Nursing leadership. With the publication, From Novice

Nursing is a unique profession in which the experience of the practitioner is themost significant attribute to professional growth and knowledge development. PatriciaBenner’s theory, novice to expert, and the concept of reflective practice both validate thisidea.

Benner utilized reflection within her study of the nursing profession in order todepict the unique characteristics and knowledge embedded in the experience of the nurse.Both the theory and the concept have been employed to enhance knowledgedevelopment, professional growth and innovative changes within the nursing profession.The purpose of this paper is to profoundly explore Benner’s theory: novice toexpert and the concept of reflective practice. The paper also depicts the unique andsimilar attributes within the theory and concept as well as there utilization within nursingpractice, education, and leadership.With the publication, From Novice to Expert: Promoting Excellence and Power inClinical Nursing Practice in 1984, Benner introduced her theory. The theory states thatovertime, nurses develop skills and knowledge through sound education and experience.

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It differentiates practical, “knowing how”, and theoretical knowledge, “knowing that” innursing practice (Brykczynski, 2010a). Her theory was one of the first to characterize thelearning process of nursing. In 1989, working with Judith Wrubel, Benner extended hertheory to include the identification and integration of caring into the process of skillacquisition (Sitzman & Eichelberger, 2011).Description of Theory: Novice to ExpertTheory ElementsPatricia Benner’s novice to expert theory is a theory of skill acquisition. In thistheory, Benner poses that developing nursing skills through situational experience is aprerequisite for expertise (Nursing Theories, 2011).Levels of skill acquisition. Benner adapted the Dreyfus Model of SkillAcquisition to nursing practice.

The Dreyfus Model hypothesizes that in the developmentof skill, an individual moves through five levels of proficiency: novice, advancedbeginner, competent, proficient, and expert (Dreyfus ; Dreyfus, 1980; as cited by NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 6Benner, 1984). The model also asserts that as an individual progress through these levels,changes are reflected in three aspects of skill performance. One, the individual movesfrom dependency on abstract principles to the use of concrete experience. Secondly, thereis a change in the individuals perception of the situation, the situation is seen less asseparate, equal pieces and more as a whole where only certain pieces are pertinent.Lastly, the individual changes from an observer of the situation to an involved performer.

Novice. Benner (1984) defines a novice as a beginner with no experience of thesituation in which they are expected to perform. In order for the novice nurse to developskills, the nurse must be put into new clinical situations. Benner also states that novicenurses must be taught about a patient’s condition in objective and measureableparameters. This is done so the novice can recognize features of the patient’s conditionwithout any situational experience.

Novice practice is very limited and inflexible; theyutilize strict rules to govern practice because they have limited to no clinical experience.Because of this inflexibility and rule based practice, the novice nurse cannot separate outthe relevant pieces of the situation; instead all pieces are seen as equal. They act in amanner of “tell me what I need to do and I will do it” (Nursing Theories, 2011).Advanced beginner. The next level of skill acquisition is the advanced beginner.

Benner describes the advance beginner as a nurse “who can demonstrate marginallyacceptable performance, one who have coped with enough real situations to note therecurring meaningful situational components that are termed aspects of the situation” inthe Dreyfus Model (1984, pg. 22). Aspects are global characteristics that require priorexperience in actual situations for recognition.

The advanced beginner develops NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 7principles based on experience and begins the use of these experiences to guide theiractions (Nursing Theories, 2011).Competent. A competent nurse is a nurse who has gained two to three years ofexperience in the same work area or in similar day-to-day situations (Benner, 1984).Benner states that competence develops when the nurse starts to see or plan his or heractions in terms of long-range goals. The competent nurse, unlike the novice andadvanced beginner nurse, plans actions based on the pertinent aspects of the situationinstead of including all aspects. For the competent nurse “a plan establishes perspective,and the plan is based on considerable conscious, abstract, analytic contemplation of theproblem” (Benner, 1984, pg. 26). It is the planning, that is characteristic of this skilllevel; it is what helps the competent nurse to be more efficient and organized.

Proficient. The proficient nurse perceives situations as a whole instead of interms of aspects. According to Benner (1984), “perspective is not thought out but”presents itself” based upon experience and recent events” (pg. 27). Perception isfundamental to the proficient nurse. In this level, the nurse understands more holistically,thus improving decision making (Nursing Theories, 2011). The proficient nurse haslearned from experience typical events to expect in a clinical situation and how plansneed to be modified to response to these events (Benner, 1984).Expert.

