Nurses making the transition to nurse educator can find the process stressful. By sharing my experience, I hope to ease that transition. I relate my personal journey through each of Patricia Benner’s five stages of skills acquisition, and explain how I incorporate Milton Mayeroff’s ingredients of caring, in attaining teaching expertise as a nurse educator.
Nurse educators are familiar with Benner’s original work related to the Dreyfus model of skills acquisition. The five stages of skills acquisition as nurses progress from novice to expert have been incorporated into nursing curricula and used as a standard for nurses in various practice settings. Here is a brief overview of the 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.
- 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.
- 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.
- 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.
Ingredients of caring
The American Association of Colleges of Nursing identifies caring as essential in baccalaureate education. Educators have the ability to foster the learning of caring by their students by modeling caring in their teaching. Mayeroff described eight Major Ingredients of Caring and four of the caring ingredients are included in my story: alternating rhythms, honesty, trust, and humility:
- 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).
- 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.
As a novice “beginner” educator (brand new to teaching), lectures were planned and thought-out in detail, and I paid careful attention to content that had to be covered. I was intimidated if students asked questions that I could not answer.
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.”
My task was to teach the theoretical information to the students, and the “rules” were the course objectives. Because the focus of the lecture was on what had to be taught, I realize that not much, if any, caring behavior was demonstrated in the classroom. I was caught-up in the details and what needed to be covered, and wasn’t really hearing the student’s individual learning needs.
As I progressed to advanced beginner, lectures were still planned and thought-out in detail, and careful attention to content was still a priority; however, I began to draw on personal clinical experiences in the delivery of content.
Nursing practice as an advanced beginner is a time of extraordinary transition in terms of knowledge, feeling comfortable in the practice environment, and self-understanding as a nurse. Although more comfortable in the classroom setting, intimidation still occurred if students asked questions that I did not have the answer to; but I responded honestly and said,” I’ll look it up.”
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.
As I advanced to competent educator, I no longer solely focused on the content or depended on the lecture notes. Rather, 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.
The competent nurse experiences a critical juncture of increasing sense of agency and responsibility with the growing awareness of the limits of scientific knowledge for particular situations. 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.
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.
In Expertise in Nursing Practice, the authors described proficiency as a transition stage because once the nurse begins to see changing relevance, a current clinical situation can be seen in terms of a past clinical situation, complete with all its sense of salience, thus enabling a higher level skill of perception. The crucial shift 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. 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.
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. 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. The practice of the expert, like that of the proficient nurse, is characterized by engaged practical reasoning, which relies on mature and practiced understanding as well as a perceptual grasp of distinctions and commonalities in particular situations.
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. Prizes are candy bars or lollipops; occasionally the prizes are review books or memorabilia with the school logo imprinted on them, or a school tee shirt. Student teams have fun competing against each other and winning prizes.
Growing the next 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 challenge for expert nurse educators is to articulate expert practice to the novice or advanced beginner educator. The ultimate goal is to facilitate growth in the beginner educators as they become tomorrow’s expert educators.
Judith Drumm is an Associate Professor of Nursing at Palm Beach Atlantic University in West Palm Beach, Florida.
From our readers gives nurses the opportunity to share experiences that would be helpful to their nurse colleagues. Because of this format, the stories have been minimally edited. If you would like to submit an article for From our readers, click here.
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.