title: The Dreyfus model of clinical problem-solving skills acquisition: a critical perspective.
abstract: BACKGROUND
  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.
  
  
  OBJECTIVE
  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.
authors.affiliation: VA National Quality Scholars (VAQS) Fellowship Program. adolfope@uab.edu
authors.forename: Adolfo
authors.initials: A
authors.lastname: Peña
mesh_terms: D000465:Algorithms; D002983:Clinical Competence; D004501:Education, Medical; D055317:Evidence-Based Practice; D007722:Health Knowledge, Attitudes, Practice; D006801:Humans; D007858:Learning; D017145:Models, Educational; D010686:Philosophy, Medical; D011340:Problem Solving