Critical Elements
Patricia Benner's Skill Acquisition in Nursing Theory
Patricia Benner’s Theory is based on the Dreyfus Model of Skill Acquisition and explains the five stages of: novice, advanced beginner, competent, proficient, and expert, to acquire expertise in nursing. It highlights the differences between practice and theoretical knowledge and is considered a model and philosophy rather than a theory.
The following is a description of Patricia Benner’s Theory of Nursing Expertise Model by Nursing Theories, A companion to nursing theories and models:
Novice
v Beginner with no experience
v Taught general rules to help perform tasks
v Rules are: context-free, independent of specific cases, and applied universally
v Rule-governed behavior is limited and inflexible
v Ex. “Tell me what I need to do and I’ll do it.”
Advanced Beginner
v Demonstrates acceptable performance
v Has gained prior experience in actual situations to recognize recurring meaningful components
v Principles, based on experiences, begin to be formulated to guide actions
Competent
v Typically a nurse with 2-3 year’s experience on the job in the same area or in similar day-to-day situations
v More aware of long-term goals
v Gains perspective from planning own actions based on conscious, abstract, and analytical thinking and helps to achieve greater efficiency and organization
Proficient
v Perceives and understands situations as whole parts
v More holistic understanding improves decision-making
v Learns from experiences what to expect in certain situations and how to modify plans
Expert
v No longer relies on principles, rules, or guidelines to connect situations and determine actions
v Much more background of experience
v Has intuitive grasp of clinical situations
v Performance is now fluid, flexible, and highly-proficient
The different levels of skills reflect changes in 3 aspects of skilled performance:
v Movement from relying on abstract principles to using past concrete experiences to guide actions
v Change in learner’s perception of situations as whole parts rather than in separate pieces
v Passage from a detached observer to an involved performer, no longer outside the situation but now actively engaged in participation (Nursing Theories: A companion to nursing theories and models, 2011)
Dreyfus Model of Skills Acquisition