In this chapter we look at how clinical skills develop over time, at the diversity of skills to be learned, and at the inherently social and interactive character of the learning process. Learning to identify when something has “gone wrong”—that is, to identify discrepancies from what was expected—is a crucial element of this process of learning clinical skills and continuing to improve those skills over time. We also explain why and how ethics pervades the performance of all clinical tasks, as well as why attention to the touchstones for learning and touchstone questions serves as a means of understanding and addressing the ethical challenges and problems of the clinical milieu.