Expert nursing practice: a mathematical explanation of Benner's 5th stage of practice development.

Aim. This paper is a theoretical discussion of a mathematical explanation for Benner's theory of practice development. Background. Benner's practice development theory demonstrates how a nurse moves from a beginning, rule-based practice through to expert care. Her notion of expert practice as intuitive has not been well-accepted or understood in nursing. A new description of expert practice includes three types of intuitive practice (cognitive, transitional and embodied), the development of which are dependent on knowledge, experience and reflective time. Data sources. This paper is based on phenomenological research conducted in 2000-2003 and Benner's publications, as well as recent discussions about the relationship between mathematics and phenomenology. Discussion. The mathematical explanation for Benner's theory of practice development relates reflective time and knowledge to the mathematical power of experience and links the unique components of intuitive practice to expert care. On reaching expert practice, the three types of intuition include previously identified themes (knowledge, experience, connection, feeling, syncretism and trust) as differentials along the reflective time axis. When graphically represented, expert practice becomes a three-dimensional figure as practice becomes more complex, rather than a two-dimensional one as seen in previous stages. Conclusion. Having the intuitive component of expert practice further clarified from Benner's first vision confirms it as a valid component of practice. It is important to recognize that experience is a powerful component of practice and that it is essential to the development of expertise. Although this discussion has been nested within nursing practice, it has wide implications for medical, psychological and educational practice. [ABSTRACT FROM AUTHOR]