Expertise in sports, music and chess is measured by the “analysis of reproducible superior performance on representative tasks within the domain”.

There is a long history in these fields of teaching improvements in the skills that make a player an expert performer.

Performers are constantly asked to identify and improve on the tasks that they perform in becoming an expert practitioner.

An adequate assessment of competence in nursing has proven difficult to identify.

What are the characteristics that takes a nurse from proficient to expert?

It has been established that the length of professional experience does not lead to better performance and treatment outcomes.

Neither does the extant of the nurse’s knowledge.

The acquisition of knowledge is important.

But knowledge alone does not lead to superior performance in nursing.

Superior performance in nursing would be better treatment outcomes for patients.

Most nurses will improve their skills throughout their initial training and at the beginning of their working life until they reach an acceptable level of performance.

But once the acceptable level has been achieved, further improvement is unpredictable.

The years of experience is typically a poor predictor of further performance improvement.

Experts in other fields have been asked to explain as they go along why they are doing when they perform a complex task.

The expert’s actions when they were performing a challenging task was not intuitive.

The process an expert performer takes when undertaking a demanding task is never “Intuitive”.

Experts do not automatically recognise a pattern and retrieve a response directly from their memory.

Instead they look at the information in front of them with ‘working representations’ that recreates the actual task in their working memory.

The working representation allows the expertto plan, evaluate and reason about alternative courses of action.

Novices do this but take longer than experts.

Experts are faster because they have practiced the scenario many times.

To improve performance, it is just not enough to spend time practicing.

Experts who improve seek out a particular kind of experience called “deliberate practice”.

Deliberate practice is where activities are designed to effectively improve specific aspects of an individual’s performance by setting goals with

   1. repetition.

    2. immediate feedback

    3. time for reflection and problem solving.

Acquiring knowledge does not make you an expert.

As most nurses already know it is the “doing” that matters.

To learn more about expert performance:

Ericsson, K. Anders, James Whyte IV, and Paul Ward. “Expert Performance in Nursing: Reviewing Research on Expertise in Nursing Within the Framework of the Expert‐Performance Approach.” Advances in Nursing Science 30.1 (2007): E58-E71.