The clinical performance of junior hospital staff concerning the management of patients with acute abdominal pain, may be enhanced by placing greater emphasis on teaching clinical decision-making skills during the pre-intern year. Final year medical students at the Royal Prince Alfred Hospital (RPAH) took part in a teaching session where groups of 6–8 rotated through six stations, each structured to present a critical management problem concerning a patient with acute abdominal pain. Students, guided by a tutor, spent 25 minutes at each station, working through the sequence of data acquisition and data analysis before making a management decision. To assess the educational value of the programme, the study group completed a sequence of pre-test, structured teaching and post-test over a period of 2 weeks. Their multiple choice question (MCQ) performance was compared with a control group from a different campus who also did the pre-and post-test but without the teaching. The study group (n = 38) significantly (p<0.001) improved their MCQ mark from a pre-test mean 68% (SD 8) to 74% (SD 6) following the teaching. The performance of the control group (n = 25), with no teaching, did not change significantly (p = 0.5) between pre-test (mean 66% SD 13) and post-test (mean 68% SD 6). The method appears an effective way to teach critical decision-making skills to medical students. Students regarded the innovation as educationally more effective than traditional teaching methods.