The next level in the skill acquisition model is the expert nurse.According to Benner (1984), the expert nurse has a deep connection and understanding ofthe situation. The expert no longer relies on analytic principle; instead the expert has anintuitive grasp of situations that is utilized to determine actions.

The performance of theexpert nurse is fluid, flexible, and highly proficient (Nursing Theories, 2011). Though the NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 8expert nurse can make assumptions based on “hunches”, Benner points out that the expertnurse still needs to be exceedingly skilled in the use of analytic tools, as these tools needto be used in new situations or if the nurse gets the wrong “hunch” (1984).Assumptions from TheoristBenner conducted a study of clinical nurse practice in an attempt to learn anddepict the knowledge that is embedded in nursing practice. Nurses who were new to theprofession as well as nurses known for their expertise were interviewed, in an attempt todetermine and understand characteristic differences in clinical situations. “Not knowingwho and what we are about now will seriously impede what we want to become”(Benner, 1984, pg xxi). In her work, Benner sought out to present new ways to viewnursing practice in order to provide understanding of the complexity and significance ofthe nursing profession.

Benner (1984) believed that the collection and record keeping ofexpert nurses’ perceptions, recognition abilities, meanings and characteristics, andoutcomes would enable nurses to refine skills and advance practice. However, nursestend to be delinquent in documenting clinical learning. The lack of charting of nursingpractice and clinical observations robs nursing theory of the uniqueness of knowledgethat is found in expert clinical practice (Benner, 1984).Also from her research, Benner made theoretical distinctions from theory itself;there are two different types of knowledge, “knowing that” and “knowing how”. Theextension of practical knowledge (know-how) through theory based scientificinvestigations (know-that) is necessary for knowledge development of the discipline(Benner, 1984). Kuhn (1970) and Polanyi (1958), point out that we have many skills thatcannot be theoretically accounted for (as cited in Benner, 1984).

This leads into the skill NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 9level of the expert, who through experience has learned to allow their perceptions to leadto confirming evidence.Relation of Major ComponentsBenner states “expertise develops when the clinician tests and refinespropositions, hypotheses, and principle-based expectations in actual practice situations.Experience is therefore a requisite for expertise” (1984, pg. 3). Expert and proficientnurses need to be mentors for less experienced nurses.

Utilizing descriptions of superiorclinical judgment from expert nurses offers new possibilities for less experienced nursesand may facilitate their movement into a higher level of skill performance (Benner,1984).It is important to make note that expertise is situational, that is not all nurses areexperts in every situation (Brykczynski, 2010a). Experience in the same or similarclinical situations is what separates the levels of skill acquisition. As a nurse moves intohigher levels of skill performance a more holistic approach is utilized in practice.

Theexpert nurse perceives the situation as a whole, uses past concrete situations, and movesto the exact location of the problem without wasteful consideration of irrelevant options;whereas less experienced nurses in a new situation must rely on conscious, deliberate,analytic problem solving of an elemental nature (Benner, 1984).Benner’s description of the levels of skill acquisition has been useful for ongoingarticulation of embedded knowledge in advanced nursing practice (Brykcznski, 2010a).NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 10Description of Concept: Reflective PracticeConcept DefinitionReflective practice can be defined as a method of self-examination that requireslooking back over what has happened in practice in an attempt to improve or encourageprofessional growth; it is an imaginative, creative, nonlinear, human act in whichpractitioners recall their experience, think about it, and evaluate it (Ruth-Sahd, 2003).Essential ComponentsDewey introduced the concept of reflective practice in 1933.

He believed that”reflection is not only a rational, intellectual act but also an act that involves the wholeperson, including his or her emotions” (Ruth-Sahd, 2003, pg 498). A critical-analysis ofdata-based studies, found that reflective practice increased learning, enhanced selfesteem,improved critical thinking and judgment, and promoted a greater self-awarenessthereby improving practice (Ruth-Sahd, 2003). Reflective thinking is an ongoing processthat encompasses a critical analysis of a practitioner’s actions, decision making andthought process during and after a clinical situation.Because reflection depends on experience, it can be restricted due to limitedclinical exposure of the practitioner (Heath, 1998). Past experiences advance thereflective process.Utilization of ConceptReflective thinking is an analysis of feelings and knowledge that can helpfacilitate learning from complex situations. Reflective practice helps nurses to createmeaning from their experience.

