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These levels of learning, from novice to expert , reflect a movement from past abstract
to past concrete experience. It has a big impact on our current nursing practice, nursing
administration, education and research.
PRACTICE
"Nursing skills through experience are a prerequisite for becoming an expert nurse",
explained by Benner's writings. This theory helps to develop skilled nursing practice
through experience and encountering variety of situations. Exposure and experience in
the clinical setting helps the nurses develop and gain more knowledge as well as the
skills in providing efficient, competent and excellent care to the patient. For acquiring
competence and expertise, one must gain knowledge through formal education
combined with the experience we get from our everyday practice. It is the basis in
constructing clinical competency, a tool used to assess competence of the staff nurse in
providing quality patient care. In any healthcare organization, a newly hired nurse will
start as a novice and undergoes a series of process, training, orientation and clinical
exposure in the specific unit to acquire competence with the guidance of the mentor or
preceptor. The staff is being evaluated by using clinical competency tool. The standard
of practice, and the policies and procedures in the specific unit will be acquainted and
integrated to the staff through repetition of procedures as time passes by, thus make the
staff more skillful, proficient and then later on become expert in delivering nursing
practice. An example of that is the development of Initial Skills Assessment and
Competency Evaluation. A specific example of it is the introduction of computer-
generated nursing documentation, wherein nurses being novice at first in charting in
computer, after series of training and day-to-day practice of charting in computer, the
nurse integrated how to document properly and became used to it. Thus competence
acquired over time through education and experiential learning.
ADMINISTRATION
This theory became the framework in synthesizing mentorship or preceptorship
program in the healthcare organization. It is utilized to develop career ladder, a guide
and a basis for the promotion and moving up in an organization. It is used as a method
for recognition and rewards, to determine expert practitioners and recompense their
work. It serves as a guide for staff development, to acquire expertise in practitioner, to
have more knowledgable practitioner providing quality care. It is one of the useful
frameworks in initiating clinical knowledge development seminar. It is the background
which brought reflective practice into existence for enhancing leadership capabilities of
nurses through examination of their practice. Examples cited are the creation of policy
by the healthcare organization for Training and Development, Performance
Management, Appraisal and Evaluation, Promotion of Employees and Preceptorship
program. One specific example of this is the Magnet Hospital Framework. The Magnet
Recognition Program recognizes healthcare organizations for quality patient care,
nursing excellence and innovations in professional nursing practice.
EDUCATION
Benners stages of clinical competence describe nursing as a continuous learning experience until final level of competency
Nurses, before becoming full-fledged nurses, have to go to nursing school and study the concepts for 3 to 4 years to gain
the knowledge. In the Philippines, students start with a general course in their first year taking mathematics, science and English
subjects. They progress in their second year to their final year with nursing subjects such as fundamentals in nursing, maternal and
child nursing, adult health nursing, community health nursing and nursing research. On their 2 ndor 3rd year, they start their clinical
duties on affiliated hospitals to correlate the nursing concepts learned in school and apply them in a real life, hospital setting. This is
where they learn the reality of the actual hospital based versus the theory based scenario while being observed and taught by a
After nurses graduate and successfully pass the licensure exam, they go into hospital duty to take on a concrete level of
practicing the knowledge they learned in school. During this time, they are answerable to their own actions without the help of their
clinical instructors. As they acquire a higher level of learning through experience, they are also required to increase their learning
As mandated by law (RA 9173), staffs need to undergo further studies in order to apply for a vacant position in the higher
organizational level. The trend of enrolment to graduate school is more driven by professional growth through job promotion rather
than professional growth through theoretical learning. In universities and colleges, they also require proof of continued studies and
This shows that Benners theory on the stages of clinical competence corroborates the idea that as a nurse continuous to
acquire knowledge through education and experience, the higher the level of experience and learning, the higher the demands for
responsibility and accountability in the work place. Also, educators become more confident in dealing with students learning
capabilities. They are able to create a modifiable teaching strategy to enable to adapt to the individual learning needs of the students.
RESEARCH
Nursing, as an evolving science needs constant research development to re-evaluate certain clinical practices and theories
that are currently in place if they could still be applied to the changing needs in healthcare delivery.
Part of the difficulty is that although nurses perceive research positively, they either cannot access the information, or cannot
People who have developed expertise in particular areas are, by definition, able to think effectively about problems in those
areas. understanding expertise is important because it provides insights into the nature of thinking and problem solving. Research
shows that it is not simply general abilities, such as memory or intelligence, nor the use of general strategies that differentiate
experts from novices. Instead, experts have acquired extensive knowledge that affects what they notice and how they organize,
represent, and interpret information in their environment. This, in turn, affects their abilities to remember, reason, and solve
problems.
In relation to Benners theory, expert researchers (Masters or Doctorate degree) could construct a more relatable topic to the
chosen field of study. Most of the topics they consider for research are those that they have encountered during their clinical or
theoretical experiences. This eventually leads to nursing research conducted to address certain demands in the changing and