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The Miller model for assessing competence

Thee Miller Pyramid is an learning model which is particularly relevant to consideration of learning outcomes in assessing clinical competence.

Although this taxonomic structure was designed for medicine, and is very well known through all health professions, the approach has application well beyond the health area.

The model illustrates a progressive development from being able to demonstrate knowledge to performing in a workplace context.

As students start their development of professional expertise, they move from the lower levels of the pyramid to the upper levels. At the lower levels, they will understand the theory that underpins the clinical competence, which they will learn from knowledge transmission learning activities such as lectures, readings, and demonstrations. At the upper levels, they will seamlessly integrate theory (intellectual skills), psychomotor skills and professional attitudes to perform as health professionals in different contexts. 

Miller's pyramid [Source:]

Adapted from