Benner’s Findings Regarding Nurses’ Skill Acquisition
In 1984, Patricia E. Benner published the finding from a study aimed at identifying what nurses do and how they develop. She went to the clinical setting and asked practicing nurses to describe specific cases or situations they had encountered which stood out in their memories. These experiences were called exemplars or paradigm cases because they changed the perceptions of the nurse. In comparing the reported exemplar’s, Benner identified seven domains of nursing practice. She also drew from a model (the Dreyfus model of skill acquisition) that proposed that nurses pass through five levels of proficiency as they develop. The five levels of proficiency are novice, advanced beginner, competent, proficient, and expert. The following is a summary of her descriptions of these levels.
NoviceThe novice has no practical experience and must base what they do on principles and rules. Benner states that “nursing students enter a new clinical area as novices; they have little understanding of the contextual meaning of the recently learned textbook terms” (p.21). She goes on to say that any nurse entering a setting with a new patient population will be dealing with the same issues.
AdvancedThe advanced beginner has dealt with enough real patient care experiences to Beginnerrecognize recurring components of the situation. They are also learning to discriminate between normal and abnormal situations and establish priorities as to what’s important.
CompetentBenner describes the competent nurse as one who has been in the same setting or working with the same population for 2 to 3 years. The competent nurse is better at projecting into the future and developing plans based on “conscious, abstract, analytic contemplation of the problem” (p. 26). This promotes efficiency and organization. Although the competent nurse has a sense of mastery and is able to cope with...