Expert physicians are constantly moving through a series of learning cycles throughout their career. Identifying where your student is in that cycle will assist you to plan activities and feedback that fits with that student's progression.

New Challenges move the person back into the cycle		1. Unconsciously Incompetent BEGINNING	At this stage, the learner doesn't know what they don't know even though they may assume that they know.
4. Unconscious Competence	This is the point of automaticity, where the learner no longer thinks about what to do, they do it correctly and seem to be leaping from A-F automatically. This is also the point of muscle memory.			2. Consciously Incompetent	The learner becomes aware of how much they need to learn.
Slips are common at this transition point between conscious and unconscious competence.		3. Consciously Competent	The learner tries very hard to demonstrate what they know but are awkward and slow because they have to mentally rehearse each step ABCDEF.

Stage	Learner Needs	Teaching activity
Unconsciously Incompetent	Awareness	Experiential learning Videotape/audiotape Feedback (in extreme cases of incompetence, multiple sources of feedback)
Consciously Incompetent	Teaching	Role modelling Direct teaching
Consciously Competent	Practice	Feedback Supervision
Slip	Reassurance	Constructive feedback Opportunity to correct errors
Unconsciously Competent	Independence	New Challenges

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