Novice To Expert Theory Analysis

Summary of selected theory

Name and author, first published and most recent edition

Patricia Benner’s Novice to Expert theory was published in the American Journal of Nursing in 1982, and was the basis for her 1984 book, From novice to expert: Excellence and power in clinical nursing practice published in 1984 (cite website). Benner’s original theory was expanded in 1989 to include the concept of caring when Benner coauthored, The Primacy of Caring, Stress and Coping in Health and Illness with Judith Wrubel. In 1999, the theory was again expanded to include domains specific to critical care nursing when Benner coauthored Clinical Wisdom and Interventions in Critical Care: A thinking-in-action-approach with Pat Hooper-Kyriakidis and Daphne

One of the main concepts of Benner’s theory is the widely known five level skill acquisition model stemming from the application of the Dryefus Model of Skill Acquisition to the nursing profession (CITE BENNER, 1982). The five levels describes a nurses career progression from novice, one who relies on rules and guidelines rather than discretionary judgement to guide practice, to an advanced beginner, with the ability to recognize reoccurring meaningful elements. Within three years, the level of competent is usually achieved, wherein the nurse is able to see their actions as part of a long-term plan. In the fourth or proficient level, the nurse’s expectations of events and ability to modify interventions are guided by previous experience. The fifth and final level is that of expert, a nurse, who has an intuitive grasp of the situation with the confidence and ability to change the plan of care accordingly. Each stage of the journey builds upon the previous stage. Benner’s theory deems practical experience crucial to the delivery of holistic patient care, and speed of movement through the five levels is individual to each nurse, factoring in real life experiences, rather than being based solely on longevity. CITE BENNER

Benner’s Novice to Expert theory depicts the metaparadigm of nursing as a complex caring relationship, the delivery of patient care is a moral art, guided by ethics and responsibility, combining health, illness, disease and the lived experience. Nursing is providing holistic care meeting physicall, psychological and emotial needs. CITE BENNER & WRUBEL 1989

Benner employs Heideggers phenomenological definition to the metaparadigm of person; stating that the person is self interpreting. The definition of person is specific to the individual, and changes throughout time. A person in defined by the events experienced in the course of living life, and gains understanding of self through reflection on himself and his world, including the role of the situation, the body, personal concerns, and temporality. CITE BENNER & WRUBEL.

Utilizing Benner’s theory, the metaparadigm of health is described as something that can be assessed, while well-being is experiential rather than observable. Well-being and being ill are two separate and distinct ways of being in the world. Additionally, the state of health while observable, is not merely the absence of disease or illness, as, health combines both physical and psychological components. CITE