An educational instrument, the Clinical Teaching Techniques Self-assessment Inventory, was designed and administered to determine how clinical instructors react to difficult aspects of medical student instruction such as involving, facilitating, serving as a resource, problem solving, role modelling and clinical supervision. It confirmed the hypothesis that in such situations, teachers choose instructional techniques which limit active student involvement in patient care. That is, they selected the techniques of role modelling and providing feedback more frequently than those of facilitating and involving. This contrasts with students' views on what they consider to be important factors contributing to learning clinical medicine, namely assuming responsibility for their own learning and becoming involved in patient care. Requests for the instrument, together with feedback material for teachers, have been received from 18 medical schools.