Benner Model of Skill Acquisition

Abstract 

This paper seeks to explore Benner skill acquisition model, Novice to Expert theory. In the introduction, the paper looks at the background of the particular theory and the philosophy and terms used by the author. The paper also defines this theory and identifies its goals. There is also the discussion of this theory’s significance and scope. The paper identifies the personal reasons for the selection of the particular theory. There is the analysis of this theory, which includes the discussion about the theory’s elements and the associated assumptions, their relationships and its application. The paper also identifies the role of this theory to a nurse, patient and families, and through a case study. Finally, there is the summary of the paper’s content in the summary and conclusion section. 

Introduction 

In the process of acquiring and developing skills, nurses need to learn in different stages to enhance their competence. When taking the studies, nurses begin as beginners or people with no confidence and as the learning process continues, one acquires the appropriate skills to be applied in the nursing practice. Nurses gain expertise after going through various situational experiences. Dreyfus model of skill acquisition looks at the process followed for the students to gain skills through the formal education and engaging in practices. On the other hand, Patricia Benner model of skill acquisition (Novice to Expert Theory) was established in 2011 and is an advancement of Dreyfus model (Dreyfus & Dreyfus, 1980) as cited in Grochow, (2008). The novice to expert model entails the development of nursing skills through the situational experience and identifies the process as being the requirement for expertise. Therefore, from the beginner who has no experience a nurse learns and develops skills while in the clinical situations. Although nursing skills are learned in class, one gains the expertise by being engaged in different clinical circumstances, thus the “Novice to Expert.” 

Definition and Basis of the Nursing Theory 

Patricia Benner’s novice to expert theory refers to an approach whereby Benner argues that the development of nursing skills is enhanced by being involved in situations for acquisition of experience which is essential for the nursing expertise. This theory is derived from “Dreyfus model of skill acquisition”. Dreyfus model of skill acquisition entails that for a student to acquire and develop a skill, one goes through like five stages of proficiency; that is, novice, advanced beginner, competent, proficient, and expert (McCutchen, 2011). The specific levels of proficiency demonstrate the transformations in three aspects of skilled conduct. This is where a nurse student stops relying on the intellectual principles and start applying the historical actual experience as examples. Secondly, one changed his or her perception regarding the demand situation where only little is identified to be relevant and later, the major parts become relevant. Lastly, the nurse student is separated from just observing to being a performer, whereby one becomes fully engaged in situations. 

Goals of the Theory 

The novice to expert theory focuses on enabling nurse students to acquire competence necessary in the nursing practices (Benner, 1984). The theory also hopes enable nurse trainers and tutors to emphasize on the provision of nursing education that would equip them with the skills necessary in their engagement in real health situation (Field, 2004). The application of this theory will enable the beginner to have the confidence that is appropriate in coping with real clinical situations. Indeed, the provision of nursing education will change to putting much emphasis on enabling the novice to get life experiences for their enhanced expertise. Through the application of this theory, it will be possible for a nurse to overcome stressors and effectively cope with the situation at hand (Mohedas, Daly, & Sienko, 2016). Therefore, this theory will lead to changes on how nursing education is offered to enhance the acquisition and development of skills. 

Importance and Scope of the Theory 

This theory is significant in the nursing process of acquisition of skills. Through this theory, one learns how to offer care to a patient through having the understanding of nursing process, person, health, situation, stress, and coping abilities. This theory is essential in enhancing educators and students to predict clinical practices (Thomas, & Kellgren, 2017). The theory is vital to nursing students since it focuses on enabling their expertise and competence in taking part in real clinical situations. After passing through the five developmental stages, the nurse student will have learned more concerning the means of providing quality care. Moreover, the theory is relevant to nursing-based employers as they will hire nurses who are already competent and skilled enough to engage in various situations as per their expertise. Indeed, this theory benefits the students in their learning and practice. 

Personal reason for choosing the theory 

The choice of this theory was based on the fact that it focuses on closing the gap that has been existing in the process of acquisition of basics in class and getting skills during the nursing practices. This theory is also demonstrating the concern that has been there for a long period about some nurses lacking confidence and competence to engage in real situation even after entering in the job market (Haag-Heitman, 1999). In addition, this theory looks at the real nature of how a nurse develops from being novice or beginner to being an expert. Indeed, through the application of this theory, it will be possible for a nurse to secure a job and offer satisfactory and quality services as well as being a performer in the clinical situations. 

As a nurse, this theory will be applied in learning to become competent in the real situations. It will also be used in the acquisition of the necessary nursing experience because of being involved in practices while in the process of gaining skills. I will manage to move through all the levels of proficiency novice, advanced beginner, competent, proficient, and the expert, through being involved in real situations, therefore having the required experience. By using this theory, I will enter in the job market after having coped with adequate real situations. 

