Patricia benner.apa format


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Patricia benner.apa format

  1. 1. Running Head: PATRICIA BENNER’S NOVICE TO EXPERT THEORY 1 Patricia Benner’s Novice to Expert Theory Jezrel C. Oberes Northern Negros State College of Science and Technology Author Note Jezrel C. Oberes, Graduate School, Northern Negros State College of Science and Technology This paper was prepared in partial fulfillment of the subject course MN 101 Advanced Philosophical Theoretical Foundations in Nursing Correspondence concerning this paper should be addressed to Jezrel C. Oberes, Graduate School, Northern Negros State College of Science and Technology, Cadiz City Campus, Hda. Hortencia, Brygy. Daga, Cadiz City.
  2. 2. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 2 Abstract The purpose of this paper is to present and explore Patricia Benner’s Novice to expert theory. It depicts the unique and similar attributes within the theory and concept as well as their utilization within nursing practice, education, and leadership. It contains information on the academic background of the theorist, the definition of the theory, and its significance to the different facets involving the field of nursing. The articles involved in this paper include writings from authorsAltmann, T. K. (2007), Dracup and Bryan-Brown (2004) and Wandel, J. C (2003). This paper presents Benner’s theory with an intention of interpreting the theory in relation to the progression of a nurse’s capacity or experience. Keywords: Patricia Benner, novice to expert, nursing experience
  3. 3. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 3 Background of the Theorist A noted nursing educator, Patricia Benner is a Professor Emerita in the Department of Social and Behavioral Sciences at the University of California, San Francisco. She is a former senior scholar at the Carnegie Foundation for the Advancement of Teaching, for which she authored a study titled Educating Nurses: A Call for Radical Transformation. Her book From Novice to Expert: Excellence and Power in Nursing Practice has been translated into ten languages. Benner is a fellow of the American Academy of Nursing and was elected an honorary fellow of the Royal College of Nursing. She is the recipient of the 2010 President's Award for Creativity and Innovation in Nursing Education. Benner received her Bachelor of Arts in Nursing in Pasadena College, also known as Point Loma College. She earned her Master’s Degree in Medical and Surgical Nursing at University of California San Francisco (UCSF), and was able to accomplish her Doctorate Degree in UCSF and UC Berkeley in 1970. Since 1979, she was able to conduct her researches at the UC Berkeley. In 1982, she published the “Novice to Expert Theory”, from which she was greatly recognized for. Through her books and publications, she introduced the concept that expert nurses develop skills and understanding of patient care over time through a sound educational base as well as a multitude of experience. She proposed that one could gain knowledge and skill, also known as “knowing how”, without ever learning the theory or the “knowing that”.
  4. 4. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 4 Concept and Definition of the Theory Levels of skill acquisition Patricia Benner conceptualizes in her writings that nursing skills as experience is a prerequisite for becoming an expert. She discussed the five specific levels of nursing experience: the Novice; the Advance Beginner; the Competent; the Proficient; and the Expert. Novice.A novice is a beginner with no experience and is being taught the general rule to help perform tasks. These rules are context-free, independent of specific cases and applied universally. Their behavior is rule-governed, and is limited and inflexible. Advance Beginner. An advance beginner demonstrates acceptable performance, gaining prior experience in actual situations to recognize recurring meaningful components, and follows principles that are based on experiences. Competent.With a competent nurse, typically, there is a 2-3 year experience on the job in the same area of in similar day-to-day situation. There is more awareness of long-term goals, and gaining perspective from planning own actions based on conscious, abstract and analytical thinking is being observed. Proficient.A proficient nurse perceives and understands the situation as whole parts. There is more holistic understanding which improves the decision-making process. There’s a 5year experience, and learning from experiences what to expect in certain situations and how to modify plans are being observed.
