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Dreyfus Model

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The Dreyfus model is defined as a model of skills acquisition which was initially developed through observing of nurses while doing their work. The model outlines five stages through which the skills are developed (Bosscher, 2007).  The stages are made up of: novice, advanced beginner, competent, proficient and lastly expert. The Dreyfus Model indicates that when skills develop within an individual, their dependence on rules reduce as their ability to make judgments independently increase.  It works in such a way that when a person gets to the proficient and expert levels, they can identify patterns within the environment and function (at least) on insight.

In explaining the stages involved in the Dreyfus Model, I will use a scenario of an early medical student being trained on how to obtain an Electrocardiogram (EKG) forchest pain.

At this stage the learner has no previous experience and has to adhere to particular rules to deal with particular circumstances. Additionally, novice is devoid of modifiers and can be said to be content free. The learner does not feel responsible for their actions other than following the rules of practice.

The early medical student is trained to take an EKG to establish pain problems, this happens devoid of other modifiers (Stefl, 2008).

At this stage, there is identification of new situational elements. The learners start applying rules to associated conditions. However, the judgments are made basing on rule application and they don’t experience individual responsibility (Bosscher, 2007).

The relatively more experienced medical learner discovers that dyspenea also might be connected to cardiac ischemia and asks for an EKG for that condition too.


Stefl (2008) asserts that tt this level, the total rules become extreme hence the student learns principles of organizing or viewpoints.  The viewpoints (perspectives) allow arranging information by application. Consequently, the experience of responsibility comes up from lively decision-making.

Here, the competent physician acknowledges a number of factors affecting the probability that a single symptom signifies ischemia and is makes use of a decision tree to allot likelihoods balancing a composition of factors in choosing when to order for an EKG or additional modalities of diagnosis to commence treatment.


At this point, that physician employs intuitive diagnosis. The approach to a given circumstance is shaped by a perspective originating from a combination of real life experiences. In other words, there is holistic similarity identification.  The learner makes use of intuition to recognize whatever is going on. Additionally, there is mindful decision-making and use of rules to formulate plan (Stefl, 2008).

The proficient physician acknowledges that it is an infarction hence applies the rules to make decision on thrombolysis.


According to Bosscher (2007), they neither make decisions nor solve problems but perform whatever works. At this stage, there is no decomposition of circumstances in to separate elements.

The verdict will be that the situation is an infarction and the expertise will give direction on appropriate therapeutic and diagnostic steps. 

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