Traditional Precepts Research Articles

Reimagining Ummah: The Role of Third-Generation Immigrant Women in the Transformation of Turkish Islam in Europe

For decades, the traditional precepts of “Turkish Islam” have defined the community structure for Turkish immigrants in The Netherlands. Today, spiritualism rather than Islamic morality is emerging as the more compelling religious practice among young people, especially among women who are looking to break out of their culturally enclosed communities. This study uses the terms “enclosure” and “opening up” as metaphors for immigrant participation in Dutch society and suggests that religious Muslim women immigrants are both the founders and dismantlers of the two metaphors. Through their own narratives, women are shown to challenge and resolve social compartmentalization, and the role of cultural transmission through “Ummahtism” (the global Islamic community) is detailed as it is reinterpreted in Europe by Dutch–Turkish women. The findings of this paper are based on field research conducted in The Netherlands between September 2020 and April 2022.

Decoding visual culture

As visual narratives become potent tools for emotional manipulation, it is imperative for our educational paradigms to evolve beyond traditional precepts to address this shift. We introduce ‘The Visual Code’ – an innovative educational tool tailored to nurture the ability to decode visual cues, foster critical thought, and elevate self-awareness. This concept operates through a triadic process: attentive observation, active interpretation, and rigorous validation. With visual culture firmly ensconced in modern design's ethos, frameworks like Design Theory become pivotal in deconstructing its nuances. Our proposed model for bolstering visual literacy equips individuals to both comprehend and critique intricate visual narratives, enabling them to discern and potentially counteract undue influences. Through a meticulous analysis rooted in keen observation, this article delves into the multifaceted role of visual codes across diverse campaigns, from art history, through visual communication to designed products, we are advocating for a more informed and discerning viewer. An inclusion of empirical research enhances the validity of this model in the context of high-school design education.

Reimaging epistemology: A historical analysis of shifting paradigms

Over the past five decades, the field of epistemology has undergone a profound transformation that has challenged its traditional underpinnings. Previously, epistemologists ardently pursued the formulation of definitive rules for the attainment of absolute knowledge, basking in the quest for unwavering certainty. However, as time has passed, a collective realization has set in: the pursuit of undoubtable knowledge once the lodestar of epistemology has lost its luster and feasibility. This shifting intellectual landscape has brought the need for a fundamental reexamination of epistemology’s role and purpose to the forefront. The conventional role of epistemology as a proponent of unassailable principles for knowledge acquisition has waned. The once-central premise of epistemology, which claims the attainability of unshakeable certainty, now faces skepticism. Epistemologists grapple with a formidable question: Can we genuinely secure unquestionable knowledge in a world characterized by uncertainty and complexity? The prevailing sentiment among contemporary thinkers leans toward growing skepticism regarding the possibility of achieving undoubtable knowledge, necessitating a thorough reevaluation of the essence of epistemology. This profound reevaluation has given rise to two influential paradigms, the ‘psychologistic’ and ‘naturalistic’ projects, which seek to redefine epistemology’s scope and objectives, departing from traditional precepts. The field is currently undergoing a transformation within the crucible of these new paradigms, as this essay will delve into more deeply.

VIDA DE YOGA E NEO-HIDUÍSMO: IDENTIDADES E PERTENCIMENTOS

Abstract This article addresses the themes of embodiment of tradition and the building of new religious identities by the case study of a Vedanta group in Rio de Janeiro. From the historical context of the transnational movements that have propagated practices and beliefs of Hindu origin, we present the interlocutors’ religious identifications and lifestyles. We then discuss the tensions and contradictions involved in the discourses, to some extent ambiguous, about autonomy and belonging. The data collected in the field reveals the meanings of a life of yoga and the different levels of engagement with the Hindu tradition and its practices and rituals. Beyond the notion of conversion, we argue that the construction of this neo-Hindu identity not only involves restrictions and adaptations to traditional precepts, but also a creative experience of transformation through the choice of certain prescriptions, identifications, and behaviours.

Exploring Readiness for Teleprecepting in Psychiatric Mental Health Nurse Practitioner Training.

