The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective
Open Access
- 1 January 2010
- journal article
- review article
- Published by Taylor & Francis Ltd in Medical Education Online
- Vol. 15 (1)
- https://doi.org/10.3402/meo.v15i0.4846
Abstract
Context: The Dreyfus model describes how individuals progress through various levels in their acquisition of skills and subsumes ideas with regard to how individuals learn. Such a model is being accepted almost without debate from physicians to explain the ‘acquisition’ of clinical skills. Objectives: This paper reviews such a model, discusses several controversial points, clarifies what kind of knowledge the model is about, and examines its coherence in terms of problem-solving skills. Dreyfus’ main idea that intuition is a major aspect of expertise is also discussed in some detail. Relevant scientific evidence from cognitive science, psychology, and neuroscience is reviewed to accomplish these aims. Conclusions: Although the Dreyfus model may partially explain the ‘acquisition’ of some skills, it is debatable if it can explain the acquisition of clinical skills. The complex nature of clinical problem-solving skills and the rich interplay between the implicit and explicit forms of knowledge must be taken into consideration when we want to explain ‘acquisition’ of clinical skills. The idea that experts work from intuition, not from reason, should be evaluated carefully. Keywords: clinical skills; Dreyfus’ model; expertise; intuition; learning; medical education; novice to expert (Published: 14 June 2010) Citation: Medical Education Online 2010, 15: 4846 - DOI: 10.3402/meo.v15i0.4846Keywords
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