Stories, styles, and perceptions of practice constructs among intensive care nursery nurses

Dorothy Konowitz Fischer, University of Pennsylvania


The concept of expertise and its development, as well as the composition, meanings, and expressions in style within a specific practice discipline of being an expert, is a topic of current interest and the subject of this dissertation. This study focused on nurses working with ill and premature newborns. The purpose of this study was to discover if perception and beliefs regarding events in daily work lives of intensive care nursery nurses were reflected in practice and levels of clinical expertise according to the Dreyfus and Dreyfus Skill Acquisition Model from which Benner (1984) adapted a model of skill acquisition for use within nursing practice settings. Components of Benner's model of skill acquisition and Benner's definition of expert were used as a framework for the study. The design incorporated qualitative (interviews and observations with 16 nurses) and quantitative (a questionnaire answered by 66 other respondents) methods in its approach. In-depth interviews resulted in the identification of four inherent constructs of practice in this clinical setting: Technical/Scientific; Sensory/Intuitive; Professional Growth; and Ethicality. Based on these constructs, a 45-item Likert-scale questionnaire was developed, checked for content validity, and administered to nurses in intensive care nurseries from three hospitals in different areas. While there was overall support, and the evidence of tendencies, for the incorporation of a blended approach of technical and intuitive expression in the practice styles of the nurses in this study, there were no statistically significant findings when variables of age, type of preparation, or length of practice were compared with the various constructs that had evolved from the interviews. All nurses in each of the three surveyed hospitals scored the highest in the area of technical/scientific belief and perception about practice in this environment. This study did not demonstrate support among this group of experienced intensive care nursery nurses for Benner's statements of belief in the dominant nature of the intuitive aspect of an expert's practice.

Subject Area

Nursing|Educational psychology

Recommended Citation

Fischer, Dorothy Konowitz, "Stories, styles, and perceptions of practice constructs among intensive care nursery nurses" (1993). Dissertations available from ProQuest. AAI9321387.