From Novice to Expert

Patricia E. Benner

ABOUT THE THEORIST

 Patricia E. Benner, R.N., Ph.D., FAAN is a Professor Emerita at the University of
California, San Francisco.
 BA in Nursing - Pasadena College/Point Loma College
 MS in Med/Surg nursing from UCSF
 PhD -1982 from UC Berkeley
 1970s - Research at UCSF and UC Berkeley
 Has taught and done research at UCSF since 1979
 Published 9 books and numerous articles
 Published ‘Novice to Expert Theory’ in 1982
 Received Book of the Year from AJN in 1984,1990,1996, 2000

LEVELS OF NURSING EXPERIENCE

She described 5 levels of nursing experience as;
1. Novice
2. Advanced beginner
3. Competent
4. Proficient
5. Expert
Novice
 Beginner with no experience
 Taught general rules to help perform tasks
 Rules are: context-free, independent of specific cases, and applied universally
 Rule-governed behavior is limited and inflexible
 Ex. “Tell me what I need to do and I’ll do it.”
Advanced Beginner
 Demonstrates acceptable performance
 Has gained prior experience in actual situations to recognize recurring meaningful
components
 Principles, based on experiences, begin to be formulated to guide actions
Competent
 Typically a nurse with 2-3 years experience on the job in the same area or in similar day-
to-day situations
 More aware of long-term goals
 Gains perspective from planning own actions based on conscious, abstract, and analytical
thinking and helps to achieve greater efficiency and organization
Proficient
 Perceives and understands situations as whole parts
 More holistic understanding improves decision-making
  Learns from experiences what to expect in certain situations and how to modify plans
Expert
 No longer relies on principles, rules, or guidelines to connect situations and determine
actions
 Much more background of experience
 Has intuitive grasp of clinical situations
 Performance is now fluid, flexible, and highly-proficient
Different levels of skills reflect changes in 3 aspects of skilled performance:
1. Movement from relying on abstract principles to using past concrete experiences to guide
actions
2. Change in learner’s perception of situations as whole parts rather than in separate pieces
3. Passage from a detached observer to an involved performer, no longer outside the
situation but now actively engaged in participation
SIGNIFICANCE OF THE THEORY
 These levels reflect movement from reliance on past abstract principles to the use of past
concrete experience as paradigms and change in perception of situation as a complete
whole in which certain parts are relevant
 Each step builds on the previous one as abstract principles are refined and expanded by
experience and the learner gains clinical expertise.
 This theory changed the profession's understanding of what it means to be an expert,
placing this designation not on the nurse with the most highly paid or most prestigious
position, but on the nurse who provided "the most exquisite nursing care.
 It recognized that nursing was poorly served by the paradigm that called for all of nursing
theory to be developed by researchers and scholars, but rather introduced the
revolutionary notion that the practice itself could and should inform theory.