Telehealth offers a solution to many challenges in health care, including the shortage of psychiatric providers. Recently the need to limit patient and provider exposure to coronavirus disease 2019 (COVID-19) has escalated implementation of telehealth across the globe. As telehealth utilization expands, its role in nursing education and training requires systematic evaluation. Since publication of the National Organization of Nurse Practitioner Faculty white paper supporting telehealth in health care delivery and nurse practitioner education, several studies have demonstrated successful didactic instruction and training in telehealth. However, a recent literature review found no studies evaluating the use of telehealth technology as a means of precepting in clinical training. This small-scale qualitative study investigates the readiness of one behavioral health clinic to provide teleprecepting to psychiatric mental health nurse practitioner students. Two preceptors and one student were interviewed using a peer-reviewed semistructured interview guide using video chat. Responses were reviewed, coded, and categorized into themes. Thematic analysis of the interviews revealed three categories for consideration in establishing teleprecepting. Clinical factors, logistics, and comparison with traditional precepting are discussed. Interviewees viewed teleprecepting as a viable method of increasing access to clinical training. This project supports teleprecepting as a feasible strategy for improving access to clinical training and as a technological resource that merits systematic evaluation. Practice guidelines are needed for teleprecepting of advanced practice registered nurse students, and both preceptors and students may benefit from training to support best practices prior to implementation.

We Are The River

The New Zealand Parliament has recently granted the Whanganui River and the Te Urewera mountain ecosystem rights as legal persons, with a Māori governing board to speak for the nonhuman entities, based upon traditional cultural precepts. Far from an isolated precedent, in what the U.N. Secretary General calls “the fastest growing legal movement of the twenty-first century,” legislatures, courts, or voters in Australia, Colombia, Ecuador, Bangladesh, India, Uganda, and the U.S. have also declared that rivers and other living systems have legal rights. This Article chronicles the movement to grant nonhuman entities legal rights. I analyze the statutes and judicial opinions driving this legal evolution, drawing extensively from interviews I conducted with key figures negotiating and advocating for these initiatives. I explain what the current and developing laws and judicial opinions seek to achieve. Deriving from disparate historical, philosophical, and legal backgrounds, they pursue disparate goals; yet all of the moves to grant legal rights to nonhuman entities aim to enshrine in the law the fundamental symbiosis between human and nonhuman ecological health, and to empower suitable stewards who will nurture that symbiosis. I describe how newly vested spokespersons for nature seek to turn novel legal theories into real legal work that protects human and nonhuman communities. I explain who now represents the nonhuman entity and discuss what improvements--for human and nonhuman communities--they hope will redound that would not have resulted from more traditional legal protections. I also discuss early results that have emerged from grants of legal personhood to nonhuman entities. As these laws inscribe new legal relationships between people and nature, they ask: what does it mean to convert from “we own the River” to “we are the River?” I conclude that by sanctifying the interdependent relationship between human needs and healthy ecosystems, granting legal *546 rights to rivers may contribute to reversing ecological degradation in this century and beyond.

The Work of Art in the Age of Advertising: The Case of Estridentismo

This paper analyzes the intense engagement of Estridentismo—Mexico’s most important avant-garde literary movement of the 1920s—with the contemporary culture of advertising. By focusing specifically on Manuel Maples Arce’s manifesto Actual No 1 and German List Arzubide’s El movimiento estridentista, this paper shows the ambiguous attitude of Estridentismo towards advertising. On the one hand, Estridentista artists showed a true fascination with advertising as a new artistic paradigm that, like the avant-garde project, broke with traditional artistic precepts. Despite their aesthetic attraction to advertising, both Maples Arce and List Arzubide used parody to mimic the discourse of marketing to criticize the culture of mass consumption that characterized contemporary capitalism. Through their parodic appropriation of advertising, both authors claim humor as an effective tool of political and social critique that challenges the economic values and literary expectations of their audiences

Irish Women Evicted: The Rural Home and the Gendered Politics of Economic Morality in Claire Keegan’s Walk the Blue Fields

At first glance Claire Keegan’s collection of short stories Walk the Blue Fields, published during the tail end of the Celtic Tiger, seems out of place. While her contemporaries situate their counter-narratives of wealth disparity, gender identity crisis, and familial demise within urban high-rises, impoverished slums, and brooding cityscapes, Keegan’s priests, farmers, and housewives inhabit a seemingly timeless rural Ireland filled with sprawling farmlands, Protestant estates, and ancient cliffs. However, Keegan destabilises and re-appropriates traditional Ireland, making the rural a resource for challenging the gendered hierarchy of spatial, and by extension, economic relations in contemporary Ireland through the image of the home. In both ‘The Parting Gift’ and ‘Night of the Quicken Trees’, not only does Keegan position women in precarious relationships to land, property, and the rural home to identify the unequal social impact of economic morality for women, but also to illuminate the ways in which the continuing dependence on traditional precepts of gender and national belonging are employed to regulate what the prevailing power structures of the state conceive as a threatening femininity in contemporary Ireland. Underneath the rhetoric of hostile femininity, Keegan reveals the regressive and unequal gendered moral logic present within a neoliberal ‘new’ Ireland.

