ABSTRACT
Using the Dreyfus model for skill development in medical practice, Carraccio have provided a list of appropriate behaviors for each stage in the development of physician competence, along with their implications for teaching and learning. Certainly, educational objectives cannot cure all the ills that beset teaching programs; however, they provide a study guide for residents, a teaching outline for faculty, and a source of valid questions for examiners. They also facilitate communication among those responsible for the various phases of the educational continuum. Dreyfus has described the continuum of learning and skills acquisition as occurring in six stages: novice, advanced beginner, competent learner, proficient learner, expert, and master. There are three essentials for learning in the clinical setting: relevance; personal commitment by the learner; and feedback. It should be emphasized that the context in which learning is expected to occur may be more important in fashioning the end product than any curriculum.
