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

22 Expertise in Nursing Practice
progressing fromthe novice stageoflearning in any field to becoming an
expert. Expertise is gainedbydeveloping interpretive abilitiesto identify
the natureofpractical situations and the development of skillful responses
to what must be done as well as when and how. Learning more and
more rules and routines to structure practice works only as a temporary
measure to shore up the safety and suspension of the novice in highly
complexunfamiliar situations. Initially, students profit frombreaking the
situationdown into simplersets of tasks, but this strategy will notwork for
long if the student is not also being coachedto developarecognition of the
natureofthe situationandasenseofsalience (Benner, Sutphen, Leonard-
Kahn, Day, 2008; InPress). Situatedlearning is holisticor integratedby
the understanding of the nature ofthe practical clinical situation.
Nurseeducators have beeninfluenced strongly to adapt to academic
preference for formal abstract theories that are able to be generalized
over a rangeofsituations rather than situated cognition and use in particular
situations. All professions have bent to this prevailing preference in
academic agendas (Sullivan & Rosin, 2008). What has been particularly
useful to nursing education has beenthe strong influence of Dewey and
the valueofexperiential learning. Dewey (1933) called for a “progressive
reform” toeducationto place moreemphasis on everyday learning and as
being lifelong.. He highlights the importance of learning from experience
in actual practical situations rather than through drills of isolated skills:
“I take it that the fundamental unity of the newer philosophy is found
in the idea that there is an intimate and necessary relation between the
processes of actual experience and education (Dewey, p. 100).
Furthermore, Dewey (1987) held that the learner must be prepared
to learn and that environments for experiential learning could be enriched:
Noone with an honest respect forscientificconclusions can deny that experience
as experience is something that occurs only under highly specialized
conditions, such asarefound in a highly organized creature which in turn
requires aspecialized environment. There is no evidence that experience
occurs everywhere and everywhen. (p. 3)
As Dewey (1987) suggests, experiential learning does not happen in
just any condition with just any person or on every occasion. Experiential
learning happens most in environments where feedback onperformance
is rich and the opportunities for articulating and reflecting on experiential
learning are deliberately planned. Nursing educators actively plan