2. Patricia Benner, R.N, Ph.D, F.A.A.N,
F.R.C.N
is a Professor Emerita at the University
of California, San Francisco
BA in Nursing - Pasadena College/Point
Loma College
MS in Med/Surg nursing from UCSF
PhD -1982 from UC Berkeley
1970s - Research at UCSF and UC
Berkeley
3. Has taught and done research at UCSF since
1979
Published 9 books and numerous articles
Published ‘Novice to Expert Theory’ in 1982
Received Book of the Year from AJN in
1984,1990,1996, 2000
4. expert nurses develop skills and understanding of patient care
over time through a sound educational base as well as a
multitude of experiences
one could gain knowledge and skills ("knowing how") without
ever learning the theory ("knowing that")
conceptualizes in her writing about nursing skills as
experience is a prerequisite for becoming an
expert
5. • From Novice to Expert
• The Primacy of Caring
• Interpretive Phenomenology
• Expertise in Nursing Practice
• Clinical Wisdom and Interventions in Critical Care
6.
7. Benner’s Theory
categorized nursing into 5 LEVELS OF EXPERTISE : ( NACPE )
Novice
Advanced beginner
Competent
Proficient
Expert
believed experience in the clinical setting is key to nursing
8. NOVICE
beginner with no experience
governed by rules to help perform tasks
Rule-governed behavior is limited and
inflexible
Ex. “Tell me what I need to do and I’ll do it.”
10. ADVANCED BEGINNER
Demonstrates acceptable performance
Has gained prior experience in actual
situations to recognize recurring meaningful
components
Principles, based on experiences, begin to be
formulated to guide actions
12. COMPETENT
Nurse with 2-3 years experience on the job in the
same area or in similar day-to-day situations
More aware of long-term goals
Consciously plans nursing
14. PROFICIENT
Perceives and understands situations as
whole parts
More holistic understanding improves
decision-making
Learns from experiences what to expect in
certain situations and how to modify plans
16. EXPERT
No longer relies on principles, rules, or guidelines
to connect situations and determine actions
Much more background of experience
Has intuitive grasp of clinical situations
Performance is now fluid, flexible, and highly-
proficient
18. Different levels of skills reflect changes in 3 aspects of
skilled performance:
1. Movement from relying on abstract principles to using past
concrete experiences to guide actions
2. Change in learner’s perception of situations as whole parts
rather than in separate pieces
3. Passage from a detached observer to an involved performer,
no longer outside the situation but now actively engaged in
participation
19. SIGNIFICANCE OF THE THEORY
• These levels reflect movement from reliance on
past abstract principles to the use of past
concrete experience as paradigms and change in
perception of situation as a complete whole in
which certain parts are relevant
• Each step builds on the previous one as abstract
principles are refined and expanded by
experience and the learner gains clinical
expertise.
20. • This theory changed the profession's
understanding of what it means to be an
expert, placing this designation not on the
nurse with the most highly paid or most
prestigious position, but on the nurse who
provided "THE MOST EXQUISITE NURSING
CARE”.