Abstract
Patricia Benner’s Novice to Expert Theory (NET) has had a profound influence on the field of nursing. The theory posits that nurses progress through stages of development, from novice to expert, and each stage is characterized by distinct knowledge and skills. The approach has been used to guide educational programs and to evaluate nurses’ competency. It has also been used to inform research on nurses’ decision-making and clinical judgment. The Novice to Expert Theory is essential to understanding how nurses develop expertise.
Introduction
Numerous nursing theories can be employed to guide care and inform practice. After conducting some research, Patricia Benner’s theory seemed relevant to investigate, as it aligns with modern nursing concepts. The theory is based on the idea that nurses gain expertise through a process of cumulative experience. The theory also emphasizes the importance of clinical judgment, which is essential for providing high-quality care. Overall, the theory offers a helpful framework for understanding nursing and guiding my professional development. This paper will focus on analyzing the theory, the theorist, and how the ideology can be applied.
Education and Experiential Background
Patricia Benner is a widely respected nurse theorist whose philosophy has had a profoundly influential impact on the field of nursing. Her philosophy is centered on the idea of expertise through experience (Brykczynski, 2017). In other words, she believes that nurses can become experts in their field through academic study and the accumulation of hands-on clinical experience. This philosophy has led to a greater focus on clinical simulation and other experiential learning opportunities for nursing students. As the healthcare landscape continues to evolve, Benner’s philosophy remains as relevant as ever due to the ever-growing demand for skillful professionals.
Her epistemology emphasizes the development of knowledge and skills in nurses through experiential learning. This type of learning occurs through a cycle of action, reflection, and evaluation. In other words, nurses gain experience by doing, reflecting on their practice, and then evaluating their experience to inform future practice (Brykczynski, 2017). Benner’s epistemology has been influential in nursing education, leading to the development of simulation-based educational initiatives that provide nurses with opportunities for experiential learning.
Benner’s research methods, used in developing the NET, are based on five primary research approaches. These methods include hermeneutic phenomenology, symbolic interactionism, critical theory, feminist research, and post-positivist research. She interviewed over 100 participants from various clinical settings, including hospitals, nursing homes, and clinics. Additionally, she conducted field observations to gain a deeper understanding of the research context (McEwen & Wills, 2022). Benner’s multiple research methods helped her develop a comprehensive theory widely used in nursing education and practice.
Patricia Benner has been in the healthcare industry for many years and has remained relevant through sheer determination. She earned her diploma in nursing from Byram General Hospital School of Nursing in California in 1957. She then earned a Bachelor of Science in Nursing from the University of California, San Francisco, in 1960, followed by a Master of Science in Medical-Surgical Nursing from the same institution in 1961.
In 1968, she received her MSN from the University of California, Berkeley. After completing her education, Benner began her career as a faculty member at the University of California, San Francisco School of Nursing, where she taught for four years. From there, she took a position as an assistant professor at the University of Southern California School of Nursing. In addition to her academic work, Benner has also worked as a clinical nurse specialist in cardiology and intensive care units.
Nursing Metaparadigms According to the Theory
In her theory, Patricia Benner outlines the five dominant nursing paradigms. These paradigms are defined as follows:
- The Medical Paradigm: The medical paradigm views illness as a disturbance in the body’s normal functioning (Benner, 2001). This model is focused on disease and pathology, and nurses are trained to identify and treat conditions using evidence-based interventions.
- The Biopsychosocial Paradigm: The biopsychosocial paradigm views illness as a disturbance in the connection between the mind, body, and spirit (Benner, 2001). This paradigm considers the impact of social and psychological factors on physical health, and nurses are trained to promote healing by addressing the whole person’s needs.
- The Nursing Process Paradigm: The nursing process paradigm views illness as a problem to be solved (Benner, 2001). This model focuses on assessment, diagnosis, planning, intervention, and evaluation, and nurses are trained to utilize critical thinking skills to plan and provide individualized care.