Education as self-government: the Minhaj Education Society’s answer to managing violence in Pakistan

ABSTRACT Development thinking and planning consistently identify religious markers of self-development as inimical to social cohesion in the Global South. Practitioners in the field see any educational philosophy that emphasises the disciplined formation of character by non-secular means as an undesirable reaction to modernisation. Religious or madrasa education is identified as an intrinsically regressive aspect of the indigenous social order that limits the transition to an open-access-order society. Using qualitative data from interviews with the managers of an NGO and a political-reform movement in Pakistan, we explore this conclusion and ask whether the secular norms of citizenship, often insisted upon by the international donor community, are strong enough to challenge residual violence. If they are not strong enough, what resources are available within traditional precepts about self-government such that Pakistanis do not need to learn lessons from Europe to protect minorities from communal predation?

The struggle for clinical ethics in Jordanian Hospitals.

The Arab and Islamic world is in cultural, political and ethical flux. Pressures of globalisation contend with ancient ideas and concepts that permeate cultural frameworks. Health professionals are among the many groups battling to accommodate the rapidly changing conditions. In many predominantly Muslim countries intense debates are underway among clinicians about the impact of the forces of change on their practices. To help understand these forces we conducted a study of the experiences of clinicians in the Hashemite Kingdom of Jordan, a Middle Eastern nation state where the overwhelming majority of the population is Muslim. The sample contained 508 doctors and doctors-in-training, of whom 63% were male and 80% were younger than 40 years of age. It included both a quantitative survey, covering a wide range of issues, and qualitative, free-text written responses. Our results demonstrated high levels of disquiet related to the overall organisation and administration of the health care system, the specific content of ethical decisionmaking, and the impact of changing social, cultural and religious factors. Concerns included overcrowding, widespread corruption and hierarchical, non- democratic, management practices, and tensions relating to traditional and modern approaches to ethics, especially in relation to consent, organ donation, confidentiality, privacy, abortion, and the role of women. The roles of religion and religious authorities, the relative importance of the family, and community and tribal obligations were also areas of contention. The study exposes profound divisions and widely differing perspectives among Jordanian doctors and an abiding sense of uncertainty and instability within the profession. Many doctors express ambivalence in relation to both modern trends and traditional precepts. Three main axes of ethical contention were demonstrated, relating to the tensions between: "conservative" and "pragmatic" styles of decision-making; "traditional" approaches and internationalised standards of ethics; and the role of Islam and pressures to disengage ethical decision- making from religious authority. We speculate that these issues and divisions, and the deep sense of disquiet revealed by our data reflect large-scale forces to which Jordanian society is exposed and to a substantial degree may provide a way to understand the ethical predicament of many other countries in the contemporary Arab world.

Concrete and non-concrete: exploring the contemporary authenticity of historic replicas through an ethnographic study of the St John’s Cross replica, Iona

ABSTRACTWhat do we actually know about how replicas of historical objects and monuments ‘work’ in heritage contexts, in particular their authenticity, cultural significance and intangible qualities? In this article we examine this question drawing on ethnographic research surrounding the 1970 concrete replica of the eighth-century St John’s Cross on Iona, Scotland. Challenging traditional precepts that seek authenticity in qualities intrinsic to original historic objects, we show how replicas can acquire authenticity and ‘pastness’, linked to materiality, craft practices, creativity, and place. We argue that their authenticity is founded on the networks of relationships between people, places and things that they come to embody, as well as their dynamic material qualities. The cultural biographies of replicas, and the ‘felt relationships’ associated with them, play a key role in the generation and negotiation of authenticity, while at the same time informing the authenticity and value of their historic counterparts through the ‘composite biographies’ produced. As things in their own right, replicas can ‘work’ for us if we let them, particularly if clues are available about their makers’ passion, creativity and craft.

