Novice To Expert: Constructivism in Nursing

Novice to Expert

Working under stress requires the ability to prioritise, multi-task, advocate, maintain effective time management and is part of a suite of learning skills considered ‘novice to expert’ in nursing (Benner, 1982). This ability to transfer thoughts and process information, which are relevant to the particular situation, time and place, is of utmost importance for effective decision-making. Moreover, Jean Piaget’s theory of cognitive development states that thoughts, memory, past experience, problem solving, and processing information all influence the learner.

Piaget’s concept of schema theory involves the organized structure of memories, past experience and the knowledge we possess and develop over time. Constant interpretation is considered the process of adaptation and assimilation to the environment. Cognitive processes of types of knowledge, using the taxonomy of Krathwohl (2002) are utilized in the work environment by educators to engage and develop the learner in high-level engagement. Assimilation is using new experiences to already existing schema, knowledge and experiences. This constant building of experience on experience is the scaffolding of learning in nursing. It can take years to build experience on top of knowledge to scaffold performance on the novice to expert pathway.

Clinical shifts regularly provide feedback opportunities through clinical supervision, along with performance management plans. This feedback practice must align with the nursing students learning objectives. For nurse mentors or peer support, the development of constructive feedback methods is essential as part of clinical supervision. Reflection is a major component of development and learning, and applying frameworks, such as Gibbs (1988) and Johns (2009), for reflective processes in nursing can help make sense of experiences and summarize events.


Using Benner (1984) “novice to expert” or Bondy (1983) “dependent to independent” frameworks to create the learning environment can help align content to nursing experience or skills expected to be learnt and assessed (see Intended Learning Outcomes).

Curriculum development from setting intended learning outcomes, subject content and assessments can be aided by the use of Bloom’s Taxonomy to align and scaffold education delivery . This can help provide focus for the delivery of education and meeting educational objectives.


Benner, P. (2004) Using the Dreyfus Model of Skill Acquisition to Describe and Interpret Skill Acquisition and Clinical Judgment in Nursing Practice and Education. Bulletin of Science, Technology & Society June 2004 24: 188-199.

Benner, P. (1984). From novice to expert. Menlo Park.

Bondy, K, N. (1983). Criterion-referenced definitions for rating scales in clinical evaluation. Journal of Nursing Education. Vol. 22, no. 9, pp. 376-382.

Krathwohl, D. R. (2002). A revision of Bloom’s taxonomy: An overviewTheory into practice, 41(4), 212-218.

Iowa State University. (2016). Revised Blooms Taxonomy. Center for Excellence Learning & Teaching.

Nursing Education Network. (2017). Blooms Taxonomy & Constructivism.

Bloom’s Taxonomy & Constructivism

The use of Blooms Taxonomy to provide focus for the delivery of education and meeting educational objectives is a commonly used structure. The taxonomy can aid developing curriculum learning objectives, assessments and activities to align and scaffold education delivery. Organising levels of expertise of Bloom’s taxonomy categorises and orders from simple to complex and from concrete to abstract, and cover the learning objectives in the cognitive, affective and sensory domains.

Bloom's Taxonomy

For The Educator

“This connection between the ‘teaching objectives’ (what lecturers say they want to do) and their ‘teaching activity’ (what they actually do) – a lack of relationship between intention and performance. This unrecognised contrast between intent and the effects of teaching is often expressed as a distinction between the formal and the hidden’ curriculum” (Entwistle et al, 1971, pg. 12).

  • What are the aims of the education?
  • What level of knowledge and understanding is expected of the student?
  • Scaffolding towards critical thinking.
  • Guides and aligns type of assessment.

For The Student

  • What is expected of me (what educators want students to know)?
  • What am I going to develop by attending this course?
  • Are values, attitudes, and interests affected?
  • To understand and use concepts, to demonstrate particular skills.


The updated taxonomy by Krathwohl (2002) using the knowledge and cognitive domains states that “the Taxonomy of Educational Objectives is a scheme for classifying educational goals, objectives, and, most recently, standards. It provides an organizational structure that gives a commonly understood meaning to objectives classified in one of its categories, thereby enhancing communication”.


Krathwohl, D. R. (2002). A revision of Bloom’s taxonomy: An overviewTheory into practice, 41(4), 212-218.

Iowa State University (2016) Revised Blooms Taxonomy. Center for Excellence Learning & Teaching.

Nursing Education Network (2016) Intended Learning Outcomes

Experiential Learning from Five Perspectives

Journal Club: Fenwick, T. J. (2001). Experiential Learning: A Theoretical Critique from Five Perspectives. Information Series No. 385.

