NUR 3320 Module 2 Novice to Expert Paper: Benner's Stages and Reflection in a Career-Change Nursing Student Example

Following the Rules, Watching the Expert: Where a Second-Degree Student Starts on Benner's Ladder

Student Name

B.S.N., Accelerated Second Degree, Thomas Edison State University

NUR-3320: Nursing Science Foundations: Theory, Ethics, and Practice

Mentor Name

Month Day, Year

Following the Rules, Watching the Expert: Where a Second-Degree Student Starts on Benner's Ladder

Introduction

In accounting I was considered an expert. I could look at a balance sheet and sense a problem before I could name it. On my first clinical days in nursing, that sense was gone. I followed checklists, asked permission for everything and felt slow. This paper uses Benner's model to understand where I am, why the gap feels so large and how I can move forward.

Benner's Five Stages

Benner (1982) brought a general model of skill acquisition, first proposed by the Dreyfus brothers, into nursing and later developed it in her book (Benner, 1984). She described five stages. Novices, lacking experience with the situations in front of them, lean on rules that ignore context, such as taking vital signs every four hours. Advanced beginners have enough experience to recognize recurring meaningful aspects of situations but still struggle to prioritize. Competent nurses, often two or three years into similar work, plan consciously and link actions to longer goals. Nurses at the fourth stage, which Benner called proficient, see situations whole and notice when the usual picture fails to appear. Experts no longer rely on rules or guidelines to connect their understanding to action; they have an intuitive grasp of situations and focus on the accurate region of the problem.

Benner argued that expertise develops through experience with actual patients, which refines theory and changes perception, and that much expert knowledge is embedded in practice rather than written down.

Where I Am

By Benner's description, I am a novice on most clinical tasks and perhaps an advanced beginner in a few, such as basic assessment of post-surgical patients. My checklists are the context-free rules novices need. My previous expertise does not transfer because in Benner's account expertise grows from repeated contact with particular kinds of clinical situations. My skill at noticing patterns in numbers may help with vital sign trends, but I have no experience yet of what a patient looks like before a crisis.

Watching an Expert

The nurse I shadowed on the surgical unit, invented for this paper and called Ms. Okoro here, had worked there for 22 years. Walking into a room, she glanced at a patient and said quietly that he did not look right. Within minutes she had checked his abdomen, raised his head and called the resident. When I asked how she knew, she said she was not sure, he just looked like patients who were about to have trouble. Benner (1982) described exactly this: experts perceive the whole situation and recognize subtle changes without breaking them down into steps.

Reflection-in-Action

Schön (1983) studied professionals including architects, therapists and managers and argued that much of their knowledge is tacit, revealed in action rather than stated. When a situation surprises them, skilled practitioners reflect in action, rethinking their approach while they act, and reflect on action afterward. Schön criticized the view that professionals simply apply scientific theory to problems, noting that real practice involves messy, unique situations that theory does not fully address.

Ms. Okoro reflected in action: when the patient's pain did not ease after repositioning, she changed her plan on the spot. I reflect mostly on action, in my journal after shifts.

Why Rules Still Matter

Benner's model can be misread as a reason to abandon rules. For novices, rules are protective. They prevent omissions and give structure until experience builds. The danger lies in staying with rules when the situation calls for judgment, or, for experts, in trusting intuition without checking it. Ms. Okoro still counted medications twice.

Turning Experience Into Knowledge

Schön's work suggests that experience alone is not enough; reflection turns it into knowledge. I will use three practices. First, after each clinical day I will write about one situation that surprised me and what I would do differently. Second, I will ask experienced nurses to explain their reasoning after a decision, as I did with Ms. Okoro, since tacit knowledge often becomes visible when an expert is asked. Third, in simulation, I will request debriefing that focuses on what I noticed and when.

What Prior Expertise Offers

My accounting career is not useless in nursing. I am comfortable with numbers, so medication calculations and intake and output totals come easily, and I am used to checking my own work. I know how to manage a heavy workload and ask for clarification when instructions are vague. What does not carry over is the perception Benner describes, the ability to see a patient and sense that something is wrong. That kind of knowing has to be built from clinical experience, one patient at a time.

Asking Experts Good Questions

Experts often cannot fully explain what they know, so the way I ask matters. Instead of asking Ms. Okoro why she did something in general terms, I learned to ask what she saw first, what she expected to see and what she would have done if the patient's pain had not improved. Specific questions like these made her reasoning visible in a way that general questions did not.

Limits

Benner's stages describe tendencies and may not apply evenly across all skills. My self-placement is subjective. Ms. Okoro and my clinical unit are invented.

Conclusion

Benner's model explains why my previous expertise does not carry into nursing and why my reliance on checklists is appropriate for now. Watching an expert showed me what perception shaped by years of experience looks like. Schön's reflective practice gives me a way to speed the journey: by reflecting on each situation, asking experts to make their reasoning visible and treating surprise as a chance to learn.

References

Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407. https://doi.org/10.2307/3462928

Benner, P. (1984). From novice to expert: Excellence and power in clinical nursing practice. Addison-Wesley.

Schön, D. A. (1983). The reflective practitioner: How professionals think in action. Basic Books.