Scenario. Hana is fourteen months into a pediatric residency. She's technically competent; her notes are clean and her call skills are sharp. Last Tuesday her attending, Dr. Adeyemi, stopped her on the way out of a family meeting and said, quietly, "You did the visit correctly and the mother left the room alone." Hana didn't understand, then over the weekend she did. In the two months since, she has been watching how Adeyemi sits down, how she lets silences run, how she asks the second question. Hana realizes she is being taught what good care is, not just how to deliver it — and that no part of her formal curriculum is the vehicle for that teaching. If Adeyemi retires, she worries, the transmission ends.

Challenge: Design an apprenticeship structure that transmits judgment about an institution's purpose — not just technical skill — from experienced practitioners to newcomers, and produce the structure's selection of master-apprentice pairings, the practices that carry the unscripted portion of the craft, and the signals by which you can tell purpose-transmission is actually happening.

Evaluation. Strong designs make the tacit, purpose-forming portion of the apprenticeship survive even where it can't be reduced to a competency checklist, and have an answer for masters who retain technical skill but have lost contact with the craft's purpose.