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Dreyfus Model of Skill Acquisition, by Craig McClure
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Dreyfus Model of Skill Acquisition, by Craig McClure

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A description of the Dreyfus Levels, from the Arizona Medical Education Consortium

A description of the Dreyfus Levels, from the Arizona Medical Education Consortium

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  • 1. Dreyfus Model of SkillAcquisition ! " Craig McClure, MD ! " EOSG ! " University of Arizona ! " March 2005
  • 2. Five Stages! "Novice! "Advanced Beginner! "Competent! "Proficient! "Expert
  • 3. Novice! "The novice follows rules! "Specific rules for specific circumstances! "No modifiers! "“Context free”! "Don’t feel responsible for other than following the rule
  • 4. The early medical student is taughtto obtain an EKG for chest pain,without other modifiers.
  • 5. Advanced Beginner! "New “situational” elements are identified! "Rules begin to be applied to related conditions! "Decisions still are made by rule application! "Does not experience personal responsibility
  • 6. The more experienced medicalstudent finds that dyspnea alsomight be associated with cardiacischemia and orders an EKG forthat situation as well.
  • 7. Competence! "Numbers of rules becomes excessive! "Learn organizing principles or “perspectives”! "Perspectives permit assorting information by relevance! "The experience of responsibility arises from active decision-making
  • 8. The competent physician realizesthe multitude of factors influencingthe likelihood that a single symptomrepresents ischemia and has adecision tree to allocateprobabilities balancing a number offactors in deciding when to order anEKG or other diagnostic modalitiesand begin treatment
  • 9. Proficiency! " Intuitive diagnosis! " Approach to problem molded by perspective arising from multiple real world experiences! " “Holistic similarity recognition”! " Learner uses intuition to realize “what” is happening! " Conscious decision-making and rules used to formulate plan
  • 10. The proficient physician realizes“this is an infarction” and thenapplies rules to decide aboutthrombolysis.
  • 11. Expertise! "Don’t make decisions! "Don’t solve problems! "Do what works! "No decomposition of situation into discrete elements! "Pattern recognition extends to plan as well as diagnosis
  • 12. “This is an infarction and we shouldimplement the following diagnosticand therapeutic interventions.”
  • 13. Novice