Expertise in Nursing Practice: Caring, Clinical Judgment and Ethics
01 Jul 1996-Journal of Continuing Education in Nursing (SLACK Incorporated)-Vol. 27, Iss: 4, pp 196-196
About: This article is published in Journal of Continuing Education in Nursing.The article was published on 1996-07-01. It has received 448 citations till now. The article focuses on the topics: Nursing ethics.
Citations
More filters
TL;DR: An exploratory study is described that originated and pilot tested a rubric in the simulation laboratory to describe the development of clinical judgment, based on Tanner's Clinical Judgment Model.
Abstract: Clinical judgment is a skill every nurse needs, but nurse educators sometimes struggle with how to present it to students and assess it. This article describes an exploratory study that originated and pilot tested a rubric in the simulation laboratory to describe the development of clinical judgment, based on Tanner's Clinical Judgment Model.
557 citations
Cites methods from "Expertise in Nursing Practice: Cari..."
...Clinical Judgment This study used a definition of clinical judgment described by Benner et al. (1996): “Clinical judgment refers to the ways in which nurses come to understand the problems, issues, or concerns of clients/patients, to attend to salient information and to respond in concerned and involved ways” (p....
[...]
...This study used a definition of clinical judgment described by Benner et al. (1996): “Clinical judgment refers to the ways in which nurses come to understand the problems, issues, or concerns of clients/patients, to attend to salient information and to respond in concerned and involved ways” (p. 2)....
[...]
TL;DR: In this article, the authors propose an alternative model that builds on the strengths of previous models while seeking to overcome their main limitations, and outline the implications of their alternative model for professional education, workplace practices, and research on professional development.
Abstract: In research across professions, the development of professional skill traditionally was seen as a process of accumulation of knowledge and skills, promoted by practical experience More recently, this view has been modified to incorporate skillful know-how that is progressively acquired by passing through developmental stages, such as novice, competent, and expert The authors of this article critically review contemporary stage models that are typically applied across professions Their principal critique is that a focus on stages veils or conceals more fundamental aspects of professional skill development On the basis of their critique, the authors propose an alternative model that builds on the strengths of previous models while seeking to overcome their main limitations Finally, the authors outline the implications of their alternative model for professional education, workplace practices, and research on professional development
540 citations
TL;DR: In this paper, three studies using the Dreyfus model of skill acquisition were conducted over a period of 21 years, where nurses with a range of experience and reported skillfulness were interviewed.
Abstract: 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-fulness 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 expertise. 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.
530 citations
Cites background from "Expertise in Nursing Practice: Cari..."
...(Benner et al., 1996, p. 52) The advanced beginner has a heightened awareness of any feedback on performance and pays close attention to the practice of colleagues....
[...]
...A second study of skill acquisition and clinical knowledge of critical-care nurses was conducted between 1988 and 1994 (Benner et al., 1992; Benner et al., 1996)....
[...]
...(Benner et al., 1996, pp. 116-117) The nurse gains a much more differentiated world of practice at the proficient level....
[...]
...(Benner et al., 1996, p. 95) Anxiety is now more tailored to the situation than it was at the novice or advanced beginner stage when a general anxiety exists over learning and performing well without making mistakes....
[...]
...They describe the frustrating situation of “chasing a problem” and never being quite “in synch” with the situation when they do not have a good perceptual grasp of the situation at hand (Benner et al., 1999, pp. 23-87; Benner et al., 1996, pp. 146-147)....
[...]
TL;DR: The interpretive process is explained, illustrated by examples from a recent research study, and approaches as systematically as possible within a nonlinear methodology streamlines and clarifies interpretations of the interview data.
Abstract: Background Although hermeneutical interpretive phenomenological methodology has been used in many nursing research studies, reports of findings are generally not specific regarding the analysis, or "interpretive process," of this methodology. Approach The purpose of this article is to assist researchers in analyzing interviews and observations, as part of hermeneutical interpretive phenomenology. In this article the interpretive process is explained, illustrated by examples from a recent research study. Results Other facets of the methodology including research question development, sampling issues, and interview and observation methods are briefly reviewed. Discussion Approaching the interpretive process as systematically as possible within a nonlinear methodology streamlines and clarifies interpretations of the interview data.
514 citations
Cites background from "Expertise in Nursing Practice: Cari..."
