From the educational bench to the clinical bedside

Translating the Dreyfus developmental model to the learning of clinical skills

Carol L. Carraccio, Bradley J Benson, James Nixon, Pamela L. Derstine

Research output: Contribution to journalReview article

134 Citations (Scopus)

Abstract

The Accreditation Council for Graduate Medical Education Outcome Project has shifted the focus of residents' education to competency-based outcomes of learning. The challenge of meaningful assessment of learner competence has stimulated interest in the Dreyfus and Dreyfus Model, a framework for assessing skill acquisition that describes developmental stages beginning with novice and progressing through advanced beginner, competent, proficient, expert, and master. Many educators have adopted this model, but no consensus about its adaptation to clinical medicine has been documented.In this article, the authors seek to integrate generally accepted knowledge and beliefs about how one learns to practice clinical medicine into a coherent developmental framework using the Dreyfus and Dreyfus model of skill acquisition. Using the general domain of patient care, the characteristics and skills of learners at each stage of development are translated into typical behaviors. A tangible picture of this model in real-world practice is provided through snapshots of typical learner performance at discrete moments in time along the developmental continuum. The Dreyfus and Dreyfus model is discussed in the context of other developmental models of assessment of learner competence. The limitations of the model, in particular the controversy around the behaviors of "experts," are discussed in light of other interpretations of expertise in the literature. Support for descriptive developmental models of assessment is presented in the context of a discussion of the deconstructing versus reconstructing of competencies.

Original languageEnglish (US)
Pages (from-to)761-767
Number of pages7
JournalAcademic Medicine
Volume83
Issue number8
DOIs
StatePublished - Jan 1 2008

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Clinical Competence
Clinical Medicine
Mental Competency
Competency-Based Education
Learning
Graduate Medical Education
Accreditation
learning
Consensus
Patient Care
medicine
expert
accreditation
patient care
education
expertise
graduate
educator
resident
interpretation

Cite this

From the educational bench to the clinical bedside : Translating the Dreyfus developmental model to the learning of clinical skills. / Carraccio, Carol L.; Benson, Bradley J; Nixon, James; Derstine, Pamela L.

In: Academic Medicine, Vol. 83, No. 8, 01.01.2008, p. 761-767.

Research output: Contribution to journalReview article

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