Contributor: Rosemary Eustace
August 21, 2020
Author – Patricia Benner, RN, PhD, FAAN
Year First Published – 1982
Middle Range Theory
Benner’s Novice to Expert Theory presents a systematic way of understanding how a learner whether a student, new or seasoned nurse develops skills and understanding of a practice situation/event over time. The theory has been applicable to a broad variety of situations, including nursing education, retention of graduate nurses, and nursing management and administration. Benner’s theory was derived from the Dreyfus Model of Skill Acquisition, and drew from knowledge of engineering and philosophy. Inasmuch as the theory has been found to be relevant for nursology, it can be considered a shared theory.
As can be seen in the Table, Benner (1982, 1984) proposed that as learners attempt to develop competency, they move through five stages–Novice, Advanced beginner, Competent, Proficient and Expert. Proceeding from novice to expert is a circular, rather than linear process, not linear. Accordingly, learners do not necessarily move systematically from one stage to the other and ultimately develop competency in certain skills. Instead, learners may move from one stage to another repeatedly as they learn new knowledge and skills.
Table: Stages of Proficiency
|Stage||Definition||Potential strategies for skills and knowledge acquisition|
|Novice||The learner has had no previous experience making them struggle to decide which tasks are most relevant to accomplish.||Teach simple, objective concepts/attributes that are easily identified|
|Advanced beginner||The learner has enough real-world situations that the recurrent component is easily identified when it is related to rules and guidelines.||Increase assistance and support in setting priorities to clients’ needs by providing guidelines for recognizing patterns|
|Competent||The learner has been on the job two or three years and is able to see actions in terms of goals or plans and works in an efficient and organized manner.||Offer inservice education or opportunities|
|Proficient||The learner performs by using pieces evidence (i.e. maxims) that provide directions to see a situation as a whole.||Use case studies to stimulate critical thinking especially in situations with principles or rule that are contradictory.|
|Expert||The learner grasps the situation and understand what needs to be accomplished beyond rules, guidelines, and maxims.||Provide opportunities for experts to share their skills and knowledge and also their analytical abilities to solve new situations|
Benner, P. (1982). From novice to expert, American Journal of Nursing, 82(3), 402-407.
Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison‐Wesley Publishing Company
Patricia Benner, professor of nursing at the University of California, and Judith Wrubel, medical researcher at the University of California-San Francisco, are two major writers in nursing theory who specialize in what can be termed a “developmental” or “interpretive” approach to the person as patient. In general, the basic concept of nursing here is based around an ethic of care that deals with the patient as a whole. Therefore, the main thrust of nursing is a type of care that deals with patient mental issues, stress and emotions as well as clinical practice. (https://careertrend.com/about-6315001-benner-wrubel-s-nursing-theory.html)
“Dr. Benner is the Chief Faculty Development Officer for EducatingNurses.com. She is a noted nursing educator and author of From Novice to Expert: Excellence and Power in Nursing Practice. Dr. Benner was the Director of this Carnegie Foundation for the Advancement of Teaching National Nursing Education Study, which is the first such study in 40 years. She additionally collaborated with the Carnegie Preparation for the Professions studies of Clergy, Engineering, Law and Medicine. Dr. Benner is a Fellow of the American Academy of Nursing. She was elected an honorary fellow of the Royal College of Nursing. Her work has influence beyond nursing in the areas of clinical practice and clinical ethics. She is the first author of Expertise in Nursing Practice: Caring, Ethics and Clinical Judgment with Christine Tanner and Catherine Chesla, and has co-authored 12 other notable books including a March, 2011 Second Edition of Clinical Wisdom and Interventions in Acute and Critical Care: A Thinking-in-Action Approach with Pat Hooper Kyriakidis and Daphne Stannard.” (from https://www.educatingnurses.com/biography-of-patricia-benner/)