Question

Describe Patrica benner theory and assess its value to clinical nurse educator role?

Answer 1

Benner's novice to expert theory asserts that expert nurses develop their knowledge of patient care and extensive skill set by obtaining experiences collected over a course of time as well as having an education background.

Dr. Benner's theory focuses on how nurses acquire their nursing knowledge, particularly how a nurse could gain knowledge or "know-how" without learning a theory, referred to as "know-that". The novice to expert process is one of skill acquisition and is supported as well as defined by the Dreyfus model of skill acquisition, which acts as a foundation for the theory. This model demonstrates how students gain knowledge or skills.

Benner applies this theory to the nursing profession by outlining the same five stages or levels of clinical competency: novice, advanced beginner, competent, proficient, and expert. These five levels represent an overall change in two aspects of a nurse's skills, increased independence in reliance on abstract ideas and principles and an increase in critical thinking. As one collects more concrete experiences, they are then able to use these as paradigms rather than abstract principles, which also leads to an increase in critical thinking. Experiences gained over time will enable a change in perception. Such a change in perception will then open up a new level of thinking that is based on each situation and is more holistic, rather than abstract and pieced-together knowledge that a novice might have

Dr. Benner’s Stages of Clinical Competence

Stage 1 Novice: This would be a nursing student in his or her first year of clinical education; behavior in the clinical setting is very limited and inflexible. Novices have a very limited ability to predict what might happen in a particular patient situation. Signs and symptoms, such as change in mental status, can only be recognized after a novice nurse has had experience with patients with similar symptoms.

Stage 2 Advanced Beginner: Those are the new grads in their first jobs; nurses have had more experiences that enable them to recognize recurrent, meaningful components of a situation. They have the knowledge and the know-how but not enough in-depth experience.

Stage 3 Competent: These nurses lack the speed and flexibility of proficient nurses, but they have some mastery and can rely on advance planning and organizational skills. Competent nurses recognize patterns and nature of clinical situations more quickly and accurately than advanced beginners.

Stage 4 Proficient: At this level, nurses are capable to see situations as “wholes” rather than parts. Proficient nurses learn from experience what events typically occur and are able to modify plans in response to different events.

Stage 5 Expert: Nurses who are able to recognize demands and resources in situations and attain their goals. These nurses know what needs to be done. They no longer rely solely on rules to guide their actions under certain situations. They have an intuitive grasp of the situation based on their deep knowledge and experience. Focus is on the most relevant problems and not irrelevant ones. Analytical tools are used only when they have no experience with an event, or when events don’t occur as expected.

Beginner nurses focus on tasks and follow a “to do” list. Expert nurses focus on the whole picture even when performing tasks. They are able to notice subtle signs of a situation such as a patient that is a little harder to arouse than in previous encounters.

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 whole in which certain 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 what it means to be an expert, placing this designation not on the nurse with the most highly paid or most prestigious position, but on the nurse who provided "the most exquisite nursing care.

• It recognized that nursing was 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.