# Stages of Clinical Competence --- The **stages of clinical competence** are a theoretical framework for conceptualizing the clinical competence of a nurse. First theorized by [[influential nurses#Patricia Benner|Patricia Benner]] who adapted the an existing framework and adapted to be specific to [[nursing]]. **Advanced beginner** - Enters clinical situations with some apprehension - Sees task requirements as central to the clinical context, whereas other aspects of the situation are seen as background** - Requires knowledge application to meet clinical realities - Perceives each clinical situation as a personal challenge - Are typically dependent on standards of care, unit procedures **Competent** - Focuses more on clinical issues in contrast to tasks - Can handle familiar situations - Expects certain clinical trajectories on the basis of the experience with particular patients - Searches for broader explanations of clinical situations - Has enhanced organizational ability, technical skills - Focuses on managing patients' conditions **Proficient** - Responds to particulars of clinical situations in a broader way - Requires an experiential base with past patient populations - Understands patient transitions over time - Learns to gauge involvement with patients and families to promote appropriate caring **Expert** - Has increased intuition regarding what are important clinical factors and how to respond to these - Engages in practical reasoning - Anticipates and prepares for situations while remaining open to changes - Performs care in a "fluid, almost seamless" manner - Bonds emotionally with patients and families depending on their needs - Sees the big picture, including the unexpected - Works both with and through others ___