Evaluation of Benner’s Novice to Expert Theory
Individualized nursing care is an indicator of quality care because it enhances positive patient outcomes. Nurses need the experience to be able to develop individualized care perceptions that can be utilized effectively in the classification systems and nursing processes to achieve quality care. Novice nurses must be supported when implementing individualized care to gain clinical experience and become experts. Patricia Benner’s Novice to Expert Theory best reflects these concepts by depicting the characteristic changes that are witnessed as nurses gain experience within the practice settings.
Benner’s Novice to Expert Theory was introduced by Patricia Benner in 1982. The theory discussed how nurses nurture their skills and understanding of patient care from the time they venture into nursing practice until they become fully qualified nurses who can handle complex cases. Benner’s Novice to Expert Theory was based on the observation that student nurses graduate from nursing schools and programs every year and join clinical settings to start practicing. With time, they gain more insights and knowledge to become seasoned nurses and mentors for the next generation of nurses. Benner’s Novice to Expert Theory discussed how long-term and continuous career development played an important role in nursing because of the complex nature of the profession. Patricia derived her theory from the Dreyfus Model of Skill Acquisition and adapted it to provide an objective way of evaluating nursing skills and subjects. Benner’s Novice to Expert Theory has been extensively utilized in nursing to increase nurse retention and build experience with new nurse administrators and managers. The model discusses how new nurses begin at the novice stage and progress through several stages as they gain skills, knowledge and experience to become experts. The five stages of Benner’s Novice to Expert Theory are a novice, advanced beginner, competent, proficient and expert (Benner, 1982). Evaluation of Benner’s Novice to Expert Theory
This is the initial stage in the model, a stage that describes new nurses with no experience in nursing. It is the stage where new nurses are taught simple and objective nursing attributes that can be identified easily. In the leadership realm, this stage is considered as the first management job where individuals’ experiences tend to be inflexible, limited and require further professional development and growth. Benner (1982) considers individuals at this stage to be lacking experience and hence the inability to utilize discretionary judgment. At this stage, individuals struggle to decide the tasks that are relevant to accomplish because there are no existing rules to regulate performance in real-life situations.
Advanced Beginner Stage
As Novice gains skills and knowledge, they enter the advanced beginner stage, a stage that Benner (1982) considered comprising of individuals who have been involved in several real-life nursing experiences that they can easily recall some of the important aspects when they encounter similar cases in future. However, mastering the rules and guidelines that have been taught was considered to be the main problem faced by advanced beginners. Just like the novices, the need to support advanced beginners in clinical settings by setting priorities was considered crucial. For instance, advanced nurse leaders were considered to have some experience but needed some influence and guidance from mentors to set priorities and provide constructive feedback.
The competent stage is also known as nurse manager is the stage where individuals can prioritize tasks on their own based on past experiences. Benner (1982) described individuals at this stage to be competent enough, just like people who have been practicing for two to three years and their actions can be seen in terms of goals and plans. Competent people were considered to have the ability to work in an efficient and organized manner because they are conscious and deliberate in planning. The only weaknesses recorded by people at this stage were the lack of multitasking and flexibility capabilities like proficient leaders, although they were able to plan consciously using the abstract and analytic principles that focus on long term goals and plans. Evaluation of Benner’s Novice to Expert Theory
As competent people continued to practise and gain more skills, knowledge and experience, they entered the proficient stage, a stage where individual performances were guided by maxims because they could see situations in their entirety (Benner, 1982). Maxims were described as pieces of evidence that provided direction to take important actions in different situations. Proficient nurses were considered to have a holistic understanding of situations at hand which allowed them to make more advanced decisions.
The Expert Stage
The final stage in the model was the expert stage, a stage where individuals were considered experts because they possessed extensive knowledge of concepts and situations that allowed them to have confidence and instinctive grasp of complex situations (Dale et al. 2013). Individuals at this stage no longer relied on guidelines, maxims and rules because they had become part and parcel of them. At this stage, individuals could grasp concepts, analyze situations and come up with strategies to address the situation without necessarily consulting rules and guidelines.