Experiential Learning


The importance for the educator in understanding the adult learner and their experience in a world of lifelong learning, workplace learning, informal learning and self-directed learning. Experiential learning means a process of human cognition (or to learn).

Three main perspectives of experiential learning exist:

  1.  Phenonomenological: use of reflection to analyse self (Schon, Kolb and Bould).
  2.  Critical Theory: use of critical self reflection (Habermas, Mezirow, Foucault and Friere).
  3.  Situated and Action Theory: the role of cultural action and power (Lave and Wenger).

“Education is not preparation for life; education is life itself.” ― John Dewey

Five orientations on experiential learning in adult education are explored by Fenwick.

Reflection: Constructivism

Reflection is the most prevalent understanding of experiential learning. Reflecting and interpreting lived experience, and then transferring this understanding to new situations. Kolb (1984) theory of  learning through the cognitive process by integrating their ‘concrete’ emotional experiences with reflection. “The learner takes some time for reflective observation. The learner asks of the experience: What did I observe? What was I aware of? What does this experience mean to me? How might this experience have been different?”

Schon’s reflection theory focuses on everyday action by professional workers. Reflection-in-action” and “reflection-on-action” provides critical reflection on what informs practice and how they develop or hinder workplace practices.

Some constructivist theorists:

Interference: Psychoanalytic Perspective

Educational analyses are drawn from the works of Sigmund Freud and Carl Jung. “The inside world is configured by knowledge dilemmas, these unfold through struggles between the unconscious and the conscious mind”. Learning and desire to learn are considered enmeshed, in that as we learn we may learn to desire to learn more. Lacan (1978) learning theory of experience is where the psychic mind meets the external world, where understanding self, ego, unconsciousness and reality are explored and where the problem is attempted to be solved.

Participation: Situative Perspective

“Knowing and learning are defined as engaging in changing processes of human activity in a particular community. Knowledge is not a substance to be ingested and then transferred to new situations, but part of the process of participation in the immediate situation”. Lave and Wenger (1991) state that learning is entwined participating an interacting with the community. The objective is to become an active participant in this ‘community of practice’.

Simulation provides the possibility of designing environments that promote embodied, situative learning. A simulation or case study can be ways top integrate learning whilst tackling work problems.

Resistance: Critical Cultural

Critical cultural perspectives focus on power, and the relations in human cultural systems. Political, historical, cultural and gender provide conflicting perspectives and practices in critical cultural perspectives. Learning occurs informally and incidentally in everyday life, and some of the most powerful learning occurs as people try to make sense during the struggle against oppression (Foley, 1999). The need for individualism in learning, through choice and learning needs.

Some critical cultural theorists:

C0-Emergence: Enactivist Perspective

“Enactivism is a theory explaining the co-emergence of learner and setting. Enactivism explores how cognition and environment becomes simultaneously enacted through experiential learning” (Maturana and Varela, 1987; Varela, Thompson & Rosch, 1991). The person and context are deemed inseparable, influencing systems. As learners participate, they adapt, develop and learn, their behaviours then effect and change the systems themselves. An environment and learner approach is central to the process of cognition in the enactivist perspective.

For The Educator

As the educator consider these perspectives on experiential learning and if the issues of reflection, inferences, participation, power and co-emergence are raised in your education setting. Do your beliefs of adult learning experience and learning match the education philosophy of your workplace?


Fenwick, T. J. (2001). Experiential Learning: A Theoretical Critique from Five Perspectives. Information Series No. 385.


Create a Constructivist Online Learning Environment

Constructivist Learning Environments

Bloom taxonomy

In a constructivist learning environment, the educator needs to allow the learner to develop and learn, ideally allowing progression suited to the individual. The content will have to be incorporated into lesson plans and intended learning outcomes to scaffold learning. Integrating varied theoretical approaches to assist and encourage learning is key. The facilitator will need to be comfortable and confident in providing an environment that encourages active learning. If the educator is confident enough then a heutogogy based learning environment could be created, especially in an online learning approach.

Constructivist Online Course

  • E-learning would be planned to deliver a step by step program of the course topics.
  • At the interface level for the student, developing an engaging learning community to share ideas and create discussion.
  • To create an experimental environment, an online community would require rules of engagement, such as privacy and respect.
  • A positive and safe environment to encourage learning and seek challenges. Mistakes are welcome.
  • To build an experience, then encourage active engagement through discussion forums and online posting. The facilitator will need to know when to contribute or step back during discussions to allow open discussion.
  • Online lectures or recordings must have the ability for discussion and question to make collaboration possible.
  • Low stakes quizzes and tasks to create skills based assessment at certain stages through the course. Relate to real life situation, such as a workplace scenario to encourage active engagement and problem solving skills. Not all questions to have yes/no answers, allow multiple options to create different perspectives and rationales.
  • Create new ideas and receive feedback from learners.
  • Provide tips and advice of how to learn and study.
  • Use of reflective practice to encourage self-management and own learning development on a journey of lifelong learning,
  • Teach to learn, not just aiming to pass the test or the final numbers.