This theory is helpful in acquiring concrete experience and in becoming a good performer. In addition, the theory is also useful when one is trying to gain situational experience. It is a simple theory to use in a setting such as caring for the victims of accidents or the emergency department (English, 1993). The student gets involved in such cases and by the time one gets in the expert level, he or she will have the appropriate courage and skills in offering maximum care. 

Analysis of the theory 

The novice to expert theory is adopted from Dreyfus model, which focuses on the development of skills through five levels of proficiency, which comprise of novice, advanced beginner, competent, proficient, and expert. In addition, this approach proclaims that a person progresses through the particular levels and the acquired changes in aspects of skill presentation (Thomas, & Kellgren, 2017). This is where a person moves from dependency on theoretical principle to the usage of real experience. Then a person changes personal perception in relation to a situation and sees it minimally as separate similar pieces and an advanced whole. The individual also views the particular changes not through personal observation of the situation, but through taking part in the performance. 

Novice, as defined by Benner (1984) refers to a beginner who has no experience concerning the situation where one is needed to perform. For a novice nurse to acquire skills, one needs to be in placed in new clinical settings. He also says that novice needs to be taught concerning the condition of a patient in measurable and objective parameters (Cockburn, Gutwin, Scarr, & Malacria, 2015). Such practices aim at enabling the novice to realize the features of patient’s condition with no situational experience. There is also the aim of the implementation of care concept in the nursing practices. 

Advanced beginner as described by Benner is the nurse who has the ability to show marginally adequate performance, and one who has handled efficient real situations to identify the repeated meaningful situational parts that are termed features of the condition. Such aspects are worldwide features in need of preceding experience in actual incidences for acknowledgement (Benner, 1984). The advanced beginner generates principles as per the experience and starts the usage of the particular experiences in directing the conducts. 

Competent nurse according to Benner is one who has acquired around three years of experience in a similar work area and in the same situations a nurse develops competence to identify and plan his or her movements as per the goals. This nurse plans activities as per the pertinent characteristics of the situation rather than adding aspects. The planning assists the competent nurse to be organized and efficient (Peterson, & Bredow 2009, 48). Proficient nurse identifies situations in general but not based on aspects. Benner (1984), says “perspective is not thought out but “presents itself” based upon experience and recent events” (pg. 27). The nurse realizes more on the improvement of decision making because of learning out of experience of events to presume in future clinical situations and plan on what is needed to handle them. 

Expert nurse as per Benner (1984) has maximum relationship and comprehension of the situation. The nurse does not rely on investigative principles but the expert has an instinctive understanding of events in the determination of actions. The performance of expert nurse is highly proficient. Expert needs to be skilled in using the appropriate tools for new situations. 

Assumptions from Theorist 

Benner studied the clinical nurse practice while trying to learn and illustrate the knowledge that is embedded in the nursing practice. The new nurses to the profession and those identified based on their expertise helps in determining the recognizing the features dissimilarities in clinical situations. Benner in the study focused on presenting new methods to look at nursing practice to offer comprehension of significance and complexity of nurse profession. Benner (1984) believes that acquisition and retention of expert nurse’s outcomes, features, meaning, capacities, and perceptions would help nurses to advance practice and refine their skills. Benner also makes approach differences from the theory, “knowing that” and “knowing how.” Apart from the provision of care, investigations are needed in the nursing discipline. 

Benner (1984) argues that expertise aids in the conduct of clinical tests and meeting principle expectations in the real practice situations. Experience is hence important for an expert proficient and expert nurses require be mentoring the less experienced nurses. Expertise is eventual given that every nurse is expected to be an expert in every situation. Usage of descriptions in superior clinical judgment provides new capacities for the nurses who are not experienced and might enhance their skill performance. Experience in a similar nursing situation marks the skill acquisition. As the nurse improves personal skills, the holistic approach is used in the practice. Expert nurse recognizes the wholeness of the situation and those experienced in new events engage in problem solving through their consciousness. Indeed, Benner (1984) explains skill acquisition stages to be applicable in the acquisition of knowledge in the developed nursing practice. Therefore, according to Peterson and Bredow, (2016, 48), this theory demonstrates thorough understanding about its context. 

