ABSTRACT
Expertise develops when the clinician tests and refines propositions, hypotheses, and principle-based expectations in actual practice situations. Experience, as it is used here (Heidegger, 1962; Gadamer, 1970), results when preconceived notions and expectations are challenged, refined, or disconfirmed by the actual situation. Experience is therefore a requisite for expertise. For example, the problem solving of a proficient or expert nurse differs from that of the beginner or competent nurse, as described in Chapter 2. This difference can be attributed to the know-how that is acquired through experience. The expert nurse perceives the situation as a whole, uses past concrete situations as paradigms, and moves to the accurate region of the problem without wasteful consideration of a large number of irrelevant options (Dreyfus, H., 1979; Dreyfus, S., 1981). In contrast, the competent or proficient nurse in a novel situation must rely on conscious, deliberate, analytic problem solving of an elemental nature.
