A Qualitative Multi-method study to explore the relevance of Benner's 'novice to expert' nursing theory in contemporary post-registration wound care higher education.

Research output: ThesisDoctoral Thesis


AIM: The aim of this thesis is to explore the relevance of Benner’s 1984 five-stage ‘novice to expert’ nursing theory of skills acquisition and development in post-registration wound care nursing higher education in one institute in south west Scotland.

BACKGROUND: Since 1984, the fundamental assertions and learning and teaching strategies associated with each stage of Benner’s theory have continued to inform pre- and post-registration wound care nursing education. However, in the last four decades, numerous influential governmental, political, economic, regulatory and practice policy developments have taken place and indications suggest that Benner’s theory may now no longer best serve the unique needs of wound care education and that use of this approach to curriculum development would benefit from review.

METHOD: Through the prism of advocacy-participatory research, a qualitative sequential multi-method research design was used to review Benner’s theory in three distinct phases. First, a critical analysis of the effects of policy discourse on education and practice was undertaken, followed by a directed investigation to identify particular characteristics of regular everyday wound care practices able to enlighten curriculum design. Finally, the thesis moves to understand how incorporating the informed and deliberated views of students themselves in theory development itself might benefit future provision.

FINDINGS: The findings challenge many of Benner’s original assertions and uncover deficiencies in contemporary approaches to curriculum design thought to contribute to the extensive unacceptable levels of variation and inequitable standards in patient wound care. Ambiguity is inherent in wound care and, although undesirable and thought to compromise professional accountability, it is an intrinsic and essential feature for practitioners to manage the extremely unpredictable nature of such care. As an adjunct to the learning and teaching strategies associated with Benner’s theory and an alternative to standardising and loading the curriculum, it should be accepted that, in wound care, there are never enough resources and information that is available to direct practice is often inconclusive or incomplete. Learning should therefore instead develop particular cognitive, meta-cognitive and attitudinal skills for practitioners to arrive at the ‘best answer’ possible by adapting Wood’s ‘build-bridge-extend’ (BBE) approach to the wound care context.

CONCLUSIONS: Benner’s theory no longer adequately characterises wound care education provision and should be developed to represent the influences of policy, practice and student voices.
Original languageEnglish
Awarding Institution
  • University of Strathclyde
  • Rivers, Ian, Supervisor, External person
  • Beck, Anna, Supervisor, External person
Award date25 Nov 2020
Place of PublicationGlasgow
Publication statusPublished - 2 Dec 2020


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