BENNER'S STAGES

OF CLINICAL
COMPETENCE
Reported by: Sushmita Ann Japzon
Jacutin

5 levels of nursing experience

as;

Novice
Advanced beginner
Competent
Proficient
Expert

Novice

Beginner with no experience

Acquires rules for determining clinical
actions
Relies on rules, guidelines, standards,
rather than experienced-based knowledge
Ex. Tell me what I need to do and Ill do
it.

Novice

Excited about learning the new role

Possibly overwhelmed by most clinical
situations, while adjusting to a new
patient care provider role
Concerned about missing something

Novice

Basic advanced practice guidelines of

health care
One-on-one expert support (e.g., a mentor
to validate understanding of care
parameters and patient outcomes)

Advanced Beginner

Begins to increase skill performance but still

relies in external standards, guidelines and
input
Focuses on the moment, rather than the
broader pictures
Begins to organize and prioritize to accomplish
all tasks
Begins to recognize situational elements that
differ from skill elements
Has gained prior experience in actual situations
to recognize recurring meaningful components

Advanced Beginner

Overwhelmed by the required knowledge

and complexity of skills
May become frustrated and have concerns
about competence
Feels like a marginal team member and
becomes reliant on others judgment

Advanced Beginner

A mentor who can provide a safe

environment to ask questions and
increase confidence, enhance
communication, validate clinical
judgment, and provide coaching about
appropriate interventions
Help to see a broader picture

Competent

Typically a nurse with 2-3 years experience on the

job in the same area or in similar day-to-day
situations
More aware of long-term goals
Gains perspective from planning own actions based
on conscious, abstract, and analytical thinking and
helps to achieve greater efficiency and organization
Begins to increase clinical judgment/management,
organizational ability, skills, and ability to
anticipate patient trajectories
Relies less on others opinions for direction
Becomes more active team member with increased
comfort level with communicating with physicians

Competent

May describe this time as a roller coaster

with both nerve-wrecking times and good
experiences
Engages in increased risk taking,
responsibility, and accountability assists
movement in next stage; if not, stagnation
and role questioning with regression may
develop
Experiences increased stress
accompanying ethical questioning

Competent

Experiential learning opportunities for

further development
To learn that there a limits to scientific
knowledge, and begin to question the
system
Opportunities for involvement in problem
solving and change are important
Ongoing education is important to foster
continued growth and understanding of
changes in the field and to ensure
clinical currency

Proficient
Perceives and understands situations as whole parts
More holistic understanding improves decisionmaking
Learns from experiences what to expect in certain
situations and how to modify plans
Demonstrates practical grasp of clinical situations
with use of intuition
Finds that actions become easier and less stressful
Becomes more flexible, responsible, and
appropriately involved with all team members
Becomes excellent patient educator

Proficient

Emotional attunement to various

situations
Decreased stress as the necessary
actions to achieve outcomes are more
apparent
Increased satisfaction as a result of
improved competence and comfort level
with role

Proficient

Small group educational opportunities to

broaden perspectives and care
expectations for clinical situations
Problem-based learning with multiple
perspectives in addressing patient care

Expert
No longer relies on principles, rules, or guidelines
to connect situations and determine actions
Much more background of experience
Has intuitive grasp of clinical situations
Is remarkably skilled, fluid, flexible, and highlyproficient clinician/performer who can sees the big
picture
Reads and recognizes a situation and its changing
relevance, and can shift perspective accordingly
Uses the team and technology, and integrates
theoretical and practical knowledge

Expert

Possibly frustrated due to lack of

acknowledgement and accommodation
If part of an organization geared toward
minimum expectations, may experience
additional frustrations

Expert

Integration of theoretical and practical

knowledge
Positive mentoring relationships with
others
A voice in change to improve patient
care and the broader health care
system

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