The Critical Incident Technique in General Practice

Abstract

The authors illustrate the critical incident technique (CIT) as a potential research tool in General Practice. An incident is defined as 'Any observable human activity which allows inferences and predictions on the person conducing the activity'. An incident is said to be critical when 'it happens in a situation when its purpose and intent are clear to an observer and when its consequences are sufficiently defined as not to leave doubts about their effects'. In order to underline the practical difficulties and caveats of the technique, the authors also present a partially unsuccessfull pilot study about the relational implications of referring patients to a specialist. For two weeks five GPs recorded, in the form of anecdotes, the consultations which followed a referral to the specialist. An observer took notes of these consultations identifying apparent relational problems. A panel analysed the anecdotes but could not identify elements that were clearly 'critical' according to definition. The authors observe that only contacts creating uneasyness (a clearly identifiable consequence) should have been selected, and that doctors should have been asked in advance to clearly identify what they expected from the specialist referral.