The teaching of clinical skills at a postgraduate hospital.

The teaching of 'clinical skills' is generally held to be central to postgraduate training in psychiatry, but the term itself has so far escaped exact definition. In an effort to study some of the component clinical abilities, their inter-relationships, and the factors promoting their transmission, all junior psychiatrists at the Maudsley Hospital were surveyed for their views on the clinical training they had received. Three hundred and seventy three assessement on 43 units were made. Trainees perceived the academic instruction and advice on formulating cases which they had received as being quite unrelated to the quality of help with interview skills and instruction in practical management, but feedback from the consultant to the trainee on the latter's performance was necessary for a high standard of both academic and practical instruction. Encouragement to do research was transmitted independently of other clinical teaching. Over a 3-year period the standard of multi-disciplinary teamwork appeared to improve, but there was a decline in the standard of academic instruction and in encouragement to do research. These overall differences were due to changes in the teaching staff, rather than alterations in teaching methods. Surveys such as this may help to define the goals of postgraduate clinical training, and also monitor the extent to which an institution is achieving these goals.