...“Naming,” which is the conceptualization and coding of central concerns and exemplars (Benner et al., 1996) may naturally shift....
[...]
...Interpretive procedures guide the inquiry while remaining open to new research questions (Benner et al., 1996)....
[...]
...Paradigm cases are vibrant stories that are particularly compelling and to which the team tends to return, to examine from new perspectives (Benner et al., 1996)....
[...]
References
More filters
TL;DR: In this article, an alternative conceptualization of professional development is proposed, based on philosophical assumptions congruent with evidence about professional learning from seminal educational research of the past two decades, and an argument is presented for a shift in discourse and focus from delivering and evaluating professional development programs to understanding and supporting authentic professional learning.
Abstract: Continuing to learn is universally accepted and expected by professionals and other stakeholders across all professions. However, despite changes in response to research findings about how professionals learn, many professional development practices still focus on delivering content rather than enhancing learning. In exploring reasons for the continuation of didactic practices in professional development, this article critiques the usual conceptualization of professional development through a review of recent literature across professions. An alternative conceptualization is proposed, based on philosophical assumptions congruent with evidence about professional learning from seminal educational research of the past two decades. An argument is presented for a shift in discourse and focus from delivering and evaluating professional development programs to understanding and supporting authentic professional learning.
1,057 citations
TL;DR: In this article, the authors propose an alternative model that builds on the strengths of previous models while seeking to overcome their main limitations, and outline the implications of their alternative model for professional education, workplace practices, and research on professional development.
Abstract: In research across professions, the development of professional skill traditionally was seen as a process of accumulation of knowledge and skills, promoted by practical experience More recently, this view has been modified to incorporate skillful know-how that is progressively acquired by passing through developmental stages, such as novice, competent, and expert The authors of this article critically review contemporary stage models that are typically applied across professions Their principal critique is that a focus on stages veils or conceals more fundamental aspects of professional skill development On the basis of their critique, the authors propose an alternative model that builds on the strengths of previous models while seeking to overcome their main limitations Finally, the authors outline the implications of their alternative model for professional education, workplace practices, and research on professional development
540 citations
TL;DR: In this paper, three studies using the Dreyfus model of skill acquisition were conducted over a period of 21 years, where nurses with a range of experience and reported skillfulness were interviewed.
Abstract: 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-fulness 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 expertise. 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.
530 citations
TL;DR: The interpretive process is explained, illustrated by examples from a recent research study, and approaches as systematically as possible within a nonlinear methodology streamlines and clarifies interpretations of the interview data.
Abstract: Background Although hermeneutical interpretive phenomenological methodology has been used in many nursing research studies, reports of findings are generally not specific regarding the analysis, or "interpretive process," of this methodology. Approach The purpose of this article is to assist researchers in analyzing interviews and observations, as part of hermeneutical interpretive phenomenology. In this article the interpretive process is explained, illustrated by examples from a recent research study. Results Other facets of the methodology including research question development, sampling issues, and interview and observation methods are briefly reviewed. Discussion Approaching the interpretive process as systematically as possible within a nonlinear methodology streamlines and clarifies interpretations of the interview data.
514 citations
TL;DR: The theory of transition presented in this article incorporates a journey of becoming where new nursing graduates progressed through the stages of doing, being, and knowing, which was evolutionary and ultimately transformative for all participants.
Abstract: Newly graduated nurses are entering the work force and finding that they have neither the practice expertise nor the confidence to navigate what has become a high ly dynamic and intense clinical environment burdened by escalating levels of patient acuity and nursing workload. This research used qualitative methods to build on and mature aspects of the new nurse’s transition experience into acute care. The theory of transition presented in this article incorporates a journey of becoming where new nursing graduates progressed through the stages of doing, being, and knowing. The whole of this journey encompassed ordered processes that included anticipat ing, learning, performing, concealing, adjusting, question ing, revealing, separating, rediscovering, exploring, and engaging. although this journey was by no means linear or prescriptive nor always strictly progressive, it was evo lutionary and ultimately transformative for all participants. The intense and dynamic transition experience for these newly graduated nurses should inspire educational and ser vice institutions to provide preparatory education on transition as well as extended, sequential, and structured orientation and mentoring programs that bridge senior students’ expectations of professional work life with the reality of employment. J Contin Educ Nurs 2008;39(10):441-450.
505 citations