Accepted for Publication: August 2, 2014.
Published Online: November 3, 2014. doi:10.1001/jamainternmed.2014.5437.
Study concept and design: Cook, Holmboe, Wilkinson.
Acquisition, analysis, or interpretation of data: Cook, Holmboe, Sorensen.
Drafting of the manuscript: Cook, Wilkinson.
Critical revision of the manuscript for important intellectual content: All authors.
Statistical analysis: Cook.
Administrative, technical, or material support: Cook, Sorensen, Wilkinson.
Study supervision: Cook.
Conflict of Interest Disclosures: Dr Holmboe reports receiving royalties from Mosby-Elsevier for his textbook, Practical Guide to the Evaluation of Clinical Competence; and, during the initial phases of conceptualization and analysis, serving as Chief Medical Officer of the American Board of Internal Medicine. No other disclosures were reported.
Funding/Support: This work was supported by internal funding through the Knowledge Delivery Center, Mayo Clinic, Rochester, Minnesota.
Role of the Funder/Sponsor: The Mayo Clinic had no role in the design and conduct of the study; collection, management, analysis, and interpretation of the data; preparation, review, or approval of the manuscript; and decision to submit the manuscript for publication.