Goodwill - Summary of Changes in Carrying Amount of Goodwill (Detail) (USD $) In Thousands, unless otherwise specified				12 Months Ended				12 Months Ended					12 Months Ended						12 Months Ended
	Dec. 31, 2013	Dec. 31, 2012	Dec. 31, 2011	Dec. 31, 2013 Sy. Med Development, Inc. [Member]	Dec. 31, 2012 Sy. Med Development, Inc. [Member]	Dec. 31, 2013 Baptist Leadership Group [Member]	Sep. 09, 2013 Baptist Leadership Group [Member]	Dec. 31, 2012 Decision Critical, Inc. [Member]	Jun. 29, 2012 Decision Critical, Inc. [Member]	Dec. 31, 2013 Workforce Development [Member]	Dec. 31, 2012 Workforce Development [Member]	Dec. 31, 2011 Workforce Development [Member]	Dec. 31, 2013 Workforce Development [Member] Sy. Med Development, Inc. [Member]	Dec. 31, 2012 Workforce Development [Member] Sy. Med Development, Inc. [Member]	Dec. 31, 2012 Workforce Development [Member] Decision Critical, Inc. [Member]	Dec. 31, 2013 Research/Patient Experience [Member]	Dec. 31, 2012 Research/Patient Experience [Member]	Dec. 31, 2011 Research/Patient Experience [Member]	Dec. 31, 2013 Research/Patient Experience [Member] Baptist Leadership Group [Member]
Goodwill [Line Items]
Goodwill, beginning balance	$ 35,746	$ 29,299	$ 21,147				$ 6,300		$ 2,900	$ 11,592	$ 11,459	$ 3,307				$ 24,154	$ 17,840	$ 17,840
Goodwill acquired				133	5,291	6,314		2,861					133	5,291	2,861				6,314
Goodwill, ending balance	$ 35,746	$ 29,299	$ 21,147	$ 5,400			$ 6,300		$ 2,900	$ 11,592	$ 11,459	$ 3,307				$ 24,154	$ 17,840	$ 17,840