The Underlying Assumptions in Benner’s Novice to Expert Theory
Benner’s Novice to Expert Theory has assumed practice to be a systematic whole with a notion of excellence. Although intuition cannot be considered as a science, sometimes it stimulates research and leads to greater knowledge and questions that must be explored. Students cannot experience intuition about patient care situations, but over time, nursing expertise is gained and students can use intuition. This theory has considered intuition to be an important part of the nursing process. In reality, nursing practice is not a systematic process. Evaluation of Benner’s Novice to Expert Theory
Caring has been assumed to be the basis of altruism. The theory has argued that nurses should care for patients in a manner that they consider fit. Benner moved away from the rules of bonding care and introduced individual and autonomous judgment of practitioners. She also considered good decisions to depend on an ethical stance which makes nurses perform caring processes. In reality, caring cannot be altruistic but rather an evolutionary stage of development.
The theory assumed that practitioners cannot practice beyond experience. This theory has described practice capacities rather than the traits and talents of practitioners. At each of its five stages, clinicians can perform best. The theory did not consider that some nurses may be talented to the extent of performing some practices without having clinical experience.
Benner’s theory presents both strengths and weaknesses. One of the main strengths of this theory is that it focuses on nurse behaviors based on their level of understanding within the nursing practice (novice, advanced beginner, competent, proficient and expert). The theory has highlighted the importance of clinical experience in enhancing nursing expertise. Based on this strength, this theory has been widely used when assigning clinical competence (Dale et al., 2013).
From the negative point of view, the theory has proposed the road from novice to expert in a poorly defined manner and the evidence to support the process is very weak. Besides, the criteria of assigning nurses to the five stages (based on years of experience) are not reliable because it may not always correlate with the expertise depending on how factors such as commitment to learning and an individual’s capability to learn quickly. Establishing the reality of the five stages (novice, advanced beginner, competent, proficient and expert) is a difficult matter that requires a wealth of quantitative data, which lacks in this theory (From novice to expert, 2013). Lastly, the status of the five stages is not clear. The stages were meant to imply that individuals can be categorized in one stage but evidence shows that individuals can be fluent in one sub-field but less fluent in another field of the same domain.
As the nursing profession continues to mature, Benner’s novice to expert theory has found its applicability in different areas. It provides a framework for the clinical institution. It has been incorporated into evidence-based practices to give quality patient-centred care. It has laid a foundation for the development of clinical settings. It has also been used in educational advancement and simulation labs to offer reflective learning experiences that aid in practice and growth for nurses. It has been referenced to achieve sound decision-making and clinical judgment in inpatient care. It is also referenced when defining leadership roles among nurses in clinical settings (Fennimore & Wolf, 2011).
Benner’s novice to expert theory has been very helpful when implementing health information technology in a clinical setting. After the staff members are trained, the individual commitment of each staff member thereafter determines those who will be allowed to utilize it in a real-life situation. An individual who fully commits themselves to learn and practice with the HITs becomes the first one to be allowed to apply them while those who are less concerned are the last to be allowed to use them (Titzer et al., 2013).
Benner’s novice to expert theory offer insights into the evaluation of nursing practices through experience. She considers nursing as a profession based on past experiences and that requires continuous growth. It is a theory that can be utilized to standardize nursing education for professional development and organizational advancements.
Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407.
Dale, J. C., Drews, B., Dimmitt, P., Hildebrandt, E., Hittle, K., & Tielsch-Goddard, A. (2013). Novice to expert: The evolution of an advanced practice evaluation tool. Journal of Pediatric Health Care, 27(3), 195-201. http://dx.doi.org/10.1016/j.pedhc.2011.12.004.
Fennimore, L., & Wolf, G. (2011). Nurse manager leadership development: Leveraging the evidence and system-level support. Journal of Nursing Administration, 41(5), 204-210. http://dx.doi.org/10.1097/NNA.0b013e3182171aff.
From novice to expert: Patricia E. Benner. (2013). Retrieved from http://currentnursing.com/nursing_theory/Patricia_Benner_From_Novice_to_Expert.html.
Titzer, J. L., Shirey, M. R., & Hauck, S. (2014). A nurse manager succession planning model with associated empirical outcomes. Journal of Nursing Administration, 44(1), 37-46. http://dx.doi.org/10.1097/NNA.0000000000000019.