Judith Drumm DNS, RN, CPNProfessor Nursing - South University

“From Clinical Expert to Novice Instructor”

At the end of this presentation, you will….

• Be able to identify the 5 stages of Benner’s skills acquisition

• Recognize 4 of Mayeroff’s 8 “Caring Ingredients”

• Identify 2 effective strategies to facilitate the clinical expert’s transition to novice instructor.

From Clinical Expert to Novice Educator

• Nurses making the transition to nurse educator can find the process stressful.

• The 5 stages of Benner’s skills acquisition have been used as a standard in nursing practice and incorporated into nursing curricula.

• Benner’s 5 stages of skills acquisition are: Novice, Advanced Beginner, Competent, Proficient, and Expert.

Definition of Benner’s 5 Stages

• Novice - beginners who have had no experience of the situation in which they are expected to perform

• Advanced Beginner – those who can demonstrate marginally acceptable performance, ones who have coped with enough real situations to note the recurring meaningful situational components that are termed “aspects of the situation” in the Dreyfus model.

Definition of Benner’s 5 Stages

• Competent - typified by the nurse who has been on the job in the same or similar situations for 2 to 3 years.

• Develops when the nurse begins to see his or her actions in terms of long-range goals or plans of which he or she is consciously aware.

Definition of Benner’s 5 Stages

• Proficient – perceives situations as wholes rather than in terms of aspects, and performance is guided by maxims.

• Proficient nurses understand a situation as a whole because they perceive its meaning in terms of long-term goals.

Definition of Benner’s 5 Stages

• Expert – the expert nurse, with an enormous background of experience, now has an intuitive grasp of each situation and zeroes in on the accurate region of the problem without wasteful consideration of a large range of unfruitful, alternative diagnoses and solutions.

Mayeroff’s 8 “Caring Ingredients”

• The American Association of Colleges of Nursing (AACN) has identified caring as essential in Baccalaureate education.

• Educators can foster the learning of caring by modeling caring in their teaching.

• Mayeroff described 8 Major Ingredients of Caring: Knowing, Alternating Rhythms, Patience, Honesty, Trust, Humility, Hope and Courage.

Definition of 4 of Mayeroff’s “Caring Ingredients”

• Alternating rhythms is the ability to maintain or modify a behavior to assist someone.

• Honesty is described as being genuine or open to the other, being fully present.

• Caring involves trusting individuals to grow in their own time and their own way. Trust appreciates the independent existence of the individual, that the individual is an individual (or unique).

Definition of 4 of Mayeroff’s “Caring Ingredients”

• Humility is being humble and includes learning from the one cared for as well: the teacher learns from the student; the parent learns from the child; and the artist learns from the work of art.

Transition From Clinical Expert

• The clinical expert transitioning to a “new role” as an instructor needs to make the leap from expert clinician to novice instructor.

• The expert clinician has an intuitive knowing of his or her role, and has confidence in his or her skills and what needs to done in a particular situation.

Transition From Clinical Expert

• In Expertise in Nursing Practice the authors state: "Normally, the instruction process begins with the instructor decomposing the task environment into context-free features that the beginner can recognize without benefit of experience.

• The beginner is then given rules for determining actions on the basis of these features, like a computer following a program."

Transition to Novice Instructor

• For the novice instructor the task is to teach theoretical information to the students, and the "rules" are the course objectives.

• For many the focus of the lecture is on what has to be taught, and the details of what needs to be covered.

• Because the focus is on what “needs to be taught” caring behaviors may not be evident to the student.

Transition to Novice Instructor

• As a novice instructor I was caught-up in the details of the lecture content and what needed to be covered, and wasn’t really hearing the student’s individual learning needs.

• Lectures were planned and thought-out in detail, and I was intimidated if students asked questions that I could not answer.

Transition to Advanced Beginner

• As I progressed to advanced beginner, lectures were still planned and thought-out in detail, and careful attention to content was still a priority.

