In 2007, Kathryn Roulston was contracted to evaluate the implementation of a 3-year federally funded programme at a family medicine residency in the United States. The residency accepted 10-12 residents each June to prepare for careers in family medicine. Working with several national experts in relevant areas, faculty involved in the delivery of the behavioural sciences curriculum planned to introduce preparation in mind, body, medicine and spirituality across the 3-year residency programme. Roulston's work as an external evaluator involved documenting the programme implementation and providing feedback to those involved in programme delivery about residents' perspectives and experiences relative to the mind, body, medicine and spirituality training programme. This case study describes some of the methodological issues that arose during the course of the project.