Throughout clinical practice, nurses implementinterventions and decisions that impact patient care outcomes. It is the reflection on these NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 11decisions that enables practitioner to develop professional growth. Many times it is thereflection on previous events that helps nurses to plan actions on subsequent clinicalsituations (Teekman, 2000).Nursing educators can help facilitate their students learning through guidedreflective practice. Educators who encouraged students to openly communicate andrecognize keys to reflective practice more successfully prepared nursing students for thecomplex world of nursing (Ruth-Sahd, 2003).Relationship of Novice to Expert Theory and Reflective PracticeCommon AttributesBenner’s novice to expert theory and the concept of reflective practice share manysimilar characteristics that contribute to the development of nursing knowledge and thegrowth of the nursing profession.

Acquisition of skills. Benner’s theory articulates skill acquisition that is useful indepicting the embedded knowledge in advanced nursing practice (Brykcznski, 2010b).The theory asserts the concept that nurses “develop skills and understanding of patientcare over time through a sound educational base as well as a multitude of experiences”(Nursing Theories, 2011, pg 1). Each level of skill acquisition builds on the previous one;abstract principles are refined and expanded as the nurse gains clinical experience. Byexploring the role and decision making process of a proficient or expert nurse, lessexperienced nurses can further develop their clinical reasoning and scope of practice(Benner, 1984). NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 12Reflective practice is also related to the acquisition of skill through clinicalexperience. Limited experience from the practitioner will restrict the reflection process(Heath, 1998). For a new nurse, guidance from an experienced practitioner is essential toreflective practice (Johns, 1995).

It is the experienced nurse who can facilitate learning ina less experienced nurse through guided reflection. The use of reflective practiceenhances nurse’s critical thinking and decision making skills, which contributes to theadvancement of the nurse’s scope of practice.Experience of practitioner. Situations that practitioners face in everyday practiceare unique to themselves and nursing (Johns, 1995).

Reflective practice, as well asBenner’s theory, novice to expert, highlights the importance of knowledge developmentthrough actual clinical situations.Nurses base actions on previous experiences rather than instrumental knowledge(Johns, 1995). In her work, Benner analyzed practitioners’ descriptions of situationalperformance and experiential learning in order to divulge the unique, richness that isembedded in the practice of expert nurses (Benner, 1984). Benner theorized thatinterpreting the descriptions of complex decision making in expert nurses’ clinicalexperience would accentuate the unique knowledge embedded in the nursing practice.The knowledge that is embedded in clinical expertise is central to the advancement ofnursing practice and the development of nursing science (Benner, 1984). Expertise innursing is developed through similar clinical situations; in the expert stage of skillacquisition the nurse is able to recognize the importance of clinical situations with a highdegree of accuracy (Benner, Tanner, ; Chesla, 1997). Nurses must deepen theirunderstanding of the important knowledge that develops during clinical work.

NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 13Reflection is a method to access, make sense of and learn through the experienceof a nurse (Johns, 1995). The use of reflective practice is also based on previoussituational experiences of the nurse. Through reflection, the practitioner learns to viewand act differently in clinical situations. Every situation is an opportunity for learning.Reflection ensures knowledge is more certain in future actions (John, 1995). Tanner(2006) states what a nurse gains from reflecting on experience contributes to the ongoingclinical knowledge development. Reflection requires a sense of responsibility, connectinga nurse’s actions with outcomes.Use of narratives.

Nurses often know more than they can communicate;attempting to express this knowledge through narratives helps the nurse to focus, shape,influence, and communicate what is experienced (Johns, 1995). Benner, Tanner, andChesla (1997), state clinical reasoning and knowledge is better understood throughnarratives. In her study of clinical nurse practice, Benner used narrative stories andinterviews from nurses to examine the thought process, decision making, and problemsolving skills related to the experience in clinical performance. Narrative thinking helpsturn experience into practical knowledge and understanding. Thinking through telling andinterpreting narrative stories, helps to make sense of experience through an interpretationof human concerns and motives (Tanner, 2006). Knowledge can be produced throughdialogue from more experienced nurses who may have a different vantage point; thislimits tunnel vision and improves clinical knowledge (Benner et al.

