OBJECTIVE: To identify elements of clinical information beyond the area of knowledge presented in medical textbooks, but used by the general practitioner when confronted with the acutely and severely ill child. DESIGN: Focus group approach. SETTING: A course for teachers in General Practice at the Division for General Practice, University of Bergen, Norway. SUBJECTS: 25 experienced general practitioners serving as clinical teachers at the Division for General Practice. MAIN OUTCOME MEASURES: Clinical descriptions arising from incident-based anecdotes and experiences. RESULTS: Issues were reported concerning the doctor's emotional reactions, cues from the parents of the child, atypical contact between doctor and child, cognitive discrepancies, and difficulties in acting on cues. CONCLUSION: This material identifies elements of tacit clinical knowledge which may provide a basis for further analysis and shared action.