Table 3.

Both before and after the patient encounter

1	Knowledge Gaps
A	Recognizing and correcting medication related knowledge gap	After the presentation, he turns to the computer and pulls up a recent admission note from the file. He reads through the admissions note, scanning and highlighting blocks of text as he goes…Moving on to the medications now, IM939 googles the first med that he sees listed [in the corresponding section of the admissions note] to see what it is Field visit 10, IM939 (PGY1)
B	Identification of knowledge gaps through reviewing prior clinical note	Probably really complex presentations. Really rare stuff or stuff I don’t have experience with. Those would be triggers… You know, I’ll see in their past medical history something that I’m not familiar with and that’ll be a trigger for me to look at Up-To-Date on what is this, what do I need to look for… So basically things that are different where I’m looking for change, and then things I don’t understand fully will be a trigger for me to look either back in the chart for some explanation or into my own, like… Up-To-Date or some other resource Field Interview 5, CC977
2	Data Collection Gaps
A	Recognizing data collection gap while documenting findings	Moving back to the ER progress notes, CC100 reads through the chart and the patient’s ECG. As she is reading the chart, she realizes that she has not done a full neurological exam and will need to go back to do one on the patient Field visit 9, CC100
B	Recognizing data collection gap during case review	IM605 sees one [a note] and enters it, interrupting the presentation to comment that there is a note here about a heart condition. CC594 does not appear to have previously read about this condition; he adds a note to his paper as IM605 mentions it…IM605 tells CC594 that he should look back and find an older ECG, so that he can contrast the findings on the patient’s ECG with the baseline…IM605 then tells CC594 to go back and see the patient again, to clarify a few of the things the presentation has shown he did not obtain the first time Field visit 14, IM605 (PGY3), CC594 (Medical student)
C	Recognizing data collection gap during analysis	IM289 then exits the note on the computer and clicks over to the investigation results section, glancing through the results quickly. She highlights one line and appears to read it more closely. She then grabs the phone and calls the core lab, requesting that they add additional bloodwork for the sample they have drawn from this patient Field visit 22, IM289 (PGY3)
D	Recognizing data collection gap during analysis	IM425 stays in this patient’s file for the moment. She returns to the investigation results page and looks through the results. She pauses as she sees that the urine electrolytes and osmolality have not been checked yet and comments that these need to be done. She adds an order for the required tests Field visit 24, IM425 (PGY2)