Application of Benner’s Theory: from Novice to Expert
In her theory titled From Novice to Expert, Dr. Patricia Benner introduced the idea that expert nurses gain the skills and comprehension of patient care not merely by undergoing a rigorous educational program but also by being exposed to a multitude of experiences. According to Dr. Benner (1984), one can gain the needed skills without ever learning the theory. Therefore, she proposes that the development of knowledge and skills in a pragmatic field such as nursing, calls for exposure to practical knowledge of clinical experience. Benner’s theory stresses on the importance of practical knowhow and proposes that experience is a prerequisite to becoming an expert (Benner et el, 1996). Her model describes five stages of expert nurse development namely novice, advanced beginner, competent, proficient and expert (Benner, 1984). This paper aims at explaining and illustrating the application of this theory to two areas of professional nursing specifically nursing practice in a patient-care setting and nursing informatics. In addition, the paper seeks to express the purpose of this theory and point out research results in support of this theory reported in scholarly literature.
Application of the theory
A crucial characteristic of an expert nurse is that he or she seldom relies on principles, rules, or guidelines to connect situations and determine actions but rather relies on his/her experience (Benner, 1984). This model lays emphasis on the development of such skill through a mentored relationship with an experienced practitioner. Benner, Tanner and Chesla (1996) observe that in regard to patient care situations, the expert nurse is able to integrate various aspects of patient care in to a holistic whole as compared to the novice who sees patient care as bits of distinct information and a sequence of separate tasks. For instance, when caring for an unstable critically ill postoperative cardiac surgery patient, the novice nurse will be mainly caught up in the mastering of the technical aspect of care such as checking and noting vital signs every fifteen minutes, assessing the cardiac rhythm, checking chest test tubes routinely and so on. On the other hand, the expert nurse will accomplish these tasks with little regard to the technicality of these activities by integrating knowledge of cardiovascular physiology and pathophysiology to assess symptoms and guide patient care i.e. the expert has gone beyond the tasks and now has the ability to look and respond to the situation as a whole. Therefore, Benner’s model can successfully be applied to train and equip nurses with the practical knowledge of nursing practices such as patient care setting.
One of the most important factors that aids in the development of skills and expertise is the formation of a close relationship between an experienced staff and the novice nurse (Benner, 1984). For instance, when a novice nurse is assigned a task in caring for a mentally challenged patient, more often than not, they may end up being irritated especially if the patient is somewhat uncontrollable. It is only through experience that an individual develops traits such as patience and tact to deal with similar situations. Professionalism grounded in academia does not provide the pragmatic aspect of nursing care and therefore experience will season such a nurse to handle different patients.
Another field of nursing profession where Benner’s model can be applied is in the area of nursing informatics. Nursing informatics is a sub-field of health informatics that combines the use of information technology with the skills and work of nurses in healthcare in an attempt to enrich the quality of nursing practice. In this field of nursing informatics, Benner’s model can be used to develop nursing informatics skills, knowledge, expertise and competence among nursing informatics specialists. In addition, this theory can be used to develop technological system competencies in practicing nurses working in an institution. Technological advancement is rapidly evolving and it is most likely that a number of the practicing nurses in the institutions today did not have an opportunity to study a lot of the newly developed information technology equipments. Thus, for them to develop the competency to use them in their routine tasks, they must be mentored by an expert in the particular field. Such a mentorship process falls right within the propositions of this theory.
Project managers, administrators and change leaders should consider the use this theory while planning implementation initiatives and other informatics training opportunities. According to Kaminski (2010), deliberate practice and the willingness to take risk or go beyond the norm are the two personal characteristics that distinguish the successful evolution to the expert level when it comes to nursing informatics. Many people do not like to stand out from the rest or look peculiar and different from others. Furthermore, man generally wants to remain in the comfort zone longer than it is necessary. Thus, many nurses will shy away from using new technologies in the performance of their duties (Kaminski, 2010). A guided and mentored process will therefore produce an encouraging environment in cultivating the needed skills and developing confidence among the novice in the nursing informatics arena.
In the field of nursing, particularly, the major purpose of this theory is to create independent and self-reliant personnel also known as expert nurses. The theory lays down a five-stage mentorship model that results in the conception of an independent and competent nurse. The five levels represent the movement from reliance on learned abstract principles to the use of the acquired concrete experience coupled with a change in perception where the expert sees a situation as a holistic whole rather than a series of distinct occurrences (Benner, 1984). Each of the preceding stage builds on the previous one as the abstract knowledge is refined and amplified by experience and this helps the learner to gain clinical expertise. This theory challenged all the prototypes that dictated that nursing theory should be developed by researchers and scholars by introducing the radical concept that the practice itself could and in fact should inform theory.
Research results supporting this theory
A number of research results published in scholarly literature have demonstrated huge support for Benner’s theory. For instance, the results of a research carried out by Barbara J. Daley of University of Wisconsin-Milwaukee to examine the different learning processes used by novices and experts showed that experts seemed to use more informal mechanisms, including consulting peers and other health care professionals as opposed to novice nurses who tended to learn through more formal mechanisms such as attendance at continuing education programs, reading journals and review of policy or procedures (Barbara, 2007). The results of this study which indicated that the novice and the experts used different learning process is in direct support of Benner’s theory especially in the distinguishing characteristics of people who are in the two different levels; novice and experts. Barbara’s study has implications for learning needs assessment and program planning as it calls for a review of continuing professional education and staff development programs to address the divergent needs of novice and expert trainees. According to Barbara (2007), educators need to develop a capacity to assess the learning needs of their audience as well as their career stages so as to enable facilitate learning in a more customized fashion. Moreover, a study by Dreyfus and Dreyfus (1985) on novice and expert teachers and pilots revealed that novice professionals were guided by rule-oriented behavior. Expert professionals on the other hand had a perceptive understanding of a problem and did not waste time on considering large possible solutions to problems.
A close scrutiny of Benner’s theory reveals its efficacy and applicability in the nursing practice both in the present moment as well as in the future. The key concepts of this theory such as guided mentorship, emphasis on practical know how and the elaboration of the critical role played by experience in the transition process from novice to an expert are exceptionally relevant in the training of skilled personnel especially in applied disciplines such as nursing. In addition, this theory is applicable in various professional areas such as nursing informatics. Lastly, numerous research results that are in support of Benner’s theory have been reported. It would therefore be worthwhile for educators and other stakeholders in the field of nursing to give this theory the much needed attention by exploiting its various advantages in both training and managing arenas of the nursing field.
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Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing. Menlo Park,
Benner, P., Tanner, C. A., & Chesla, C. A. (1996) Expertise in nursing practice: Caring, clinical
Judgment and ethics. New York, NY: Springer Publishing Company.
Dreyfus, H., & Dreyfus, S. (1985). Mind Over Machine: The Power Of Human Intuition And
Expertise In The Era Of The Computer. New York: Free Press.
Kaminski, J. (Fall, 2010). Theory applied to informatics – Novice to Expert. CJNI: Canadian
Journal of Nursing Informatics, 5 (4), Editorial. http://cjni.net/journal/?p=967