The role of the practice 

The Novice to Expert theory is widely used in the nursing profession, especially in the learning process for the students to acquire nursing based skills for application in nursing situations. In the nursing practice, this theory is used to enable the beginner to learn practical and situational skills. In the nursing practice, the novice to expert theory is applied in offering guidance to nurse practice and generate groundbreaking changes to the occupation. The particular theory has aided in the transformation of the outlook of nursing practice. It emphasizes on the knowledge of nursing practice and used in the development of practice approaches, which enhance the nursing research ( Thomas, & Kellgren, 2017). The nurse is also oriented in the acute care setting. The application of this theory as per the argument of Benner assists in the career development and the ongoing nursing education. It focuses on getting skilled knowledge and experimental learning. It generates a basis for the construction and advancement of skills to a beginning care nurse through the examination of personal experiences. Besides, in nursing practice, the novice to expert theory is used in acquiring educational needs and improvement of the professional progress. Therefore, a nurse manages to acquire competence and experience in situational practice. 

To the patients and families, this novice to expert theory is used where nurses apply the appropriate skills in real situations of taking care of the patient and the families. Moreover, through this theory, the expert nurse applies all the aspects of clinical experience for the interaction with clinical teams, families, and patients. This theory is also used for the improvement of the surveillance standards, enabling the lives of patients, and elimination of healthcare based costs because of the provision of quality health care services (Boshuizen, Bromme, & Gruber, 2006). The nurse patient relationship is also improved. The reason is that as nurses continue learning they gain skills that enable them to understand the condition of the patient and make the appropriate decision regarding the provision of health care services. In addition, because of having acquired a long time experience in the same situations, this enables a nurse to make the necessary judgments concerning the situation at hand. 

A case study and a nursing care plan 

Mr. X was presented to the hospital with an open wound which had remained in that condition for three days. The patient had been experiencing pain and the leg with the wound was swollen. The patient’s wound needs to be taken care off to prevent spreading of infection and to relieve him from pain and at the same time enable fast and quick recovery of the wound. To offer quality care to the patient, expertise and competence was needed. 

In such a situation, there would be the need for a competent nurse and someone with knowledge and experience of taking care of open wounds. Therefore, the nurse responsible for the patient would reflect on the previously gained experience after being involved in treating another patient with an open wound. Therefore, the nurse would apply the judgment based on the previous real situation. Washing of the wound, applying the required antibiotics and the provision of medication to Mr. X would be based on the nurse’s skills acquired from the previous similar situations. The nurse will be able to offer quality care services to the patient due to his or her skills as gained through learning from novice to expert 

Conclusion 

Practical knowledge is important to skills development and professional growth of every health care provider. As nurses focus on gaining skills to apply in the provision of care to patients, they need to have acquired the necessary skills and expertise, as well as competence, which are enhanced through experience. Practical experience helps in the improvement of a person’s skill level. When nurses are involved in clinical situations, they learn new things every time. The stages of acquisition of nursing skills include, novice, advanced beginner, competence, and expertise. From novice to expert theory is helpful to nurses because it enables then to learn and gain practical skills. Therefore, the ability of a nurse to realize his or her skill level is useful in effective learning. 

References 

Benner, P. (1984). From novice to expert. Menlo Park . 

Boshuizen, H. P., Bromme, R., & Gruber, H. (Eds.). (2006). Professional learning: Gaps and transitions on the way from novice to expert (Vol. 2). Springer Science & Business Media. 

Cockburn, A., Gutwin, C., Scarr, J., & Malacria, S. (2015). Supporting novice to expert transitions in user interfaces. ACM Computing Surveys (CSUR) , 47 (2), 31. 

English, I. (1993). Intuition as a function of the expert nurse: a critique of Benner's novice to expert model. Journal of advanced nursing , 18 (3), 387-393. 

Field, D. E. (2004). Moving from novice to expert–the value of learning in clinical practice: a literature review. Nurse education today , 24 (7), 560-565. 

Grochow, D. (2008). From novice to expert: transitioning graduate nurses. Nursing Management , 39 (3), 10-12. 

Haag-Heitman, B. (1999). Clinical practice development using novice to expert theory . Jones & Bartlett Learning. 

McCutchen, D. (2011). From novice to expert: Implications of language skills and writing-relevant knowledge for memory during the development of writing skill. Journal of Writing Research , 3 (1). 

Mohedas, I., Daly, S. R., & Sienko, K. H. (2016). Use of skill acquisition theory to understand novice to expert development in design ethnography. International Journal of Engineering Education , 32 (3), 1364-1371. 

Peterson, S. J., & Bredow, T. S. (Eds.). (2009). Middle range theories: application to nursing research . Lippincott Williams & Wilkins. 

Thomas, C. M., & Kellgren, M. (2017). Benner’s Novice to Expert Model: An Application for Simulation Facilitators. Nursing science quarterly , 30 (3), 227-234.