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Expertise in nursing practice : caring, clinical judgment - Springer ...

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Chapter 1 The Relationship of Theory and Practice <strong>in</strong> the Acquisition of Skill 13<br />

performer,ontheother hand, afterwrestl<strong>in</strong>g with the question of a choice<br />

of perspectiveorgoal, feels responsiblefor, and thus emotionally <strong>in</strong>volved<br />

<strong>in</strong>, the result of his choice.Anoutcome that is clearly successful is deeply<br />

satisfy<strong>in</strong>g and leaves a vivid memory of the situation encounteredasseen<br />

from the goal or perspective f<strong>in</strong>ally chosen. Disasters, likewise, are not<br />

easily forgotten.<br />

As the competent performer becomes more and more emotionally<br />

<strong>in</strong>volved <strong>in</strong> his orher tasks, it becomes<strong>in</strong>creas<strong>in</strong>gly difficult to draw back<br />

and adopt the detached rule-follow<strong>in</strong>g stance of the beg<strong>in</strong>ner. While it<br />

might seem that this <strong>in</strong>volvement-caused <strong>in</strong>terference with detached rule<br />

test<strong>in</strong>g and improv<strong>in</strong>g would <strong>in</strong>hibit further skill development, <strong>in</strong> factthe<br />

opposite seems to be thecase.Aswe shall soonsee, the replacement of the<br />

detached rule-follow<strong>in</strong>g stance of the novice and advanced beg<strong>in</strong>ner by<br />

<strong>in</strong>volvement, should it occur, sets the stagefor further advancement while<br />

resistance to thefrighten<strong>in</strong>g acceptance of risk and responsibility can lead<br />

to stagnation and ultimately to boredom and regression or withdrawal.<br />

For example, a competent driverisno longermerely follow<strong>in</strong>g rules<br />

designed toenable him or her to drive avehicle safely and courteously.<br />

Instead, the driver beg<strong>in</strong>s a trip by select<strong>in</strong>g a goal. If, for example, a<br />

driver wishes to get somewhere very quickly, comfort and courtesy play<br />

a dim<strong>in</strong>ished role <strong>in</strong> the selection of maneuvers, and slightly greater<br />

risks might be accepted. Driv<strong>in</strong>g <strong>in</strong> this manner, pride might be felt<br />

if the trip is completed quickly and uneventfully, and remorse generally<br />

follows an arrest ornear collision. Should the trip <strong>in</strong>volve, say, an <strong>in</strong>cident<br />

<strong>in</strong> which the driver passes another car dangerously so that only quick<br />

action bytheother driver prevents an accident, the competent driver<br />

can respond to this experience <strong>in</strong> oneoftwo qualitatively different ways.<br />

One response would be forthe driver toconsciously decide that one<br />

should hardly ever rush and modifythe rule usedto decide to hurry. Or,<br />

perhaps, the rule for conditions for safe pass<strong>in</strong>g might be modified so<br />

that the driver only passes under exceed<strong>in</strong>gly safe circumstances. These<br />

would be the approaches of the driver doomed to timidity and fear and,<br />

by our def<strong>in</strong>ition, to competence. Or, respond<strong>in</strong>g quite differently, one<br />

could accept the deeply felt consequences of the act without detachedly<br />

ask<strong>in</strong>g oneself what went wrong and, especially, why. If the driver does<br />

this, he orshe will not be quite so likely to hurry <strong>in</strong> the future orto<br />

pass <strong>in</strong> similar situations, and there will be amuch better chance of<br />

ultimately becom<strong>in</strong>g, with enough frighten<strong>in</strong>g or, preferably, reward<strong>in</strong>g<br />

experiences, arelaxed and expert driver. As <strong>in</strong>dicatedwhenwe discussed<br />

the advanced beg<strong>in</strong>ner’s recognition abilities, it is <strong>in</strong>nate and natural for

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