Dunning–Kruger Effect, Stages of Competence, and the Need for Endoscopy Training

Abstract

Dunning and Kruger in the year 1999 published their landmark paper describing their hypothesis based on a psychological phenomenon of illusory superiority as a cognitive bias, describing the correlation between ability or competence and ability to objectively analyze one's own ability or competence. This bias leads to people of low ability not being able to objectively analyze their lack of ability due to a lack of metacognition and overestimation of ones' capability.[1] This flawed perception has often been described as the anosognosia of everyday life. People who do not know the right answer to a question often do not have the skill to recognize what the right answer is.[2] For the acquisition of any skill, a person has to go through the four stages of competence which include unconscious incompetence, conscious incompetence, conscious competence, and unconscious competence [Figure 1].[3] All endoscopists go through these phases of achieving competence with each procedure, whether it is diagnostic endoscopy or advanced therapeutic endoscopy, over a period.