STAGES OF

CLINICAL
COMPETENCE
By: Dr. Patricia Benner
What is your Idea about
Stages of Clinical
Competence?
-a nursing theorist who first developed a model for
stages of clinical competence in her classic book
“From Novice to Expert: Excellence and Power in
Clinical Nursing Patience”
-Chief Faculty Development Officer for Educating
Nurses

-- born in Hampton , Virginia (August 1942

-- international lecturer and researcher on health

and her work influenced areas of clinical practice
as well as clinical ethics
-This nursing theory proposes that expert nurses develop skills and understanding of patient care
over time through a proper educational background as well as a multitude of experiences . Her
theory does not focused on how to be a nurse rather on how Nurses Acquire Nursing Knowledge.

-She used Dreyfus Model And Skill Acquisition as a foundation of her work.

-Found similar parallel in nursing, where improved practice depended on experience and science
(skills involvement).

-This model has been applied to several disciplines beyond clinical nursing, and understanding the 5
Stages of clinical competence helps nurses support one another and appreciate that expertise in any
field is a process earned over time.
 Benner’s Novice to Expert Theory presents a systematic way of understanding how a learner whether a
student, new or seasoned nurse develops skills and understanding of a practice situation/event over time.
The theory has been applicable to a broad variety of situations, including nursing education, retention of
graduate nurses, and nursing management and administration.

 Benner (1982, 1984) proposed that as learners attempt to develop competency, they move
through five stages–Novice, Advanced beginner, Competent, Proficient and Expert. Proceeding
from novice to expert is a circular, rather than linear process, not linear. Accordingly, learners do
not necessarily move systematically from one stage to the other and ultimately develop
competency in certain skills. Instead, learners may move from one stage to another repeatedly as
they learn new knowledge and skills.
DR. BENNER’S STAGES OF CLINICAL COMPETENCE

 Stage 1 Novice

The learner has had no previous experience making them struggle to decide which tasks
are most relevant to accomplish

EXAMPLE: signs and symptoms can only be recognized after a novice nurse has had
experience with patients w/ similar symptoms.
 STAGE 2 Advance beginner
The learner has enough real-world situations that the recurrent component is easily identified
when it is related to rules and guidelines.

 STAGE 3 Competent
The learner has been on the job two or three years and is able to see actions in terms of goals or
plans and works in an efficient and organized manner.
 STAGE 4 PROFICIENT
The learner performs by using pieces of evidence (i.E. Maxims) that provide directions to
see a situation as a whole.

 Stage 5 Expert
The learner grasps the situation and understand what needs to be accomplished
beyond rules, guidelines, and maxims.
-Beginner nurses focus on task and follow a “to do” list. Expert nurse focus on the
whole picture even when performing task. They are able to notice subtle signs of a
situation such as a patient that is a little harder to arouse than in previous
encounters.

-Significance of this theory is that levels reflect a movement from past, abstract,
concepts to past, concrete experiences.

-This theory has changed the perception of what it means to be an expert nurse.

The expert is no longer the nurse with the highest paying job, but the nurse who
provides the most exquisite nursing care.
Primary Sources:
-Benner, P. (1982). From novice to expert, American Journal of
Nursing, 82(3), 402-407.
-Benner, P. (1984). From novice to expert: Excellence and power
in clinical nursing practice. Addison ‐Wesley Publishing
Company
-https://careertrend.com/about-6315001-benner-wrubel-s-
nursing-theory.html