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We examined the extent to which consensus existed among hospital administrators' cognitive strategic groups and explored task and institutional factors that might influence these perceptions. We elicited perceived strategic groups from hospital administrators in a distinct geographic market using the full context form of the repertory grid. Our evidence indicates that beliefs are shared by a majority of administrators in the region, that differences in perception are associated with strategic position, and that cognitive groups focus managerial attention. These findings highlight the roles of both task and institutional environments on cognitive strategic group formation and suggest an important role for these groups in strategic decision-making.