From Novice to Expert Theory
Introduction
Today, individualized nursing care is emphasized in the health care system. This means that nurses should incorporate individual preferences, feelings, and perceptions in delivering care. Also, individualized care means that nurses need both knowledge acquisition and clinical experience. The theory 'from novice to expert' states that in nursing practices, nurses gain new knowledge and skills by passing through different stages. For example, in the first stage, nurses use theoretical knowledge but lack experience. In the expert stage, nurses use critical thinking skills merely because they are well-educated and they have developed experience. Benner's framework helps understand individualized nursing care and how nurses develop knowledge through different stages.
Theory description
According to (Petiptin, 2016), from novice to expert theory states that as nurses enter into the nursing field, they gain experiences and with time, they develop skills and understanding. In other words, nurses gain new knowledge through skill acquisition. This means that nurses pass through different stages with the help of experience and science. Developing skills and knowledge is a progressive process or it can also be referred to as experiential learning since they engage in various situations where they learn different clinical practices (Petiptin, 2016). Another point that Patricia Benner states is that nurses can move from novice to expert or in other words they can move from a state where they have limited knowledge to a state where they have deeper knowledge and experience through a combination of theoretical foundation and work experiences (Petiptin, 2016). From Novice to expert also indicates that nurses can gain knowledge and skills through research and understanding. This indicates that it is not a must a nurse learn about the theory. What happens is that nurses will move in a progressive process where they will learn abstract principles to intuitive intelligence.
Origin of the theory and the scope/level of the theory.
The theory was founded between the 1970s and 1980s by Stuart and Dreyfus who researched to understand how students in the American Air Force develop knowledge and skills of becoming an 'expert' pilot (Reed Debbie, 2011). The researchers found that there are five stages of development and students pass through all these stages. Later, in 1984, Benner used this model in the healthcare context. She researched the theory of novice to expert and found that nurses pass through five states in their professional lifetime. From novice to expert theory originates from the notion that as nurses enter into the clinical setting, they develop new skills and knowledge (Reed Debbie, 2011). Note that nurses come across the diversity of tasks or they work in a complex environment. As they strive to provide patient care in a complex nature, they develop new skills and knowledge. Another important point to note according to Courtney et al (2008) is that due to technological advancement, nurses have been using the technology to provide care (Reed Debbie, 2011). For example, nurses use computer-based programs such as clinical decision support systems to improve the quality of the care. However, these technologies are not so much helpful as not all nurses find the nursing data relevant to the clinical practice (Reed Debbie, 2011). Therefore, Benner came up with a new support system known as Novice to expert. Rather than using the information technology which is associated with problems such as system failure, ineffective ongoing communication, computer anxiety, usability, and other issues, Benner proposed novice-to-expert theory. Note that the role of the decision support system is to enable nurses to make clinical decisions, and apply evidence-based knowledge. Benner frameworks are connected to the notion that in making clinical decisions, nurses should apply knowledge and experience (Reed Debbie, 2011). However, the clinical decision support system do not put the experience into concern while making decisions. Thus, Benner proposed five concepts that nurses should utilize.
According to Davis & Maisano, (2016), from Novice to expert theory is in practice or other words, it has been applied in the nursing world and it is being used in the nursing practices. For example, in 2011, the Pittsburgh hospital used the novice to expert model to educate nurse managers and administrators (Davis & Maisano, 2016). In the healthcare, the novice to the expert framework has allowed individual nurses to develop knowledge and skills through the five stages. However, it is recommended that nurses in the first stage need mentor support to help them move to the next stage.
Major concepts
The major concepts of from novice to the expert theory are five concepts namely;
Novice
In this concept, nurses have entered into the nursing setting but they do not have experience. They still need professional growth for them to use discretionary judgment (Courtney et al. 2008). Since nurses do not understand the nature of the work, they need clear rules and supervision to direct them. In the first stage, the nurse has gained little knowledge and so they move to the next stage.
Advanced beginners
In this stage, nurses have been introduced to the real world and they have developed clinical knowledge in other words they understand the environment they are working in (Courtney et al. 2008). However, nurses still need support to set goals and achieve their goals.
Competent
At this stage, nurses have become adapted to the working environment and they can work without supervision (Courtney et al. 2008). They are capable of applying knowledge and skills and more importantly, they can use deliberate planning as well as abstract and analytical thinking.
Proficient
In this stage, nurses have gained a holistic understanding and can use evidence-based practices. Nurses can focus on situation-specific priorities to meet the requirements (Courtney et al. 2008). However, nurses lack extensive knowledge and in other words, they are unable to solve complex problems.
Expert
In this level, nurses have not only gained clinical knowledge but they also use evidence-based knowledge. They no longer rely on rules but they use practical and theoretical knowledge in the practices.
Pick two of the concepts, including your concept of interest, and state theoretical definitions of these concepts.
Two concepts; novice and expert. From a theoretical definition, the novice theory states that nurses who enter into the nursing field do not have experience and therefore follow instructions to complete tasks (Courtney et al. 2008). On the other, the theory of expert states that nurses have gained experience and have developed new knowledge and skills and therefore they are responsible and intuitive in nursing practices.
Conclusion
Without question, there is a theory-practice gap in the nursing field. This means that nurses are unable to interpret the general principles in the real-world. They rely on the abstract nursing theory and face challenges in practical application. However, there is a new decision-support tool known as the novice-expert model that allows nurses to make decisions and also gain professional development. Nurses should receive training and recognize these stages. They should learn that at a given time, they should move from one step to the other or within a given time, they should be able to solve problems in different situations using evidence-based knowledge and experience.
References
Petiptin, Alice (2016). FROM NOVICE TO EXPERT. ELITE CAFEMEDIA PUBLISHER. https://nursing-theory.org/theories-and-models/from-novice-to-expert.php
Davis, A., & Maisano, P. (2016). Patricia Benner: Novice to expert-A concept whose time has
come (again). Oklahoma Nurse, 61(3), 13-15.
Reed Debbie. (2011). Novice to expert. Springer Nature Limited. https://www.nature.com/articles/vital1334
Courtney, K. L., Alexander, G. L., & Demiris, G. (2008). Information technology from novice to
expert: implementation implications. Journal of Nursing Management, 16(6), 692-699.
