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Patricia Benner: Novice to Expert Theory

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Patricia Benner: Novice to Expert Theory

Medical practice theories refer to the arduous yet innovative organization of philosophies

that estimate a methodical, resolute, and cautious assessment of situations. Competency in

clinical practice is rapidly changing as a result of professional evolution; therefore, competency

remains a vital element in determining nursing care excellence. At the heart of patient

satisfaction, safety and medical outcomes in a healthcare organization is competency which

determines a nurse’s confidence and success – whether in home health, acute care, skilling

nursing or assisted living. One of the theories that aids in developing competency and

proficiency in clinical practice is the Novice to Expert theory by Patricia E. Benner.

Dr. Benner’s Novice to Expert Theory originated from her extensive research project that

she identified as Achieving Methods of Intra-professional Consensus, Assessment, and

Evaluation (AMICAE) (Munjas, 1985). From her research, Dr. Benner wrote the book “From

Novice to Expert: Excellence and Power in Clinical Nursing Practice” (Benner, 1984). It is

during the research process that she learned that medical practitioners could gain clinical practice

knowledge through practice in itself. In her theory, Dr. Benner suggested that an expert nurse

develops knowledge and skills of patient care over time – over a period of time through an

educational base and several experiences (Benner, Malloch, & Sheets, 2010). She further argued

that a nurse could develop their skills and understanding without an understanding of the theory

itself. According to Dr. Benner, knowledge development in nursing comprises the lee way of

practical understanding via characterization and research alongside medical knowledge “know

how.” Dr. Benner’s concept of nursing skills states that to become an expert, one needs to gain

proper experience.
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Patricia Benner’s theory comprises of five levels, which are, novice, advanced beginner,

competent, proficient, and expert level, which have characteristic differences in relation to the

abilities in nursing practice. The characteristics of a novice level include a beginner with lack of

experience; the beginner is taught about rules of performing general tasks; the rules are context-

free, free of exact cases, and universally applied; and there is a limited and inflexible rule-

governed behavior (Benner, & Tanner, 2009). For instance, a novice nurse may only perform

tasks which they are instructed to conduct such as conducting an hourly checkup of a patient’s

blood pressure. In case the diastolic is >100 mmHg then the nurse should call a physician. An

advanced beginner demonstrates characteristics of satisfactory performance; they possess prior

experience of real situations and have knowledge of meaningful and recurring components; and

based on experience, the nurse begins to formulate principles that guide their actions (Benner, &

Tanner, 2009). A competent nurse typically has experience of 2-3 years on the job in specific or

similar areas; they are more aware of the organization's long term goals; besides, a competent

nurse gains perspective from planning personal actions through analytical, abstract, conscious

thinking which aids in the achievement of organizational efficiency (Benner, & Tanner, 2009).

On the other hand, a proficient nurse observes and comprehends conditions as whole parts; they

demonstrate holistic comprehension and help culture the decision-making process; these nurses

also learn from past experiences on what certain situations require and how they can conduct

plan adjustment (Benner, & Tanner, 2009). Finally, an expert nurse has the ability to connect

situations and determining actions without depending on the rules and principles; they possess

greater background experience and have an instinctual hold of medical situations; they

demonstrate highly-proficient, fluid, and flexible performance (Benner, & Tanner, 2009). Instead
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of focusing on irrelevant alternative options, these nurses would focus on the most relevant

problems.

I would consider myself a novice nurse because I possess the basic knowledge about

nursing practice – most of which I have learned and continue to learn in school. However, I plan

on improving my skills over time to become an expert nurse in the future. To achieve this goal, I

will first seek advice and assistance from an expert nurse, who already possess the technical

"know how" of carrying out therapeutic treatments with ease. The expert nurse will help me

identify my learning needs through frequent questions about my practice and the challenges I

face. I will also involve my guide who will monitor my patient outcomes and we will discuss the

success and challenges together. I will request my guide to assign me patients with similar

conditions so that I could improve my clinical reasoning skills – this will help me figure out

priorities and familiarize with any complication that may arise in a patient. Besides, I will attend

support groups of new nurses at the hospital where individual nurses share their clinical practice

experiences. I will associate myself with nurses who will mentor and nurture my growth towards

professionalism and competency. The group meetings will also help me learn from other nurses’

experiences. Through this plan, I will be able to grow and become a competent nurse in clinical

practice.

In conclusion, it is the responsibility of nurses to recognize and manage patient situations

which are either noncritical or potentially life-threatening. A nurse’s perception of clinical

situations and the management of noncritical and life-threatening patient situations highly

depends on their competency which results from the experience gained. Benner’s Novice to

Expert theory explains the various stages in developing medical knowledge and experience, and

how nurses can build their skills in their daily operations.

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References

Benner, P. E. (1984). From novice to expert: Excellence and power in clinical nursing practice.

Addison-Wesley Publishers.

Benner, P. E., Malloch, K., & Sheets, V. (2010). Nursing pathways for patient safety.

Pennsylvania: Elsevier International Press.

Benner, P. E., & Tanner, C. (Eds.). (2009). Expertise in nursing practice: Caring, clinical

judgment, and ethics. Springer Publishing Company.

Munjas, B. A. (1985). From novice to expert: excellence and power in clinical nursing

practice. Journal of Psychosocial Nursing and Mental Health Services, 23(5), 39-39.