Nursing Constructivist Framework

Using Benner (1984) “novice to expert” or Bondy (1983) “dependent to independent”  frameworks to create the learning environment can help align content to nursing experience or skills expected to be learnt and assessed.

IT Platform

With so many learning management platforms available I will leave it up to Wikipedia’s explanation on learning management system. Some aspects to consider are the accessibility (is the information so important that really warrants a password?), the interface with mobile devices and the connectivity with social media and other platforms we use in our connected lives. Maybe consider the website model of open access and Wikipedia, Wikischools or Wikiversity.


Benner, P. (1982). From novice to expert. American Journal of Nursing, 82(3), 402-407.

Benner, P. (1984). From novice to expert. Menlo Park.

Bondy, K, N. (1983). Criterion-referenced definitions for rating scales in clinical evaluation. Journal of Nursing Education. Vol. 22, no. 9, pp. 376-382.

Huang, H. M. (2002). Toward constructivism for adult learners in online learning environments. British Journal of Educational Technology, 33(1), 27-37.

Koohang, A., Riley, L., Smith, T., & Schreurs, J. (2009). E-learning and constructivism: From theory to application. Interdisciplinary Journal of E-Learning and Learning Objects

The University of Sydney (2016) Constructivism

Wikipedia (2016) Learning Management System


Nurse Educator Role: A Guide For The New Nurse Educator

Starting out as a nurse educator can be a daunting and ‘thrown in at the deep end’ experience. Teaching to students, colleagues and other nurses in the workplace or higher education setting presents an array of challenges. But now you’re in the role, your expected to be able to deliver many types of education and understand adult education theory. We will provide some tips on starting out and helpful resources in these first critical elements of the role.

  • Intended Learning Outcomes: Start and finish with intended learning outcomes. This gives focus to your teaching, helps to keep on track and guides the students in what they should be getting out of attending the learning session/s (more information on intended learning outcomes).
  • Lesson Plan: Create a lesson plan to deliver focused education sessions. Make the most out of the valuable teaching time by being organised (lesson plan template).
  • Education Philosophy: First resource to consider is reading Malcolm Knowles’ The Adult Learner (link here). In nursing, the constructivist pathway for nursing proficiency is standard, so using Patricia Benner’s (1984) Novice to Expert framework is a good starting resource (link here).
  • Taxonomy: Anderson & Krathwohl (2001) revision and understanding of Bloom’s cognitive taxonomy provides consideration and assessment of different levels of knowledge, in particular for setting learning outcomes to guide the nurse educator (link here).
  • Social Learning Theory: Group work and collaboration are encouraged for adult learners, we are social learners. Can you replace the lecture with a case study or simulation for more hands on and real life learning scenarios? Make it team based or collaborative approach. Help facilitate communities of practice (CoP’s).
  • Facilitation Style: remove the traditional teacher approach and you quickly move your style to that of facilitator, encouraging adult learning and increasing engagement from the students. Adults engage in authentic learning tasks so link content to their professional environment. (#Heutagogy)
  • Flip & Prepare: If you’re an organised educator then provide a link to the content or topics to be discussed for your students to access. Maybe provide a key reading so students attend ready to get straight into the topic. Remember, the flipped classroom approach requires a motivated group who will complete any pre-reading (link here). When work and life is busy, you will find yourself finishing presentations at 02:00 on the day of the talk, so sometimes just getting through the day is an achievement.
  • Presentation Skills: Avoid death by powerpoint, go along the visualisation pathway (Slide-ology). Add quizzes into your talk to engage and test your audience. Break down session times to meet attention spans of your students, rather than fit into a set timetable. Be flexible, if the group look tired or need a break, give it to them and start again after a coffee fix. Here is one for the bored audience Presentation Bingo. 
  • Timing: This is important to ensure the aims of the session are covered, trying to fit in too much content is common at the start. A mixture of preparation, practice and experience seems to help with timing. When you become comfortable with the content and environment, it all seems to fall into place. Sometimes it can all go wrong with room bookings, guest presenters are late and equipment malfunctions, this is when you get creative and ‘wing it’. Try to have a back up plan, imagine you have no electricity or devices, how could you deliver the session in the best alternative method.
  • Handouts: You can find education research arguing for and against handouts. Some state that providing handouts makes students switch off as you have provided them with the content so they don’t bother engaging, so instead hand them out at the end. When you don’t provide handouts, you will find students complain, as they like to make notes. You will find students have a mix of handwritten and electronic note taking methods. Consider providing some brief outlines, key readings and space for students to take notes (provide either a paper or an electronic format).
  • Peer Observation: Observe other educators and use some of their approaches that you see students respond to or you believe in. Remember what seems effortless may well have taken them many attempts (a few fails along the way as well), so resist comparing yourself to them, they have developed their expertise over time.
  • Feedback: Ask for constructive feedback from your educator colleagues (#developrhinoskin).
  • Evaluations: Evaluations can be very helpful, just remember to collect a representative sample to provide a true evaluation of your teaching (link here).
  • Workload: Spread your time to make it all count and prioritise tasks. You have to make sure you catch up with all your students and keep up with other work commitments, which can be tricky to make sure everyone feels adequately supported. If you promise to see a student but are too busy or just forget, just provide an apology the student will likely be understanding. Try the one minute preceptor approach when days are busy and remember the “what is ……?” and the “why this intervention?” questions (link here).
  • Feedback Delivery: Giving effective and honest feedback can be a challenging experience. It’s not always going to be positive, but just remember to go along the constructive feedback pathway rather than destructive. Here is some advice from Nursing Times (link here) and below in the references are 2 articles on feedback from Clynes & Raferty (2008) and Duffy (2013).
  • Educators Education: You will find plenty of courses both formal and informal in developing your education and learning, so take a broad view depending on your time frame and budget. Don’t forget the opportunities social media brings to create a personal learning network and links to current topics and resources (#FOANed).


