The purpose of this paper is to present and explore Patricia Benner’s Novice to expert theory. It depicts the unique and similar attributes within the theory and concept as well as their utilisation within nursing practice and education. It contains information on the general background of the theorist, the definition of the theory, and its significance to the different facets involving the field of nursing.
Patricia Benner is a Professor Emerita in the Department of Social and Behavioural Sciences at the University of California, San Francisco. Through her books and publications, she introduced 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 experience. Benner stated that theory is crucial to form the right questions to ask in a clinical situation as well as theory directs the practitioner in looking for the problems and anticipating care needs. There is always more to any situation than theory predicts. The skilled practice of nursing exceeds the bounds of formal theory. Concrete experience provides learning about the exceptions and shade of meaning in a situation. The knowledge embedded in practice discovers and interprets theory, precede and extends theory, and synthesises and adapts theory caring nursing practice.
Benner’s model is comparatively simple about the five stages of skill acquisition. It gives a relative guide for classifying levels of nursing practice, from individual nurse descriptions and observations to actual nursing practice. Particularly, in her article published in 1982, she defined and explained that a novice is a beginner with no experience and is being taught the general rule to help perform tasks. These rules are context-free, independent of specific cases and applied universally. Their behaviour is rule-governed and is limited and inflexible. An advance beginner demonstrates acceptable performance, gaining prior experience in actual situations to recognize recurring meaningful components, and follows principles that are based on experiences. With a competent nurse, typically, there is a 2-3-year experience on the job in the same area of in similar day-to-day situation. There is more awareness of long-term goals and gaining perspective from planning own actions based on conscious, abstract and analytical thinking is being observed. A proficient nurse perceives and understands the situation as whole parts. There is more holistic understanding which improves the decision-making process. There is a 5-year experience and learning from experiences what to expect in certain situations and how to modify plans are being observed. The fifth level, an expert nurse, no longer relies in principles, rules or guidelines to connect with situations and determine actions. More background experience is observed and there’s an intuitive grasp of clinical situations. The performance is fluid, flexible and highly proficient. The interpretations are validated by agreement or by general acceptance. Clinical knowledge is relational and deals with local, specific, historical issues. Benner uses narrative accounts of actual clinical situations and preserves that the model enablers the reader to recognize similar intents and meanings, although the objective circumstances may be quite different.
According to Benner’s theory, nursing practitioners would be able to expand their practical knowledge and skills through actual experiences. Moreover, according to this model, the movement from the novice step to the upper ones would occur over time and by gaining more experiences (by gaining more experiences). However, it should be noted that simulators are very useful training tools which can be employed in the novice and advanced novice steps for providing nurses with required skills. Based on this theory, gaining experience through such tools is known as purified knowledge (Larew et al. 2006). Benner explained that moving up from the advanced novice to the component step is mainly a result of increasing self–confidence in practitioners, which is because of meeting various clinical conditions and the emergence of the feeling that they can rely on their skills (Benner 1996). So, according to Benner’s theory nursing instructors can use simulators to facilitate the progress of nursing students in gaining clinical competencies (Patrick and Sean 2017). In clinical educations, simulators can be of various forms, including written form, simulated patients, role playing, maquettes. Lastly, it should be emphasised that simulators are strong, efficient tools with can be used for facilitating the educational process in complex situations (Weaver 2011).
All things considered, Benner’s theory can be used as a guideline for conducting all fields related to nursing specially nursing education and practice. Practical knowledge is essential to knowledge development and professional growth of nursing. Reflection in practice is a tool that can be used by nurses to find deeper meaning within practical experience to advance practice as well as to enhance one’s skill level. Every clinical situation is an opportunity for learning. Through reflection and experience, a nurse can achieve a profound understanding of themselves and the practice of nursing and ultimately improve patient care outcomes.