Patricia Benner, a contemporary theorist, is renowned for her research in the field of nursing. Her research has garnered numerous accolades as it has significantly contributed to and transformed the nursing profession. Additionally, Benner is a prolific writer who has made valuable contributions to the field.
The central focus of her work revolves around the concept of knowledge. Benner aims to investigate and explain the role of knowledge in nursing practice. She refers to her research as “articulated research,” which highlights the distinction between practical and theoretical knowledge (Tomey and Alligood, 2006, p. 142). According to Benner:
Knowledge development in a ‘practical discipline’ involves the expansion of practical knowledge through scientific research based on theory as well as the documentation of existing practical knowledge gained from clinical experience in that discipline (Tomey and Alligood, p. 142). Although this concept may appear to be common sense, it forms the foundation for all of Benner’s work. She recognizes that having the ability to perform a task is distinct from understanding the theoretical aspects of a scientific event, and often practical knowledge holds greater significance than the theoretical framework imparted through education.
Practical knowledge can be developed prior to the emergence of scientific theories. Benner observed that various clinical settings can provide diverse clinical experiences. According to her, clinical experience is crucial for nurses to acquire new knowledge and ultimately become better professionals. The combination of practice and theory facilitates a harmonious experience and enables nurses to perceive greater potential in their work (Tomey and Alligood, p. 143). Subsequently, Benner encountered Hubert Dreyfus, a phenomenology scholar, and she integrated many of his ideas into the nursing field.
The model for Benner’s Novice to Expert Theory is based on the Dreyfus Model of Skill Acquisition. According to Benner, nurses go through various stages in their journey towards acquiring knowledge. The first stage is the Novice stage where individuals have no prior knowledge and learn as they work in a specific environment. This stage can be repeated if nurses transition into an unfamiliar setting. The second stage is the Advanced Beginner stage, where nurses with more clinical experience demonstrate improved performance, particularly with the guidance of a mentor.
During this stage, nurses become more skilled at following rules and completing tasks according to those rules. They still face challenges when it comes to working with clients on a larger scale. However, they begin to develop an intuition for how to handle different situations with clients as they change. According to Benner, advanced beginners in this stage feel a strong sense of responsibility for managing patient care but still rely on more experienced individuals for assistance. Once nurses have progressed through these initial stages, they become competent.
Currently, they are focused on achieving consistency and predictability while enhancing their competence in their profession. By now, they have acquired diverse approaches for interacting with clients. The nurse is likely to gain greater proficiency during this stage as it prioritizes effective time management and understanding the practical aspects of tasks, rather than solely focusing on scheduling and meeting the patient’s needs. According to Benner, nurses may experience a heightened sense of responsibility towards their patients and tend to be self-critical when errors occur.
This stage is crucial as it requires nurses to discern the significance of their actions. They gain insights into new protocols and learn to adapt their responses to meet patients’ specific care needs. Achieving proficiency in this model requires nurses to develop an acute perception of the situations they encounter and possess the necessary skills to appropriately respond. Furthermore, nurses rely on their past experience to navigate through challenges and make adjustments when required.
They no longer have to depend on others and are more self-assured in their own knowledge and capabilities. Now, the nurse is prepared to move to the next level of expertise. In the expert phase, the nurse no longer relies on analysis and instead makes decisions based solely on the present situation and its requirements. The nurse now possesses a deeper understanding of the patient. The key attributes of an expert nurse are: 1. The ability to demonstrate clinical expertise and rely on available resources. 2. They possess practical knowledge and skills. 3. They have a broader perspective. 4.
The statement “To see the unexpected” (Tomey and Alligood, p. 146) encompasses the five stages that Benner believes bring nurses into the nursing profession and enable them to become highly skilled and competent. Other researchers have tested these stages and have found that they are effective in any training setting (Chitty and Black, 2007, p. 149). Another aspect of this model addresses the socialization of nurses during their training. It is important for nurses to actively engage in their own learning and understand that although it may feel challenging, it will improve over time.
According to Chitty and Black (p. 150), it is crucial for individuals to maintain their perspective and cultivate creativity as they progress in their learning journey. Benner’s theory encompasses several assumptions that are key to comprehending it, including: 1. All data cannot be interpreted without bias. 2. Data cannot be reactive in nature. 3. The meaning of information is intertwined with skills, practices, intentions, expectations, and outcomes. 4. Individuals who share a common cultural and linguistic background possess a foundation of shared meanings that facilitates understanding and interpretation.
5. The meanings embedded in skills, practices, intentions, expectations, and outcomes cannot be fully expressed, but can be interpreted by someone with a similar language and cultural background and validated by the participants and relevant beings.
6. Humans are integrated and holistic beings (Tomey and Alligood, p. 150). I believe that Benner’s theory encompasses three nursing functions. Her theory is descriptive as it aims to illustrate the characteristics of knowledge and its application in nursing practice.
She has developed a body of work that provides insight into the acquisition of knowledge. It is informative, as it demonstrates the impact of knowledge on the field and helps nurses navigate through various stages. She also emphasizes the importance of integrating theory and practical knowledge, asserting that when they are in sync, they yield optimal results. The ongoing development of her work lends a predictive aspect to the theory, as she examines how knowledge is acquired and how it can propel the profession forward. Furthermore, her theory promotes continuous learning for nurses, as they should constantly strive to expand their knowledge.
References
References:
- Chitty, K. K. and Black, B. P. (2005). Professional nursing: concepts and challenges. Fifth Edition. Missouri: Saunders Elsevier.
- Courtney, K. L., Alexander, G. L., and Demeris, G. (2008). Information technology from novice to expert: Implementation implications. Journal of Nursing Management, 16, p. 692-699.
- Current Nursing (2009). Development of nursing theories. Retrieved September 25, 2009 from http://currentnursing.com/nursing_theory/development_of_nursing_theories.htm.
- Tomey, A. M., and Alligood, M. R. (2006). Nursing theorists and their work. Sixth Edition. Missouri: Saunders Elsevier.