- The Caring Paradigm: The caring paradigm views illness as an opportunity for nurses to show compassion and support (Benner, 2001). This paradigm is focused on the nurse-patient relationship, and nurses are trained to provide respectful, empathetic, and person-centered care.
- The Emerging Paradigm: The emerging paradigm views illness as a complex system that any one discipline cannot fully understand (Benner, 2001). This paradigm is interdisciplinary, and nurses are trained to collaborate with other healthcare providers to provide comprehensive care.
Additionally, Benner identifies several concepts essential for understanding the development of clinical expertise. One of these concepts is “schemata” (Benner, 2001). A schema is a mental model used to organize and understand experiences. The other concept is empirical knowledge, which is acquired through direct observation and experience. Empirical knowledge is often tacit, meaning that it is difficult to articulate.
“Reflection-in-action” is another significant concept employed in her work. Ideology plays a significant role in comprehending how experts develop skills. According to Benner (2011), the term refers to the ability to reflect on one’s current situation and take action accordingly. This ability to reflect and adapt allows experts to develop their skills over time.
Theoretical Concepts and Assumptions
Benner’s theory posits five stages of development in clinical expertise: novice, advanced beginner, competent, proficient, and expert. This theory is underpinned by the assumption that each stage is characterized by a different schema or way of understanding and responding to the world (Guo & Wang, 2022). At the novice stage, for instance, reflection is often limited to post-hoc self-critique (Hertzum & Simonsen, 2019). Consequently, an understanding of the theory can help shed light on the relationships among schema, empirical knowledge, and reflection-in-action.
The theory makes several assumptions, the first being that individuals go through a fixed sequence of steps or stages as they gain expertise. However, research has shown that this is not always the case. In some fields, such as music or sports, experts often start as novices and rapidly acquire the skills needed to become experts. Another assumption made in the NET is that individuals must first master the basics before moving on to more advanced concepts. However, research has shown that this is not always necessary. In some cases, individuals may be able to skip ahead to more advanced topics if they already have a good understanding of the basic concepts.
Categorization
Based on McEwen and Wills’ “Theoretical Basis for Nursing,” Benner’s theory can be categorized as a professional nursing theory. This categorization is based on the ideology itself, which is based on the professional experience of nurses. This category is closely associated with the grand nursing theory, as it focuses on the time nurses spend explaining the variations in theories.
The theory helps to explain how nurses move from novice to expert status and has provided a framework for research on clinical reasoning and decision-making (McEwen & Wills, 2022). However, it should be noted that the theory is not without its critics, who argue that it fails to adequately address the importance of formal education and knowledge in developing clinical expertise.
Moreover, McEwen and Wills categorize the NET under the subheading of “Cognitive Theories.” They state that this theory is based on the premise that “knowledge is not simply an accumulation of facts but rather an acquired ability to discern relationships among patterns of information” (McEwen & Wills, 2022, p.5). Grand nursing theory develops work based on the experiences that align with the posits of cognitive theory. Benner’s theory focuses on the individual’s ability to develop clinical expertise through experience and practice. McEwen & Wills (2022) argue that this theory has influenced nursing education, leading to the development of concept-based curricula and simulation-based learning experiences.
Critique
“Theoretical Basis for Nursing” generates a critique of Benner’s theory. It argues that the theory fails to adequately explain the complex reality of nursing practice. According to McEwen and Wills (2022), the approach overlooks the numerous variables that influence nurses’ ability to deliver care, including patients’ individual needs, the dynamic healthcare environment, and the nurses’ personal experiences. In addition, they point out that there is no evidence to support the claim that all nurses will progress through the same stages in their careers.
Instead, they argue that each nurse’s journey is unique and that the theory fails to capture this individuality (McEwen &Wills, 2022). The theory does not account for the fact that experts often revert to novice-level behavior when faced with new challenges. Moreover, the theory overlooks the role of motivation and context in determining an individual’s level of expertise. Thus, while the Expert Theory may provide a useful framework for understanding how individuals develop proficiency, it is not without its limitations.