• I began to draw on personal clinical experiences in the delivery of content.

Transition to Advanced Beginner

• According to Benner, advanced beginners move from "acting like a nurse" to the early stages of coming into their own as nurses and developing their sense of what it is to embody the nursing role.

• As I was "coming into my own" as a nurse educator, the atmosphere in the classroom was less strained and more conducive to discussion with questions and answers.

Transition to Competent Educator

• As I advanced to competent educator, I no longer solely focused on the content or depended on the lecture notes.

• I was able to draw on the students’ clinical and personal experiences to incorporate into the classroom content.

• I asked the students questions; if the students asked something I did not have the answer to they looked it up.

Transition to Competent Educator

• Intimidation rarely occurred; exploration and alternating rhythms set the mood in the classroom.

• Book knowledge combined with real patient situations enhanced the classroom lecture content.

• The students participated more in classroom discussions and were eager to share their experiences and ask questions.

Transition to Proficient Educator

• As I developed into a proficient educator, lecture and content remained important, but I incorporated innovative teaching strategies into the classroom.

• The students’ clinical and personal experiences were also incorporated into the classroom learning activities.

• Group activities were organized according to the learning needs expressed or demonstrated by the students.

Transition to Proficient Educator

• The crucial shift to proficient educator is the perceptual ability to read the situation and respond appropriately.

• The classroom climate was one of mutual respect and trust not adversarial or authoritarian.

• I used new teaching strategies and solicited student feedback.

Transition to Proficient Educator

• Students asked questions, contributed to the lecture, and processed information together.

• The students arrived at answers together; humility was the climate in the classroom.

• Group activities were lively and students demonstrated creativity in their presentations.

Transition to Expert Educator

• As an expert educator I have an intuitive knowing of my role as an educator and where the students are in their learning process.

• I am comfortable with who I am as an educator and have confidence in what plan to follow or when it’s appropriate to digress from the plan in my teaching.

Transition to Expert Educator

• Expert practice is characterized by increased intuitive links between seeing the salient issues in a situation and ways of responding to them.

• As an expert educator, I have the ability to evoke in students a desire to learn both inside and outside of the classroom.

• Learning is not a task for the student, but an adventure.

• The climate in the classroom is nurturing.

Transition to Expert Educator

• Meyeroff’s caring ingredients of alternating rhythms, honesty, trust, and humility are manifested in the classroom as I interact with students and engage them in their learning.

• I have created a fun, engaging learning atmosphere; when games are incorporated into the classroom, prizes are awarded to the students.

• Student teams have fun competing against each other and winning prizes.

Facilitating the Growth of Novice Educators

• As described in Expertise in Nursing Practice, expert practitioners in any field embody the practical knowledge, and the extant dialogical understandings, of how to integrate practical and theoretical knowledge.

• The task for the expert clinician is to articulate their expert practice into classroom content.

Growing the Next Generation of Educators

• The experienced educator impacts the professional development of the novice instructor by modeling teaching styles.

• The experienced educator is in a position to assist the expert clinician in expressing expert practice into classroom content.

Growing the Next Generation of Educators

• Providing a caring/nurturing teaching environment enhances the novice instructor’s ability to grow and learn as an educator.

• The ultimate goal is to facilitate growth in the novice instructor, as they become tomorrow’s expert educators.

References

• American Association of Colleges of Nursing (AACN). The Essentials of Baccalaureate Education for Professional Nursing Practice. Washington, DC: AACN; 2008.

• Benner P. From Novice to Expert. Menlo Park, Ca: Addison Wesley Publishing Company; 1984

• Benner P, Tanner C, Chesla C. Expertise in Nursing Practice. 2nd ed. New York, NY: Springer Publishing Company; 2009

• Mayeroff M. On Caring. New York, NY: HaperCollins; 1971.

Questions?

South University Campus

West Palm Beach, Florida

Thank You!