Dreyfus stages applied to clinical medicine5
| Dreyfus stages | |
|---|---|
| Stage 1—novice (medical student) | Learns basics of history taking and examination |
| Stage 2—advanced beginner (house officer or SHO) | Learns to apply skills in selected clinical situations which become increasingly dependent on the context of the situations—that is, hospital admissions, rounds, etc, which enables learning through experience |
| Stage 3—competent (registrar) | Learns to plan the approach to each patient’s situations in a supervised fashion. Learns consequences of actions and pattern recognition |
| Stage 4—proficient (newly appointed consultant) | Develops routines to streamline patient care. Manages multiple stimuli in a thoughtful way which is intellectually and emotionally absorbing. Integrates mastered skills with personal style |
| Stage 5—expert (mid career physician) | Recognises patterns, has intuition for the work, attuned to distortions in patterns and to slow down when things don’t fit the expected pattern |