  5. 5. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 5 Expert.The fifth level, an expert nurse, no longer relies in principles, rules or guidelines to connect with situations and determine actions. More background experience is observed and there’s an intuitive grasp of clinical situations. The performance is fluid, flexible and highly proficient. Metaparadigm in Nursing Nursing Patricia Benner described nursing as an “enabling condition of connection and concern” (Marriner-Tomey, 1989, p192) which shows a high level of emotional involvement in the nurse-client relationship. She viewed nursing practice as the care and study of the lived experience of health, illness, and disease and the relationships among these three elements. Person Benner stated that a “self-interpreting being, that is, the person does not come into the world predefined but gets defined in the course of living a life. A person also has… an effortless and non-reflective understanding of the self in the world. The person is viewed as a participant in common meanings.” (Tomey, 2002 p173) Benner believed that there are significant aspects that make up a person. She had conceptualized the major aspects of understanding that the person must deal as: 1. The role of the situation 2. The role of the body. 3. The role of personal concerns. 4. The role of temporarility.
  6. 6. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 6 Health Patricia Benner focused “on the lived experience of being healthy and ill.” She defined health as what can be assessed, while well-being is the human experience of health or wholeness. Well-being and being ill are recognized as different ways of being in the world. Health is described as not just the absence of disease and illness. Also, a person may have a disease and not experience illness because illness is the human experience of loss or dysfunction, whereas disease is what can be assessed at the physical level. Environment Instead of using the term “environment”, Benner used the term “situation”, because it suggests a social environment with social definition and meaning. She used the phenomenological terms of “being situated’ and “situated meaning”, which are defined by the person’s engaged interaction, interpretation an understanding of the situation. Theoretical Assertion Benner stated that theory is crucial to form the right questions to ask in a clinical situation; theory directs the practitioner in looking for the problems and anticipating care needs. There is always more to any situation than theory predicts. The skilled practice of nursing exceeds the bounds of formal theory. Concrete experience provides learning about the exceptions and shade of meaning in a situation. The knowledge embedded in practice discovers and interprets theory, precede and extends theory, and synthesizes and adapts theory caring nursing practice.
  7. 7. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 7 Acceptance by the Nursing Community Practice The model has been used to aid in the development of clinical ladders of promotion, new graduate programs and clinical knowledge development seminars. Education Nursing educators have realized that learning needs at the early stages of clinical knowledge development are different from those required at later researches. Research Her researches have been used in studying the impact of nursing and its seven domains in every aspect of the profession. Nurses have a clear vision of the competencies requires in order for them to climb up into the leadership ladder. Administration Benner (1984) provided the groundwork for reflecting on nursing practice in terms of developing expertise of nurses in action. Effective nursing practice and leadership are “grounded in the complexity of human relationships and therefore require systematic and careful thinking in order to achieve successful outcomes” (STTI, 2005, pg. 6). Reflective practice enhances the leadership capabilities of nurses through examination of their practice. Emden and Reid, found that reflective practice helps to advance nursing theories at a conceptual level which leads to changes at a professional, social and political level (as cited in STTI, 2005, pg. 8).
  8. 8. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 8 Analysis Simplicity Benner’s model is comparatively simple about the five stages of skill acquisition. It gives a relative guide for classifying levels of nursing practice, from individual nurse descriptions and observations to actual nursing practice. The interpretations are validated by agreement or by general acceptance. Clinical knowledge is relational and deals with local, specific, historical issues. Benner uses narrative accounts of actual clinical situations and preserves that the model enablers the reader to recognize similar intents and meanings, although the objective circumstances may be quite different. Generality Benner’s model has universal characteristic for the reason that it is not restricted by age, illness, health, or location of nursing practice. However, the characteristic of theoretical universality involve properties of functionality for prediction that is not a part of this perspective. The descriptive model of nursing practice has the potential for universal application as a framework; however the descriptions are limited by dependence on the actual clinical nursing situations from which they must be used. It depends on the understanding of the five levels of competency and the ability to identify the characteristic intentions and meanings intrinsic at each level of practice.