, 1997).The use of narratives is also an essential tool for reflective practice. Throughnarratives: an in-depth review of clinical situations, the nurse’s response to the situation,and intent to learn from decision making outcomes can be made (Tanner, 2006). NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 14Reflection can be used as a tool to breakdown clinical experiences. Narrative reflectionhelps to create a deep understanding of the nurse’s action. This fosters nurse’s decisionmaking abilities and problem solving techniques, helping to advance nursing practice.

Clinical judgment. Clinical judgment is an essential skill for nurses. Tanner(2006) asserts that clinical judgment is influenced more by what the nurse brings to thesituation than the objective data about the situation at hand. Benner’s theory emphasizesthat clinical judgment is developed through experience. An expert nurse, no longer relieson principles, rules or guidelines to connect to the situation and determine action(Benner, 1984).Clinical judgment is strengthened through the use of reflective practice. Nursesare able to develop knowledge through the use of reflection and use this reflexively toinform future actions (Johns, 1995). The concept can be used as a tool to focus oncontradictions between what was intended to be achieved in practice and the way thenurse actually practiced, thus developing clinical judgment.

Reflective practice offers anideal method to structure what takes place within a clinical situation. As Johns (1995)states, reflection enables the practitioner to “develop increasing therapeutic competence,sustaining effective work and ensuring the maintenance of high quality clinical practice”(pg. 23).Unique AttributesThe concept of reflective practice and the novice to expert theory share manycommon attributes, but there are also several distinctive characteristics that contribute totheir differences.NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 15Intuitive process.

Intuition cannot be easily observed or explained (Johns, 1995).In the theory novice to expert, Benner (1984) depicts the expert nurse as a practitionerwhose problem solving and decision making no longer relies on analytic rule-basedthinking but instead on intuitive, perceptual thinking. She highlights that an expert nurse,because of substantial clinical experience, has an instinctive grasp on a situation and canzero in on the problem. Intuition is characterized by immediate comprehension of theclinical situation and the ability of the expert nurse to recognize patterns (Tanner, 2006).Though intuitive skills can be developed through reflective practice by makingapparent the tactic knowledge within a specific clinical experience (Johns, 1995),reflection is not an intuitive process (Perry, as cited in Nielsen, Stragnell, & Jester, 2007).Reflection involves thoughtful consideration of an experience (Nielson et al., 2007).

Inorder for a novice to learn meaningful reflection, structure and guidance by anexperienced practitioner is needed.Holistic perspective. Viewing the clinical situation as a whole is another essentialcomponent to Benner’s theory.

One of the aspects of skill performance that reflectschanges in the level of skill is the movement of thought from a compilation of equallyrelevant bits, to an increased complex whole in which only certain parts are relevant(Benner, 1984). A holistic perspective provides details of situational context that helpguide interpretation (Brykcznski, 2010b). Benner (1984) asserts that holisticunderstanding of situational experience improves decision making.

On the other hand, reflective practice often breaks down clinical situations toreflect specifically on key issues. Johns (1995) states a reflection starts with the NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 16description of the experience from which key issues within the experience can be focusedon for reflection; there is always a movement from the whole to its parts.Analytic thinking. Analytic thinking is necessary in all levels of skill acquisition.Although Benner’s work emphasized the knowledge development obtained throughexperience, she also maintains the importance of analytic thinking in practice. Tanner(2006) points out that analytic process is used when one lacks the necessary essentialknowledge; when there is a mismatch between what is expected and what happens, aswell as when there are multiple options. At times, the only way to problem solve isthrough analytical thinking (Benner, 1984). Analytic tools are the back bone for clinicaldecision making.

These tools are embedded in expert nurses, enabling them to transitioninto the use of an intuitive process.Reflection on the other hand does not rely on analytic thinking. It is a process ofreflecting on action. Reflection is a tool to examine the choices that were made in aclinical situation and the outcomes of those choices. “Unlike universal, static, and contextfree nature of analytic knowledge, reflective knowledge is particular, dynamic, andcontext bound” (Johns, 1995, pg 24).

