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This paper is based upon an ethnographic study of senior house officers (SHOs; second and third year residents) intending to become general practitioners (GPs; family doctors who practise in the community). GPs/SHOs in four very different hospitals and their associated training schemes were case‐studied. The methods included structured and semi‐structured interviews, observations of training events and occupational experience, shadow studies and focus groups. Major changes in hospitals have transformed the experience of working and learning for both GPs/SHOs and consultants. Continuity of care and the stability of medical teams appears to have given way to episodic care provided by frequently changing teams, led by consultants who are subspecialists within their own field. Does hospital training still provide the breadth of clinical experience appropriate for general practice? In hospital‐based training, GPs/SHOs who are doing a ‘real’ job make ‘real’ mistakes. They do so in a climate that is increasingly intolerant of error. They receive very different messages about the acceptability of mistakes and their place in the learning process. What appears to be missing is an educational framework for recognizing and understanding both the nature of a mistake and its clinical and educational implications. The persistent message from those involved in hospital training was that it could be improved. It seems that what is needed is a radical reconsideration and reconceptualization of how to address the learning and teaching issues of providing training that prepares GPs/SHOs for the real demands practice.

This article deals with the process of assessing students' managerial abilities in a required MBA course. The article discusses the competency approach and several competency models and gives an overview of the MBA curriculum at Case Western Reserve University's Weatherhead School of Management. The managerial assessment course is described, focusing specifically on a learning team approach to managerial assessment and development. Examples from the authors' experiences conducting this course are provided, and key learnings are outlined that will help others engage in skill-based teaching.

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