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Competence and the Critical Incident

Irwin J. Schatz, MD
Arch Intern Med. 1976;136(10):1089-1090. doi:10.1001/archinte.1976.03630100007003.
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"What does the internist do?" "How well does he do it?"

Answers to these questions are essential in order to define the basic goals of our educational process in internal medicine and to assess the quality of care delivered by internists.

Medical schools and departments of internal medicine are vitally concerned with the proper evaluation of their students. To determine what levels of competence in knowledge, skills, and attitudes are needed to award the MD degree to students, we must know what it is the effective internist does in practice, and then decide what the minimum achievements for students should be.

Similarly, in order to decide whether our residents have acquired clinical competence as they near the end of their training, we need to identify those components of an internist's activities that reflect effective performance.

Fortunately, a start in answering the first of these questions has been made. The University


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