Theoretical integration to optimize the learning of nursing interns during their social service

Abstract

Introduction: clinical training of nursing interns during social service requires pedagogical approaches that integrate theory, practice, and competency assessment. In this context, Miller’s Pyramid and Patricia Benner’s theory provide conceptual references for understanding the progressive development of clinical competencies and learning needs in real healthcare settings.

Objective: to analyze an integrative pedagogical approach that articulates Miller’s Pyramid and Patricia Benner’s theory as a conceptual framework to address the learning needs of nursing interns during social service.

Methods: a qualitative analytical–interpretative study was conducted through a narrative documentary review. The analysis was based on a hermeneutic–dialectic procedure combined with thematic content analysis. Databases such as SciELO, PubMed, Scopus, CUIDEN, and LILACS were consulted using descriptors related to clinical competencies, nursing education, and the Miller and Benner models.

Results: the analysis identified conceptual convergences between both models, revealing a progression from theoretical knowledge to autonomous clinical performance. Emerging categories included theory–practice dissociation, fragmented assessment processes, and the need for situated tutorial support. In addition, a hermeneutic–dialectic convergence matrix was developed, linking Miller’s levels with Benner’s stages, which enabled interpretation of the progressive development of competencies among nursing interns.

Conclusions: the Miller–Benner integration constitutes a useful conceptual framework for understanding and guiding clinical learning during social service, promoting formative assessment, clinical judgment, and contextualized professional autonomy.