Domains of nursing practice: Application of Benner's Model

Abstract

<p>The purpose of this study was to use hermeneutical phenomenology to describe the clinical knowledge embedded within the everyday practice of senior nursing students and registered nurses. This study employs Benner's (1984) research on the nature of clinical expertise as a framework. An examination of the relationship of the research subject's practice to Benner's seven domains of nursing practice was undertaken. The subjects of the study consisted of two groups: one 5-member group of senior nursing students in their last semester before graduation from an NLN-accredited baccalaureate program, and one 6-member group of general duty registered nurses 22 to 24 months after graduation from the same NLN-accredited baccalaureate program. Subjects attended four nonmixed small group sessions and provided a paradigm case at each session. Paradigm cases are clinical experiences that stand out in one's mind, an episode that alters one's understanding of future similar clinical experiences. The unit of analysis was the 44 paradigm cases. The interviews were audiotaped and transcribed, and the cases were systematically analyzed using an interpretive approach. The interpretations were later validated with the participants. Based on the analysis of 20 student paradigm cases, the domain most often represented was the Helping Role with cases also representing four other domains. The analysis of the 24 RN paradigm cases indicated that the predominant domain was also the Helping Role. Cases representing five other domains were also found. This study contributes to knowledge development in nursing in the following ways: (a) the validity of the domains of nursing practice is supported for nurses in the advanced beginner and competent level of practice, (b) understanding of the aspects of practical knowledge is enhanced by description of examples and themes from the clinical practice of senior nursing students and registered nurses, and (c) support is provided for the use of an interpretative approach called hermeneutical analysis as a valid method for exploring the clinical practice of nurses.</p>