This study examined nurse experts’ perceptions of personal and environmental
influences on their attainment of expert performance in nursing practice. This qualitative
descriptive study focused on expert performance along a novice to expert trajectory of
skill acquisition. Specifically of interest were the unique roles of risk-taking, deliberate
practice, social models and mentors, and external rewards on attainment of expert
practice. A self-developed semi-structured interview guide and questionnaire guided the
exploration. A unique feature of this study was the consistent use of a reliable, researchbased
definition and process for determination of expert performance. Participants’
personal expert narrative stories of practice also supplemented the interview data.
An important finding was the number and diversity of work experiences that these
experts selected to enhance their development. These self-selected practice settings and
experiences varied widely among the participants, with no clinical area appearing to
restrict or promote attainment of expert performance. Participants identified the essential
role of risk-taking and challenging the status quo in expert development. Participants
commonly reported being self-confident and in their ability to influence and challenge
practices on behalf of patients and families. These experts de-emphasized the fear of
failure and viewed mistakes as learning opportunities. Their lifelong and engaged learning approaches supported their continuous learning and expert practice development.
All participants demonstrated a positive and engaged demeanor about their practice.These experts reported that early unit-based nurse leaders influenced their
development and left life-long impressions on them. Participants viewed their intrinsic
motivation as more important to their development than extrinsic factors. They valued
recognition of their practice accomplishments and contributions. Organizational
incentives, such as financial support, satisfied them as employees but were not pivotal to
their expert development. These experts used a variety of organizationally sponsored
learning activities to enhance learning and their practice development.Risk-taking, deliberate practice, social models and mentors, and recognition were
associated with the attainment of expert performance by the study participants. The
unique roles of risk-taking, deliberate practice, and expert clinical leaders warrant
additional research.