The Benner Scale, named after the internationally renowned Dr. Patricia Benner, is widely accepted and arguably the most useful framework for assessing clinical competency at different stages of professional growth on a scale from novice to expert.
Dr. Benner proposes that expert nurses develop skills and understanding of patient care on a scale from novice to expert over time, not just through a proper educational background, but also through a multitude of experiences.
Rather than “how to be a nurse”, Dr. Benner focused on how nurses acquire nursing knowledge. This theorizes that one could gain knowledge and skills and “know how to do something”, without ever learning the other particular knowledge and insight that comes from the experience of actually doing or performing it. Beyond that, she values the experience gained in comparison of doing something once, to having done or performed such tasks a couple or several times.
Dr. Benner’s work was founded on the “Dreyfus Model of Skill Acquisition”. The Dreyfus brothers believed learning was experiential or “learned through experience” and also situation-based, and that a student had to pass through five very distinct stages in learning, from novice to expert scale.
Dr. Benner found that improved practice depended on experience and science, and developing those skills was a long and progressive process. She found when nurses engaged in various situation, and learned from them they developed “skills of involvement” with patients and families.
The Benner Model has also been relevant for the ethical development of nurses since the perception of ethical issues is also dependent on the nurses’ level of expertise. This model has been applied to several disciplines beyond clinical nursing, and understanding the five stages of clinical competence on a scale from novice to expert helps nurses support one another and appreciate that expertise in any field is a process learned over time.
Novices have a very limited ability to predict what might happen in particular patient situations. Signs and symptoms, such as a change in mental status, can only be recognized after a novice clinician has had experience with patients with similar symptoms.
Advanced beginner clinicians have had more experiences which enable them to recognize recurrent, meaningful components of a situation. They have the knowledge and the know-how but not enough in-depth experience.
Competent clinicians have mastered practice and can rely on their advance planning and organizational skills. They recognize patterns and nature of clinical quickly and accurately.
Proficient clinicians can see situations as a whole, rather than just parts of it. They have learned from experience which events typically occur and are able to modify plans in response to different events.
Expert clinicians can recognize demands and resources in situations and attain their goals. longer rely solely on rules to guide their actions under certain situations. They have an intuitive grasp of the situation based on their deep knowledge and experience.
Beginner nurse focus on tasks and follow a “to do” list. Expert nurses focus on the whole picture, even when completing singular tasks. They have a distinctive ability to notice subtle signs of a situation, such as a patient that is more difficult to stimulate than they been in prior visits.
The significance of this theory is that these levels reflect a movement of increased knowledge in a series of steps. Each step builds from the previous one, the nurse gains clinical experience, and knowledge is compounded. The result of this model is that the perception of what it means to be an “Expert Nurse” has changed.
CITATION:
Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education. Bulletin of Science, Technology & SocietyJune 2004 24: 188-199. Benner, P., & Wrubel, J. (1982a). Skilled clinical knowledge: The value of perceptual awareness. Part 1. Journal of Nursing Administration, 12(5), 11-14. Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407. Benner’s From Novice to Expert – Nursing Theory (nursing-theory.org) |
Call today at (888)-953-9816
© 2022 Competency Exchange. All rights reserved.
