Dreyfus or Zwisch ... we got you covered

September 26, 2015 / Mario Rodriguez

With these latest round of updates you will notice that myTIPreport will now support two procedure rating scales (Dreyfus and Zwisch). This provides programs greater flexibility in how learners are evaluated, ultimately increasing adoption and usage of service within an organization.

By default programs will start on Dreyfus, but can at any point seamlessly switch to the Zwisch model. In order to allow for this in-flight change we have adapted the model so both are on a five point scale. We recommend organizations to try both models and evaluate which fits best culturally and educationally.

The Rating scales

A quick recap on the rating scales for skill assessment.


"In the fields of education and operations research, the Dreyfus model of skill acquisition is a model of how students acquire skills through formal instruction and practicing. Brothers Stuart and Hubert Dreyfus proposed the model in 1980 in an influential, 18-page report on their research at the University of California, Berkeley, Operations Research Center for the United States Air Force Office of Scientific Research. The original model proposes that a student passes through five distinct stages: novice, competence, proficiency, expertise, and mastery."

See Wikipedia, Bluebook, https://en.wikipedia.org/wiki/Dreyfus_model_of_skill_acquisition (describing Dreyfus model) (as of Sep 26, 2015, 20:50 GMT).


In a research paper published in 2013, Joseph (Jay) Zwischenberger, MD, FACS, outlines a simple model for teaching and assessing residents in the operating room to guide faculty and resident interaction in the OR, and designating a resident's earned level of autonomy for a given procedure. The model was developed at the University of Kentucky, Lexington to aid in the training and assessment of his residents to achieve operative independence.

The four stages of the Zwisch model of supervision are as follows: Show and tell, Smart help, Dumb help, No help.

Adapted from DaRosa DA, Zwischenberger JB, Meyerson SL, et al. A theory-based model for teaching and assessing residents in the operating room. J Surg Educ. 2013;70(1):24-30.

Customizing it to your program

To make a change to the rating scale you need to be an account admin. After opening the admin channel locate the Customizations section and Procedure Rating Scale row. Select it and this will open up the "admin :: procedure rating scale blade.

In the blade you can make the selection change. This will affect all previous and future evaluations