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126 UNIT II Nursing Philosophies

MAJOR CONCEPTS & DEFINITIONS—cont’d
functions, and meanings” (Benner, 1984a, p. 292). understand future clinical situations (Benner, 1984a).
This term is unrelated to the competent stage of the Paradigm cases create new clinical understanding
Dreyfus model. and open new clinical perspectives and alternatives.
Domain Salience
The domain is an area of practice having a number Salience describes a perceptual stance or embodied
of competencies with similar intents, functions, and knowledge whereby aspects of a situation stand out
meanings (Benner, 1984a). as more or less important (Benner, 1984a).

Exemplar Ethical Comportment
An exemplar is an example of a clinical situation that Ethical comportment is good conduct born out of
conveys one or more intents, meanings, functions, or an individualized relationship with the patient. It
outcomes easily translated to other clinical situations involves engagement in a particular situation and
(Benner, 1984a). entails a sense of membership in the relevant profes-
sional group. It is socially embedded, lived, and
Experience embodied in practices, ways of being, and responses
Experience is not a mere passage of time, but an active to a clinical situation that promote the well being of
process of refining and changing preconceived theo- the patient (Day & Benner, 2002). “Clinical and
ries, notions, and ideas when confronted with actual ethical judgments are inseparable and must be
situations; it implies there is a dialog between what is guided by being with and understanding the human
found in practice and what is expected (Benner & concerns and possibilities in concrete situations”
Wrubel, 1982). (Benner, 2000, p. 305).

Maxim Hermeneutics
Maxim is a cryptic description of skilled performance Hermeneutics means “interpretive.” The term derives
that requires a certain level of experience to recognize from biblical and judicial exegesis. As used in re-
the implications of the instructions (Benner, 1984a). search, hermeneutics refers to describing and study-
ing “meaningful human phenomena in a careful
Paradigm case and detailed manner as free as possible from prior
A paradigm case is a clinical experience that stands theoretical assumptions, based instead on practical
out and alters the way the nurse will perceive and understanding” (Packer, 1985, pp. 1081–1082).

Use of Empirical Evidence levels of competency to describe skill acquisition
From 1978 to 1981, Benner was the author and in clinical nursing practice. Benner (1984a) ex-
project director of a federally funded grant, Achiev- plains that the interpretive approach seeks a rich
ing Methods of Intraprofessional Consensus, As- description of nursing practice from observation
sessment and Evaluation, known as the AMICAE and narrative accounts of actual nursing practice to
project. This research led to the publication of provide text for interpretation (hermeneutics).
From Novice to Expert (1984a). Benner directed the Nurses’ descriptions of patient care situations in
AMICAE project to develop evaluation methods which they made a positive difference “present the
for participating schools of nursing and hospitals uniqueness of nursing as a discipline and an art”
in the San Francisco area. It was an interpretive, (Benner, 1984a, p. xxvi). More than 1200 nurse par-
descriptive study that led to the use of Dreyfus’ five ticipants completed questionnaires and interviews