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How to become a confident injector: The Dunning-Kruger effect

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How to become a confident injector: The Dunning-Kruger effectDr Tim Pearce
July 7, 2022

Dr Tim eye injection anatomy

Does your confidence in delivering cosmetic injections go through peaks and troughs? And why do the most incompetent aesthetic clinicians seem to be the most confident?

It all comes down to the Dunning-Kruger effect of cognitive bias which defines that people with low ability, expertise, or experience in a task or area of knowledge tend to overestimate their ability or knowledge.

In this blog, Dr Tim Pearce will explain the Dunning-Kruger effect, its impact on aesthetic practice, and shares how you can get your confidence back on track.

Do you feel anxious about causing complications? Many clinicians feel so overwhelmed with the thought of causing a vascular occlusion that it stops them growing their aesthetics business. Dr Tim is currently hosting a webinar series to help you overcome your fear of complications so that you can uplevel your knowledge, and increase your CPD-certified learning to build a successful aesthetics business. Sign up here >>

How the Dunning-Kruger effect impacts on aesthetic practice

Dunning-Kruger illustrates how humans work when they do not understand concepts at a deeper level. They quite often understand the big picture, or the simple components, and this gives them a disproportionate amount of confidence to proceed into the unknown, before reality bites.

Dunning Kruger

Dr Tim notes that this is the journey that many clinicians and injectors follow as they enter the aesthetic sector – going from simply learning the basics all the way through to becoming a ‘master’ – it is a bumpy ride, he warns.

At the start of the journey, you are at the stage just after you have trained – you are often most confident and have some of the basic skills. At this point, you think, “this is easy, if I put the needle there, I will get a result”. The reality begins to dawn after this stage as you start to realise the complexity involved with managing a whole patient journey, trying to get a client list, or indeed treating a complication.

Only then do you comprehend that aesthetic practice is much more complex than the step-by-step plan that you might get taught on your initial training course – patients never present in the simple way that they are often portrayed in training. At this stage, you must decipher a complex reality out of your simple, step-by-step plan, as you start to realise that it basically represents the tip of an iceberg of knowledge that we must learn in aesthetic practice.

This is often quite a crushing moment for a practitioner; you realise that although you have got the basics learnt, there is a long road ahead, nay hill, and you must work your way back up to somewhere close to the confidence that you had just after you thought it was all quite easy.

This happens over a period of months and years, but interestingly, you never quite get back to that 10 out of 10 feeling of confidence that you had at the start, because the reality of what you are doing is more complex and dangerous than the utopian step-by-step plan you initially learnt. You will find yourself channelling that energy back in to ensure that you are practising safely, and you will be thinking a lot more about everything you do, more so than you might have thought you needed based on the simple version that you were taught on day one.

Learning is a low-resolution model of reality, says Dr Tim, it is a dot-to-dot drawing of an infinitely complex universe. When you expose yourself to the real environment that you are practising in, you discover how complex things really are, and grasp that your dot-to-dot drawing does not represent the actuality. This is when you basically hit reality with a painful bump, and then the opposite happens – you go from extreme confidence to extreme doubt and uncertainty, becoming unconfident in your practice as you absorb the reality around you.

It is no surprise that this can be debilitating, and at this point, you usually follow one of two paths – you might give up completely, or you may start to gradually work your way back up that confidence hill by using the fear and anxiety that you have learned through hitting rock bottom as an energy or driving force.

You will begin to rebuild your model of the universe in a way that is more practical, using the potential threats to guide you instead of pretending that there are no threats. This is mentally much harder because you are building a vastly more complex model of how to survive in your aesthetic practice, which is not based on the step plan that you learnt, but on the thousands of steps it takes to manage a patient through their whole journey.

In a nutshell, this is the Dunning-Kruger Effect:

  •  you start out relatively incompetent and unconfident,
  •  you rapidly become very confident and then,
  •  you drop off quickly as you expose yourself to the reality of what you are doing,
  •  if you have the internal drive, you slowly work your way back up.

However, the interesting thing is that you never reach the same level of confidence as you possessed when you only had the simple model in your head that you thought was fail safe, you only ever get slightly beneath that.

Dr Tim explains that he also felt this in his practice. He clearly remembers a time when he thought that aesthetic practice was very simple and basic, fearing that he would get bored, until suddenly realising the complexities of the specialty. The dawning of reality made him appreciate that he will never get bored due to the twists and turns involved, but similarly, he has never quite reached the same stage of ‘chilled-out’ injecting that he ‘enjoyed’ six months into his aesthetic career when everything was simple. Even though the movements used when injecting are now simpler than we he first started practising, he asserts that he is thinking a lot more as he injects – the mind is more involved in the process these days, it is not simply following steps.

This is a long journey that we all need to go on; some aesthetic practitioners get stuck right at the beginning, and some never understand the complexity of the specialty, so it is only when something bad happens that they quit and leave the sector, which unfortunately is predominantly the situation we find ourselves in.

You can find Dr Tim Pearce on Instagram if you have a question on Botox treatments that you want him to answer, or if you have any other burning questions or comments about aesthetic practice..

Aesthetics Mastery Show

The Dunning Kruger Effect Explained

To find out more, watch the Aesthetics Mastery Show, where Dr Tim explains the Dunning Kruger effect and shares how you can get your confidence back on track.

BOTOX® & Dermal Fillers Foundation Courses

One way in which practitioners can improve their skills and confidence is to invest in further training resources. If you’re a medically qualified aesthetic clinician, then eLearning courses could be a great way to support your learning. Dr Tim Pearce’s foundation courses provide essential knowledge which you can refer to again and again. Find out more about the courses together with a list of modules at:

  • BOTOX® Foundation Course
  • Dermal Fillers Foundation Course

Save 10% With Foundation Package

The BOTOX® Foundation Course costs just £215 and the Dermal Fillers Foundation Course is £249 but if you buy the two together, you can save 10% on our package deal. Normal price £464.00, Package price, £417.00, Saving £47.00 with the Foundation Package.

In addition, browse our FREE downloadable resources and access FREE eLearning by following Dr Tim on social media.

Is your worst nightmare causing a VO?

If you want to be a great injector then you need to get over your fear of complications. Register here for the next webinar to help you overcome your complications anxiety >>

Subscribe to our YouTube channel for really useful regular tips and advice.  YouTube


Dr Tim Pearce eLearning

Dr Tim Pearce MBChB BSc (Hons) MRCGP founded his eLearning concept in 2016 in order to provide readily accessible BOTOX® and dermal filler online courses for fellow Medical Aesthetics practitioners. His objective was to raise standards within the industry – a principle which remains just as relevant today.

Our exclusive video-led courses are designed to build confidence, knowledge and technique at every stage, working from foundation level to advanced treatments and management of complications.

Thousands of delegates have benefited from the courses and we’re highly rated on Trustpilot. For more information or to discuss which course is right for you, please get in touch with our friendly team.

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