Anderson, L. W. and Krathwohl, D. R. (2001) A Taxonomy for Learning, Teaching, and Assessing: A Revision of Bloom’s Taxonomy of Educational Objectives. Allyn & Bacon. Boston, MA (Pearson Education Group).

Benner, P. (1984). From novice to expert. Menlo Park.

Clynes, M. P., & Raftery, S. E. (2008). Feedback: an essential element of student learning in clinical practice. Nurse Education in Practice, 8(6), 405-411.

Duffy, K. (2013). Providing constructive feedback to students during mentoring. Nursing Standard, 27(31), 50.

Knowles, M. S., Holton III, E. F., & Swanson, R. A. (2014). The adult learner: The definitive classic in adult education and human resource development. Routledge.

McNamara, P. (2016) A Nurse’s Guide To Twitter.

Race, P., Higgs, B., & Potter, J. (2008). In at the deep end: starting to teach in higher education. NAIRTL.

Sayers, J., DiGiacomo, M., & Davidson, P. (2011). The nurse educator role in the acute care setting in Australia: important but poorly described. Australian Journal of Advanced Nursing, 28(4), 44-52.

Nursing Education Network (2016) Adult Learning (Androgogy).

Nursing Education Network (2016) Learning to Learn, Understanding Understanding.

Radical Constructivism & Ernst von Glasersfeld

Radical Constructivism is?

Information is not simply transferred from one person to another, and passed from teacher to student. The learning experience is down to the individual building knowledge and their subjective interpretation of this experience.

The individual constructs knowledge, understanding and links this with their own experiences and ideas – the constructivism part. von Glasersfeld (1989) writes “understanding is not a matter of passively receiving but of actively building up”.

Assimilation is using new experiences to already existing schema, knowledge and experiences (von Glasersfeld, 2013). So according to von Glasersfeld, conceptually today’s education will soon be yesterday’s experience to construct and build on.

Theoretical Aspect

Radical constructivism provides an epistemological (theory of knowledge) approach where the cognizing individual creates meaning and understanding through active learning (von Glasersfeld, 2013). This radical constructive learning theory is based on one’s own experience and interpretation, “What we make of experience constitutes the only world we consciously live in” (Von Glasersfeld, 2013, p. 1). The complexity of Glasersfeld’s theory, which emphasises the subjectivity of the individual, and their reality and organisation of the world is a very challenging epistemological concept.

Become a Radical Constructivist with Ernst

Introduction to Radical Constructivism

Teaching & Radical Constructivism

Adaption, Assimilation & Accommodation

Keywords: Radical constructivism; pertubations; epistemological; ontological assumptions; cognizing.


Von Glasersfeld, E. (1984). An introduction to radical constructivism. The invented reality, 17-40.

von Glasersfeld, E. (2013). Radical Constructivism. Hoboken: Taylor and Francis.

Von Glasersfeld, E. (1989). Cognition, construction of knowledge, and teaching. Synthese, 80(1), 121-140.

Wikipedia (2016) Constructivist_epistemology