Self-awareness. Reflective practice builds self-awareness through the reflectionon one’s decision making in clinical practice. By promoting greater self-awareness, thenurse will improve their practice by enhancing self-esteem and critical thinking (RuthSahd,2003).

Therefore, one can assert through more experiences, the nurse will developa higher level of learning and become more aware of one self in practice.This differs in the development of experience in Benner’s theory. For the expertnurse, experience has developed a deep understanding of clinical situations (Nursing Theories, 2011); the nurse embodies an intuitive thinking process. As the nurse developsskill they become less aware of themselves, and instead perceive the situation as a whole.Application of Benner’s Novice to Expert Theory and Reflective PracticeBenner’s Novice to Expert TheoryThe novice to expert theory has provided a highly valued framework for advanceddevelopment of the nursing profession.

This philosophy has been a foundation inpractice, education, and leadership development in the nursing profession.Application to practice. Benner’s development of the novice to expert theory hasbeen used to guide nurse practice and create innovative changes to the profession(Alligood, 2010). Benner’s philosophical view of nursing has transformed the view of thenursing practice. The emphasis on the nature of nursing practice, specifically howknowledge of practice is acquired and developed overtime has been utilized indeveloping practice models, advances in nursing research, as well as orientation andpreceptor programs in acute care settings as well as non-acute settings world-wide(Alligood, 2010). Benner’s work has been used extensively as rationale for careerdevelopment and continuing education of nurses.

It “focuses on developing andunderstanding perceptual acuity, clinical judgment, skilled know-how, ethicalcomportment, and ongoing experiential learning” (Brykcznski, 2010b, pg 141). Thetheory has helped to create foundations for building and improving skills of the primarycare nurse through examining the acquisition of nurse’s experience (Fennig, Bender,Colby, &Werner, 2005,).An example of the use of Benner’s theory in practice is in the work of Meretoja,Isoaho, and Leino-Kilpi. Meretoja et al. used Benner’s theory to develop a nurse competency scale.

Meretoja et al. (2004) found that the development of a competencyscale based on Benner’s theory would help to identify areas for nurses to improveprofessional development and educational needs. The scale was also used to make surenurse competencies were put to the best possible use in patient care. Often Benner’stheory can be used to guide patient care to improve optimal outcomes throughdevelopment of nursing practice.Benner’s model of skill acquisition can be used to help define and measure expertpractice (Haag-Heitman, 2008).

Understanding nurse expert factors helps to fosterclinical staff development.Application to leadership. Benner’s novice to expert theory focuses on theembodied knowledge that is intuitively found and displayed in the work of the expertnurse. Expert nurse development must include risk taking, deliberate practice, socialmodels and mentors, and external rewards; these factors are influential in nursingleadership for skill development and expert performance and learning (Haag-Heitman,2008). The role of the expert nurse helps to stimulate less experienced nurses to interpretsituations differently and perform more effectively and efficiently. Expert nurses areleaders in the profession who are self directed involved performers who continually striveto improve and make breakthroughs in their performance and the nursing profession(Haag-Heitman, 2008).Application to education. Benner’s concepts regarding the performancecharacteristics and learning needs of nurses with varying levels of clinical competencycan be incorporated into nursing education.

Valid and reliable methods of identifying thedevelopmental stage of nurses are important when developing and implementing teaching and learning strategies (Haag-Heitman, 2008). Understanding the level of skill andcompetency of the learner can better prepare the educator to facilitate learning. Fennig etal. (2005) state the learner will respond to different cues based on levels of practice andyears of experience.Benner’s theory of novice to expert provides a framework for the development ofcompetencies in nursing education. However, she has “critiqued the concept ofcompetency-based testing by contrasting it with the complexity of proficiency and expertstages described in the Dreyfus Model of Skill Acquisition”; Benner believedcompetency based testing was limited to the less situational, less interactive areas ofpatient care (as cited in Brykczynski, 2010a, pg 150).

In addition, several nursing schools have used Benner’s philosophy of novice toexpert skill acquisition to develop a structure for nursing curricula (Brykcznski, 2010b).Reflective PracticeReflective practice is a tool that can be used to bridge the gap between theory andpractice (Sigma Theta Tau International STTI, 2005). Reflection can change conceptualperspectives. Enhancements in nursing practice, education, and leadership have beensuccessful through the application of reflective practice.Application to practice. “Reflection is an essential skill implicit in professionalnursing practice” (STTI, 2005, pg 6). In nursing, reflective practice can be used toreexamine an experience in an effort to understand and plan how to better act in a similarsituation in the future.

