A Concept Analysis of Expert Performance

Abstract

TITLE: A Concept Analysis of Expert Performance

PURPOSE:

The transition from graduate nurse to novice can be a stressful adjustment in an individual’s professional career. Currently, employers generally provide new graduates with limited orientation programs due to the high cost of training new nurses. Graduate nurses are expected to transition quickly into the role of independent nurse (Jeffries, 2005). Expertise in practice demands engaged learners who can apply evidence based domain knowledge, rather than solely depending on the acquisition of nursing skills. Expert performance requires individuals to improve practice over time, and recognize extensive situations in terms of past experiences. Recognizing the unexpected is the hallmark of expert practice (Benner, 2005; Bourne, Kole, & Healy, 2014).

Although research supports extensively competent nurses exhibit better patient outcomes, it is difficult to define expert performance as a concept in nursing education. Investigative research into expertise or superior performance in nursing practice, specifically applies self-reported instruments for data collection (Ericsson, Whyte, and Ward, 2007). Expertise studied in domains such as sports, music and chess have provided empirical evidence based on valid tools for measurement and analysis. The results of reproducible expert or superior performance are shown utilizing established tasks within these domains (Ericsson, Whyte, and Ward, 2007; Harji, & Tiwari, 2009). Valid and reliable instruments for analysis of expert performance are missing in nursing research.

This analysis explores the concept of expert performance in medicine, nursing, sports, business and music, and presents a working definition for its use in nursing education. Utilizing the expert performance approach in simulation can provide a catalyst for quick transition from student to novice nurse enhancing the delivery of safe and effective patient care.

METHOD:

Expert performance was examined using Walker and Avant’s (2011) method of concept analysis. A search of electronic databases was conducted utilizing the Cumulative Index to Nursing and Allied Health Literature (CINAHL), Nursing and Allied Health, Cochrane Library, and ERIC. The search terms used were expert performance and simulation. Thirty articles from nursing, medicine, sports, music and business were included.

RESULTS:

An empirical based definition of expert performance was constructed through the use of this method. Expert performance is the process of utilizing deliberate practice and scaffolding of acquired domain knowledge over time. Individuals exhibiting consistent superior performance possess an intrinsic reward system; are capable of self-reflection and self-observation; able to receive constructive feedback; and possess an acceptable working memory capacity. The antecedents of expert performance are focused attention, achieved motivation, persistence, risk taking, controlled anxiety and expert social mentors. The consequences of expert performance are utilizing deliberate practice consistently for superior performance and enhancement of cognitive resources.

Conclusion:

Expert performance develops and evolves over time by utilizing focused deliberate practice and acquired knowledge. Evidence-based nursing simulation can provide nursing students with feedback and self-reflection opportunities necessary to demonstrate sustained exceptional nursing performance. Expert performance utilizing Ericsson’s (2007) expert performance approach provides educators the ability to measure efforts of students in the development of flexibility, accuracy and speed to support the smooth transition from student to novice nurse.