This study described the instructional practices of selected clinical medical school faculty. It addressed the following questions:

• how do medical and surgical clinical faculty select/design and combine instructional methods and media in teaching clinical content?

• what influences clinical faculty use of a particular method or medium for clinical teaching?

The primary purpose of this research was to investigate how clinical medical school faculty make pedagogical decisions and carry out their instruction in clinical patient care settings. The research described the clinical faculty members' instructional practices with medical students and how the medical apprenticeship system is used for their clinical instruction.

The research involved two medical schools and a sample of four clinical faculty representing surgical and medical practice. A general method of descriptive research was employed including the data-gathering techniques of participant observation, interviewing, and collection of documents. Strategies developed by Spradley (1980) and Erickson (1986) were used for data analysis.

Findings indicated that the sample clinical faculty do not use an instructional planning process such as described by Gagne and Briggs (1979) or Wildman and Burton (1981). Instead, they select instructional methods and media intuitively, carefully monitoring the medical students' reactions to their instruction. The data show the instructional techniques that include the human element -- defined here as personcentered methods -- are selected most often.