CSI, which takes place in the beginning of intern year, was introduced 2 years ago to our curriculum in response to national studies demonstrating that medical schools and internal medicine residency programs are not emphasizing the teaching of basic clinical reasoning. CSI is designed to allow our program leadership to assess proficiency and educate each intern in basic clinical skills. During this 2 week course, the the morning sessions are focused on instruction of history taking, physical exam skills, writing progress notes and giving oral presentations. Ancillary diagnostic skills are also taught during these sessions, including the analysis of CXRs, EKGs, peripheral blood smears and urinalysis. Afternoons are spent at the bedside practicing the skills learned under the guidance of a clinician educator. CSI is an ideal learning environment as the clinical educators instruct interns in basic clinical skills, directly observe them performing these tasks, and provide immediate formative feedback without the distractions and responsibilities of a typical floor month.