundations that are apparent in
other disciplines. Advanced practice nursing curriculums prepare nurses to assume responsibility
for health promotion, assessment, diagnosis, and management of patients’ problems. The strong
framework of Benner’s philosophy supports lifelong learning for nurses through the continuum.
Concepts that Benner propose, implies that advanced practice nursing is vulnerable to the
educational foundations that generally affect the nursing discipline. Utilization of the theoretical
EVALUATION OF BENNER'S NOVICE TO EXPERT THEORY
framework directs education, practice, and research in advanced practice. Graduate nursing
programs can be enhanced, by referencing Benner’s theory. Preceptors gain knowledge of what
to expect from nurses new to the advanced profession. Also, in advanced practice nursing,
Benner’s theory can be referenced to formulate new theories of research based on the
groundwork that she’s supplied to the discipline. The context of Benner’s theory makes it both
socially and cross culturally relevant. The situational basis of where it is derived, affords the
theory broad coverage of its uses. The foundation of skill acquisition, gives it multi- faceted
usage. Simply changing the metaparadigm, will change its focus from nursing; however, it can
be substituted with another discipline and draw the similar conclusions.
Conclusion
Patricia Benner’s Novice to Expert Theory offers the nursing discipline insight to the
evolution of nurses through the practice. She asserts that nurses build upon past experiences to
grow within the discipline. Nursing can reference her approach to standardize educational tools
for professional nursing development that will have a profound impact on organizational
advancements.
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References
Alligood, M., & Tomey, A. (2010). Patrician Brenner. In Nursing theorists and their work (7th
ed., pp. 137-164). Maryland heights, MO: Elsevier/Mosby.
Bambini, D. (2009). Outcomes of clinical simulation for novice nursing students. Nursing
Education Perspectives, 30, 79-82.
Benner, P., Tanner, C., & Chesla, C. (2009). A transition to expertise. In Expertise in nursing
practice: Caring, clinical judgement, and ethics (2nd ed., p. 103). New York, NY:
Springer Publishing .
Cummings, G. G. (2010). Leadership styles and outcome patterns for the nursing workforce
environment: a systematic review. International Journal of Nursing Studies, 47, 363-385.
Deborah, B. (2009). Outcomes of clinical simulation for novice nursing students:
Communication, confidence, clinical judgment. Nursing Education Perspectives, 30, 7982.
Hoffman, K. A. (2009). A comparison of novice and expert nurses’ cue during clinical decision
making. International Journal of Nursing Studies, 10, 1335-1344.
Rosdahl, C., & Kowalski, M. (2008). The Nature of Nursing. In Textbook of basic nursing (9th
ed., p. 1). Baltimore, MD: Lippincott, Williams, & Wilkins.
Stuart, C. (2013). . In Mentoring, learning, and assessment in clinical practice, a guide for
nurses, midwives, and other health professionals. St. Louis, MO: Elsevier Health
Services.