Table 1.

Kegan’s five orders of mind or epistemological lenses

Stage of Kegan’s model/order of mind/epistemological lens	Description of stage
Stage 1: ‘The magical childhood mind’	Developmental stage of early childhood. Young children cannot hold the idea that objects in the world retain the same qualities over time. This stage is a time of magic and mystery as the world inexplicably changes from moment to moment
Stage 2: ‘The self-sovereign mind’	Individuals existing within stage 2, ‘the self-sovereign mind’, emphasize their own needs, interests, and agendas as their primary goal. To self-sovereign minds, relationships are transactional—a means to an end of having their own needs and desires met—and rules or philosophies are adhered to because of external reward or punishment, not due to true belief or moral integrity
Stage 3: ‘The socialized mind’	Most adults exist within stage 3, ‘the socialized mind’, where external sources shape one’s sense of self and understanding of the world. In this stage, focus has shifted so priority is placed on the ideas, norms and beliefs of other people and the systems around us, as opposed to one’s own needs. External validation is sought to develop one’s identity, e.g., from grades or feedback, as individuals don’t have a strong, independent sense of self. For many people, social maturity halts here
Stage 4: ‘The self-authored mind’	Other adults progress their identity to stage 4, the ‘self-authored mind’. Within this stage, one’s sense of self is more independent, and individuals can define who they are without relation to other people, their relationships, or their environment. An internal sense of direction is established, where individuals become the ‘author’ of their own life course
Stage 5: ‘The self-transforming mind’	The final stage of Kegan’s model, stage 5, that is beyond what Cruess et al. deem relevant to medical trainees, is ‘the self-transforming mind’, a higher state of identity development, where one’s sense of self is constantly created and recreated through exploration of roles and beliefs with others. Individuals within this stage are still self-authoring, but also able to work with the authority of others to question the identity they hold. This is a stage that is rarely achieved and, if achieved, likely requires a great deal of time for development