  9. 9. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 9 Empirical Precision In terms of empirical precision, Benner’s model was tested using qualitative methodologies. Succeeding researches suggest that the framework is applicable and useful in providing knowledge of the description of nursing practice. The strength of Benner’s model is that data-based research contributes to the science of nursing. Derivable Consequences The usefulness of Benner’s model gives a general framework for identifying, defining and describing clinical nursing practice. She uses a phenomenological approach to express and obtain meaning and abilities from interactions in life situation. The implication of Benner’s research findings lies on her conclusion that “a nurse’s clinical knowledge is relevant to the extent to which its manifestation is nursing skill makes a difference in patient care and patient outcome.” Application of theory One example of a structured faculty development plan based on the novice-to-expert framework is the Bay Area Simulation Collaborative (BASC) faculty development plan. The BASC is a group of more than 100 member schools and hospitals, totaling more than 600 faculty andhospital educators from both service and academia in the 10 counties of the San Francisco Bay Area. The California Institute for Nursing and Health Care (CINHC), in Berkeley, leads the BASC, which was funded through a grant from the Gordon and Betty Moore Foundation. CINHC was developed to increase educational capacity in schools of nursing, increase diversity in the nursing workforce, and develop leadership. The 3-year BASC project is designed
  10. 10. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 10 to train and teach nursing faculty andhospital educators in the concepts of simulation. The BASCis also designed to develop clinical simulation scenarios for use among its members. Finally, the project implements a research and evaluation agenda to demonstrate that simulation makes a difference in the critical thinking skills of nursing students. The faculty development plan was designed by the BASC operating committee and program director. The goal is to train a large number of expert clinicians and nursing faculty in the Bay Area, and the plan is built on the novice-to-expertmodel. In this plan, the faculty member in Level 1 training (basic technical skills) is in the novice stage, Level 2 (simulation methodology) is the advanced beginner stage, Level 3 (apprenticeship) is the competence stage, and Level 4 (train the trainer) is the proficient and expert stage. Ultimately, a train-the-trainer model will allow the BASC to have its own qualified instructors to teach others. To date more than 400 clinical educators and nursing faculty have been trained in the San Francisco Bay Area. More than 200 have been trained at the basic level (Level 1), more than 100 at the intermediate level (Level 2), more than 100 in debriefing, and six have completed the apprentice program and have demonstrated competency in being a simulation instructor. As for Level 4, there are currently 10 instructors that are trainers. As a result of the success of the BASC, the work is being leveraged to create a Southern California Simulation Collaborative and will include replication of the faculty development plan.
  11. 11. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 11 Conclusion Practical knowledge is essential to knowledge development and professional growth of nursing. Reflection in practice is a tool that can be used by nurses to find deeper meaning within practical experience as a means to advance practice as well as to enhance one’s skill level. Every clinical situation is an opportunity for learning. Through reflection and experience, a nurse can achieve a profound understanding of themselves and the practice of nursing and ultimately improve patient care outcomes. From a nurse educator perspective, both the novice to expert theory and reflective practice can be substantially advantageous in teaching and learning strategies. Guided reflection can foster students’ knowledge development, confidence, and self-awareness which in turn will help to advance their level of skill acquisition. Thus understanding the skill level of the student is essential to facilitate successful learning
  12. 12. PATRICIA BENNER’S NOVICE TO EXPERT THEORY 12 References Altmann, T. K. (2007). An evaluation of the seminal work of Patricia Benner: Theory or philosophy? Contemporary Nurse. Volume 25, Issue 1-2, May – June, 122. Dracup and Bryan-Brown.(2004) From Novice to Expert to Mentor Shaping the Future American Journal of Critical Care. 13: 448-450. Sigma Theta Tau International. (2005). The scholarship of reflective practice. Retrieved from The Use of Benner’s Framework in High-fidelity Simulation Faculty Development The Bay Area Simulation Collaborative Model. (2009) Retrieved September 20, 2013, from Tomey, A.M. &Alligood, M.R (2002).Nursing Theorists and Their Work.Fifth Edition.From Novice to Expert: Excellence and Power in Clinical Nursing Practice. 165 – 179 Wandel, J. C..(2003)The Institute for Nursing Healthcare Leadership Conference: Reflections on the Impact of Patricia Benner's Work. Medscape Nurses. 5(2). Accessed on 5-04-2010