(Beam, O’Brien, & Neil, 2010). Tanner (2006) believed thatreflection is critical for improvement of clinical reasoning and development of clinicalknowledge. Reflective practice has the potential to improve implementation of advanced nursing skills. Beam et al (2010) found that debriefing through reflective practice helpsnurses to manage stressors and emotions that are triggered by demanding situations thusimproving nursing practice. Because reflection gives insight into practice, nurses canidentify areas of strength and areas that need further development. Self assessment andreflection allows a nurse to consider their practice within their own environment and canassist them to maintain and improve their practice (Meretoja et al.

, 2004). Reflectivepractice enhances a nurse’s critical thinking and judgment based on experience and priorknowledge and ultimately enhances patient care (Ruth-Sahd, 2003).Application to leadership. Benner (1984) provided the groundwork for reflectingon nursing practice in terms of developing expertise of nurses in action. Effective nursingpractice and leadership are “grounded in the complexity of human relationships andtherefore require systematic and careful thinking in order to achieve successfuloutcomes” (STTI, 2005, pg. 6). Reflective practice enhances the leadership capabilitiesof nurses through examination of their practice. Emden and Reid, found that reflectivepractice helps to advance nursing theories at a conceptual level which leads to changes ata professional, social and political level (as cited in STTI, 2005, pg.

8).Like Benner’s novice to expert theory, reflection is better developed throughexperience. It is the experienced practitioner that can facilitate reflection betweenprofessionals to enable development of nursing skills. Reflective practice throughguidance from an experienced nurse can enable the development of a practitioner’stherapeutic potential to make a qualitative difference to peoples’ lives, and in doing so,enhance the societal value of nursing (Johns, 1995).Application to education. Dewey states, “reflective thinking alone is educative”(as cited in Lasater & Nielsen, 2009, pg. 40). Reflective practice is an essential tool tonursing education that is extensively used in continuing education and nursing schools.

Reflection helps to identify learning needs and styles at different levels of skillacquisition (Benner, 2004), especially situations that are ill defined, multilayered andcomplex (Lasater & Nielsen, 2009).Reflective journaling and guided reflection is a strategy used in clinical educationto gain insight into students’ clinical thinking (Lasater ; Nielson, 2009). Reflection helpsnurses and student nurses to examine and explore clinical situations to assist in theirdevelopment and confidence in critical thinking and judgment (Nielsen, Stragnell, ;Jester, 2007). Reflection through clinical narratives is an approach to “promote bothindividual and collective experiential learning and synthesis of knowledge in real-worldsituations” (Haag-Heitman, 2008, pg. 210).

Future ResearchIn Benner’s novice to expert theory there is a strong emphasis on the expert nurse:the knowledge embedded into practice and the intuitive process that expert nurses utilizein practice. There is substantial research that supports the advantages of an expert nursein clinical practice, but little is known in regards to what conditions foster expertdevelopment (Haag-Heitman, 2008). How can expert nursing be measured? What aremethods to facilitate a nurse into the level of expertise? What are the connectionsbetween different levels of skill acquisition, nursing outcomes, and patient quality ofcare? In order to more effectively understand the knowledge embedded in expert nurses NOVICE TO EXPERT THEORY AND REFLECTIVE PRACTICE 22and to utilize this knowledge to advance the nursing profession, future research is neededto address some of these limitations.ConclusionPractical knowledge is essential to knowledge development and professionalgrowth of nursing.

Reflection in practice is a tool that can be used by nurses to finddeeper meaning within practical experience as a means to advance practice as well as toenhance one’s skill level. Every clinical situation is an opportunity for learning. Throughreflection and experience, a nurse can achieve a profound understanding of themselvesand the practice of nursing and ultimately improve patient care outcomes.From a nurse educator perspective, both the novice to expert theory and reflectivepractice can be substantially advantageous in teaching and learning strategies.

Guidedreflection can foster students knowledge development, confidence, and self-awarenesswhich in turn will help to advance there level of skill acquisition. Thus understanding theskill level of the student is essential to facilitate successful learning.


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