Clinical skills centres (CSCs) have contributed significantly to undergraduate medical education. Using alternative venues for training in communication skills, clinical examination and practical procedures they avoid jeopardising patient-care in traditional clinical settings. Using simulation they enable tutors to structure learning opportunities, provide standardized and reproducible experiences and create learner-centred environments where mistakes are permissible. However, recent changes in patients' attitudes and expectations and in students' and doctors' needs indicate that further changes in the delivery and learning of clinical skills are required. Four current trends in teaching and learning are emerging in CSCs. The range of delivery methods available is expanding; educational strategies are being adopted; a variety of assessment opportunities are being identified and the need for support mechanisms for students and tutors is being recognized. The implementation of these trends gives rise to a number of resource implications that must be met. Appropriate planning is required to ensure that the future contribution of CSCs will be successful in training healthcare professionals for practice in contemporary society.