Benner’s Novice to Expert Theory

Description of the Theory’s Background and Influencing Factors, Including Worldview

In the year 1942, in Hampton Virginia, Clint and Shirley Swayer welcomed their second-born daughter, Patricia Benner. While at Pasadena College, Patricia worked as a clerk in a local hospital that led to her developing an interest in nursing. After she made the realization that she had an interest in nursing, she decided to transfer to Pasadena City College as it provided a nursing major. She graduated in 1964 after receiving her baccalaureate of art and associates of art in nursing. Patricia Benner further advanced in nursing education at the University of California, where she attained her Medical-Surgical Nursing Master’s degree. In 1982, she completed her doctorate, which earned her a spot as an Associate Professor at the University of California (Sitzman and Eicheberger, 2011).

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The theory of novice to expert states that nurses become experts after exposure to different kinds of situations on the job in the course of their clinical practice; the expertise is achievable with a background in nursing education and enough relevant experience. Patricia Benner’s theory does not delve much into what it takes to be a nurse, but the process of acquiring knowledge in nursing (Nursing Theorists, 2011). She argues that nurses can acquire skills and expertise without necessarily having to learn the theoretical aspect of nursing. The novice to expert theory is based on the Dreyfus Model of Skill Acquisition that was developed by the Dreyfus brothers. The Dreyfus model believes that one learns through experience and the kind of situation they encounter; for a student to become an expert in what they do, they have to pass through five significant stages. The five stages are a novice, advanced beginner, competent, proficient, and expert (Nursing Theorists, 2011). 

Novices need rules to guide their practice as they do not have experience in any scenario, including the one they are facing. Advanced beginners have little experience enough to be under the guidance of a mentor; they understand the situation or some features of it. A competent practitioner now has an experience of about two years in a situation similar to the one they are facing. They engage in conscious and purposeful planning and regularly apply the analytical framework (Nursing Theorists, 2011). 

The proficient stage involves viewing the scenario as one complete whole but not as a feature; they can also identify the meaning that the situation brings out. The expert stage is where the nurse has been practising for over six years, and they have undergone a variety of conditions hence has acquired relevant experience (Nursing Theorists, 2011). 

The novice to expert theory values the integrity of human beings as promoted by the Christian worldview. She urges nurses to exercise compassion to strangers and provide their services to them without prejudice.  Nurses need to establish a relationship with patients and recognize their vulnerability to suffering for them to provide adequate care to the patients (Nursing Theorists, 2011).  

Explanation of the Underlying Assumptions

The underlying assumptions, in theory, are based on the four metaparadigms concepts in nursing, which are person, situation, health, and nursing.  The person component focuses on the person receiving nursing care. However, care does not only involve the patient it also involves members of their family and anyone else close to them. Apart from the health needs of the patient, the nurse should also consider the patient’s social and spiritual needs. The nurse should, therefore, empower the patient to take care of their health and general well-being with decorum. Benner defines personification as the ability of the human body to react to significant situations (Nikfarid, Hekmat, Vedad, & Rajabi, 2018).

Patricia Benner uses the term situation in place of environment. Patients get into situations based on their understanding and opinion of the case. When one is situated, it means that their present, past, and future affect their current situation. Therefore, the situation involves social meaningfulness and description (Nikfarid et al,. 2018). 

The health component is the range of access to health care services available to the patient. The state of the patient’s health is made up of the patient’s genetics and lifespan, and their spiritual, physical, intellectual and emotional status. Therefore, all the components should be customized to favour the patient’s state of health (Nikfarid et al,. 2018).

The nursing component involves the nurse delivering nursing services to the patient after attaining a mutual relationship with the patient in an environment conducive to healing. This component utilizes the skills and knowledge that the nurse has attained, in addition to collaborations and professional communication to achieve the best patient outcomes (Nikfarid et al,. 2018). 

Evaluation of Major Strengths and Weaknesses

Benner’s theory has one major strength in that its main focus is on the performance of the nurse that is dependent on their understanding level in nursing practice. The theory emphasizes the significance of the nurse attaining clinical experience on her way to achieving expertise.  Benner’s theory is extensively used today for laying the foundation for use in the assignment of clinical competence.

One of the weaknesses of this theory is that the five stages that a nurse has to go through have no clear definition. Also, the evidence that the theory presents to support the five steps is not substantive. Another weakness is the unreliability of the measures used to assign nurses to the stages and have been seen to not correlate with expertise. In addition, quantitative data that supports assigning of the stages is unavailable.

Application Strategies for Clinical Practice

In nursing practice, the novice to expert theory is used to lay a strong foundation for the development and improvement of a nursing career in clinical practice. The model promotes reflective thinking, initiates a resolve in nursing practice, and creates a system that is useful in evaluating nurses. The evaluation is based on their expertise and the experience they acquire in the course of dispensing their duties (American Nurse Today, 2018).

A nurse can apply reflective practice to improve quality of care, stimulate professional and individual growth, and shorten the theory and practice gap. When a nurse uses reflective practice they build up and study their practice; for a nurse to attain reflective practice, they have to be self-aware, descriptive, make judgments, evaluate, and be critical analyzers. They should always strive to improve their reaction to the situation for the better.  The expectance that the nurse gains along the way will help to increase their skills in critical thinking which will, in turn, change their perception in clinical situations. They should take every situation as a learning experience that will help them handle a similar situation in the future in a better way (American Nurse Today, 2018).

A Case Example That Describes the Application in Practice

When I was a novice, all I could do was take a patient’s vital signs and then leave them with a nurse with more experience to continue with diagnosis and treatment. Much of what I did was follow guidelines and instructions from my supervisors. I could not decide for the patient without consulting my superior.  I made it a point to observe and learn how nurses with more experience than me handled different situations and the outcomes they got from their decisions. It is through this that my supervisor started giving me more responsibilities under her guidance until now that I work independently unless the situation dictates otherwise. 

American Nurse Today. (2017, November 8). From our readers: Novice to expert’a nurse educator’s personal journey. Retrieved from https://www.americannursetoday.com/from-our-readers-novice-to-expert-a-nurse-educators-personal-journey/

Nikfarid, L., Hekmat, N., Vedad, A., & Rajabi, A. (2018). The main nursing metaparadigm concepts in human caring theory and Persian mysticism: a comparative study. Journal of medical ethics and history of medicine, 11, 6.

Nursing Theorists (2011).  From novice to expert:  Patricia E. Benner.  Retrieved  September 29, 2017, from http://currentnursing.com/nursing_theory/Patricia_Benner_From_Novice_to_Expert.htmlSitzman, K.  L., & Eicheberger, L. W.  (2011).  Understanding the work of nurse theorists:  A creative beginning.  (2nd ed).  Sudbury, MA:  Jones and Bartlett. 

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