1. Patricia Benner Nurse Theorist A blog power point assignment in partial fulfillment of the requirements for NU 602 Advanced Role Theory in the College of Nursing University of North Alabama

4. The Dreyfus Model of Skill Acquisition is shown on the next slide: (Dreyfus, 2008).

6. “ Three studies using the Dreyfus model of skill acquisition were conducted over a period of 21 years. Nurses with a range of experience and reported skill fullness were interviewed. Each study used nurses' narrative accounts of actual clinical situations. A subsample of participants were observed and interviewed at work. These studies extend the understanding of the Dreyfus model to complex, underdetermined and fast paced practices. The skill of involvement and the development of moral agency are linked with the development of expertise, and change as the practitioner becomes more skillful. Nurses who had some difficulty with understanding the ends of practice and difficulty with their skills of interpersonal and problem engagement did not progress to the level of expert. Taken together, these studies demonstrate the usefulness of the Dreyfus model for understanding the learning needs and styles of learning at different levels of skill acquisition.” (Benner, 2004).

8. “ Introduced at the podium as ‘the person who taught the world how to listen to the voice of the nurse’, Benner discussed the importance of attending to the expertise embedded in clinical nursing practice. For nursing practice to flourish, she said, nurses must deepen their understanding of the important knowledge that develops during clinical work. Citing the often-discussed ‘theory to practice gap’ in which elements of science do not move into practice, she discussed the ‘practice to theory’ gap in which clinicians fail to recognize and develop the knowledge that can only be gained in the world of experience.” (Wandel, 2003).

11. Benner’s work in applying the Dreyfus Model of Skill Acquisition has produced the following five stages of nursing expertise:

13. These inexperienced nurses function at the level of instruction from nursing school. They are unable to make the leap from the classroom lecture to individual patients. Often, they apply rules learned in nursing school to all patients and are unable to discern individual patient needs. These nurses are usually new graduates, or those nurses who return to the workplace after a long absence and are re-educated in refresher programs.

15. Advanced beginners are able to translate some didactic and clinical learning principles to individual patients, but often lack the real life experiences that differentiate individual patients.

17. Competent nurses are able to plan and care for patients on an individual basis following a plan of care or the lead of a more experienced nurse. Competent nurses are able to provide safe care, but are not looked upon as formal or informal leaders. Their decision-making abilities usually consist of individual circumstances and rarely are they able to see how one situation affects the ‘big picture’.

19. The proficient nurse frequently is able to assume charge nurse duties and lead a group of nurses in clinical practice. They are frequently able to manage care of several patients without direct supervision. These nurses provide formal and informal leadership to the nursing unit, and are often the nurse that is called upon by the less experienced nurse to provide assistance.

21. The expert performs their duties without thinking; they react automatically to situations and are often ‘thinking ahead’ during a situation. They frequently are formal leaders and are called upon to provide clinical expertise to other staff members. Many times experts are able to function seemingly ‘without thinking’ as their abilities seen to others to come as second nature.