Theory Application
The NET can be applied in various settings, including education, practice, research, and administration. The theory can inform the creation of a curriculum that progresses from simple to complex educational tasks. Nonetheless, the theory has implications for both educators and students. For educators, it highlights the importance of providing scaffolded instruction that meets students where they are (Leistner & Carlin, 2019).
For students, it underscores the importance of taking an active role in their learning journey. This model can help new employees gain the skills and knowledge they need to succeed (Swift & Twycross, 2020). In research, the NET can be utilized to identify knowledge gaps and address them through a targeted study. By understanding and applying the theory, individuals can create a more effective and efficient healthcare system that meets the needs of all those involved.
In practice, especially in healthcare settings, nurses can be classified into five stages based on their years of experience and level of clinical expertise. Novice nurses may require more supervision and comprehensive training before they can care for patients independently. In contrast, expert nurses can anticipate patient needs and make sound decisions without extensive guidance (Swift & Twycross, 2020)
By understanding the various stages of competence, healthcare organizations can develop targeted training programs that cater to the specific needs of individual nurses. Additionally, the NET can assess an individual’s readiness for promotion to a new position or level of responsibility (Patel & Metersky, 2021). For instance, if an individual is currently functioning at the competent stage, they may be ready for a leadership role that requires them to supervise and train other nurses.
To apply the theory in my advanced practice nurse role, I must first identify which stage I am currently in. Once I have done that, I can set goals and objectives to help me move to the next stage. For example, my goal might be to become competent if I am a novice nurse. To achieve this, I would need to gain more clinical experience and enhance my clinical decision-making skills. Once I have reached the competent stage, I can become a proficient or expert nurse.
Moreover, in my role as an advanced practice nurse, I can apply this theory by providing support and guidance to novice nurses. I can also draw on my own experiences to help them understand complex cases. By applying the NET in my advanced practice nursing role, I can continually develop my skills and knowledge, providing the best care for my patients.
Conclusion
The paper focuses on the Novice to Expert Theory, which posits that a nurse can gain experience only through hands-on training. The driving force behind this model is the practical knowledge gained from on-site work. The key concept of the theory emphasizes the need to apply theoretical insights to practical applications. Benner specifies that there is always a possibility of obtaining new information regarding patient treatment. Hence, one should undergo training and educational programs to master their skills.
Benner’s philosophy is founded on the principle that students learn best through hands-on experience. This hands-on approach is evident in her educational background, as she holds a Ph.D. in Nursing Education and has over 20 years of experience as a nurse. The key concepts of Benner’s theory are threefold: first, that students progress through five distinct stages of learning; second, that specific tasks and skills characterize each stage; and third, that students must master the tasks and skills of each stage before moving on to the next.
By understanding where their students are in terms of learning, instructors can better tailor their lessons to meet their needs. Furthermore, because Benner’s theory emphasizes continual growth and development, it can remind educators and students that there is always room for improvement. In conclusion, Benner’s Novice to Expert theory is a valuable tool for educators who want to create an effective and engaging learning experience for their students.
References
Benner, P. E. (2001). From novice to expert: Excellence and power in clinical nursing practice (Commemorative ed). Prentice Hall.
Brykczynski, K. A. (2017). Benner’s philosophy in nursing practice. Nursing theory: Utilization and application, 118-137.
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Hertzum, M., & Simonsen, J. (2019). How do workplace procedures shape professionals’ information-seeking? A study of healthcare clinicians. Information Processing & Management, 56(3), 624–636. Web.
Leistner, L., & Carlin, J. (2019). Assisted living nurse competencies. Geriatric Nursing, 40(2), 225-227. Web.
McEwen, M., & Wills, E. M. (2022). Theoretical basis for nursing (6th ed). Wolters Kluwer Health.
Patel, K. M., & Metersky, K. (2021). Reflective practice in nursing: A concept analysis. International Journal of Nursing Knowledge, 33(3), 180–187. Web.
Swift, A., & Twycross, A. (2020). Using ways of knowing in nursing to develop educational strategies that support knowledge mobilization. Pediatric and Neonatal Pain, 2(4), 139–147. Web.
