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Unconscious incompetence and the foundation years
  1. I Higginson,
  2. A Hicks
  1. Derriford Hospital, Plymouth, UK
  1. Correspondence to:
 Dr Ian Higginson
 Derriford Hospital, Plymouth PL2 8DH, UK; Ian.higginson{at}

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One popular educational model suggests that trainees progress through the following sequence of competencies, and awareness of those competencies:

  1. Unconscious incompetence

  2. Conscious incompetence

  3. Conscious competence

  4. Unconscious competence

In our experience this model does not fit with training in emergency medicine. An additional first step can be added to represent the new senior house …

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  • Competing interests: None.

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