Boiardo and Ariosto in Contemporary Sicilian Puppet Theater and the Tuscan-Emilian Epic Maggio

Boiardo and Ariosto in Contemporary Sicilian Puppet Theater and the Tuscan-Emilian Epic Maggio Jo Ann Cavallo Characters from medieval and Renaissance chivalric texts have been given tangible form through the centuries not only in operatic, melodramatic, theatrical and, more recently, cinematic adaptations, but also in popular performance traditions such as Sicilian puppet theater (opera dei pupi) and the folk operas (maggi epici) of the Tuscan-Emilian Apennines. This essay traces the reimagining of a sampling of non-Christian characters and non-European places from Matteo Maria Boiardo’s Orlando Innamorato and Ludovico Ariosto’s Orlando Furioso by a number of contemporary puppet theater and maggio companies. My contention is that an examination of select scenes available online, in conjunction with a close reading of the original episodes, may help students think more deeply about perennial issues addressed in the two poems—related to gender roles, the foreign and religious Other, violence, and political power—that continue to be relevant today.1 [End Page 48] Sicilian puppet theater No art form has devoted as sustained and elaborate attention to the Orlando Innamorato and the Orlando Furioso as Sicilian puppet theater.2 Although today we are past the time when Orlando and his fellow knights relived their adventures a puntate every evening in teatrini across Sicily and beyond, we can still encounter puppeteers, especially in Palermo, Catania, and Siracusa, who regularly present episodes from the two poems. The plays may be adapted for audiences who are no longer familiar with the original stories, but the puppeteers themselves have an intimate knowledge of their sources and make meaningful choices as they adapt narratives for the stage.3 Angelica The two most popular plays performed in Sicily today are the Innamorato’s battle between Rinaldo and Orlando for Angelica and the Furioso’s madness of Orlando. Since Angelica is central to both episodes, these plays offer ample material for a comparative examination of her character in contemporary Sicilian puppet theater. Regarding Angelica’s physical features, neither Boiardo nor Ariosto exoticize her beauty and a longstanding Italian and European artistic tradition has for the most part represented her with European features and dress. Most traditional Sicilian puppeteers have followed suit—with one difference. Although both Boiardo and Ariosto refer to Angelica as a blonde, matching Italian Renaissance standards for ideal beauty, most of the Angelicas I have encountered when attending puppet plays and visiting puppet museums in Sicily since 2000 have had dark brown hair, possibly reflecting the more Mediterranean colors of Sicilian women.4 When I asked members of the traditional public to [End Page 49] describe Angelica, the reply was invariably that she was beautiful, tout court. Nor did her clothing set her apart as a foreigner. As the puppeteer Enzo Rossi explained, the traditional puppeteer’s wife simply made sure that Angelica had the most elaborate and exquisite outfit.5 One can also find exceptions to the general Europeanization of Angelica. The puppeteer Enzo Mancuso (Associazione Carlo Magno, Palermo) remembers that his uncle constructed a brown-toned Angelica, remarking: “Questa è una Angelica che mio zio ha visto sempre così, ha visto sempre mulatta perché giustamente è indiana.”6 The puppeteer Alfredo Mauceri (Compagnia dei Pupari Vaccaro-Mauceri, Siracusa) decided to render more visible Angelica’s foreign status initially by constructing an Indian Angelica—complete with a bindi, nose earring, and henna tattoo—and subsequently by dressing her in Middle Eastern garb that, as the puppeteer himself explains, “non è certo un abito tipico del Catai, ma ciò consente di distinguerla dagli abiti europei indossati dalle altre dame.”7 In addition to giving Angelica a physical form, puppeteers also develop her character through action and dialogue. The question my students have found most compelling has been whether the plays pick up on and accentuate her more dangerous and seductive connotations or whether they instead bring her more in line with traditional precepts for female conduct. Most Sicilian puppet plays I’ve been able to film tend to temper her more compromising moments, perhaps to avoid any behavior that would be considered outside accepted norms. Regarding, for example, the staging of the Innamorato’s opening scene in Charlemagne’s court, the puppeteer Salvatore Oliveri (Compagnia...

‘Destination’ Berlin revisited. From (new) tourism towards a pentagon of mobility and place consumption

ABSTRACTThis article is concerned with the increasing role and relevance of tourism in processes of urban change as well as its overlap and interplay with other mobilities and place consumption practices. It responds to recent debates surrounding the extension and intensification of ‘touristification’ processes in urban areas and uses the case of Berlin to draw attention to a number of intricacies and complexities that complicate their interpretation. The main argument the article advances is that developments in Berlin which are currently discussed under the rubric of ‘touristification’ can by no means be exclusively attributed to tourism, however conceived, and instead illustrate the need to adopt new ways of approaching and understanding what is perceived as tourism-induced urban change. To this end, the article will present a preliminary heuristic portrayal of (tourism) mobility and place consumption as a pentagon with five interrelated but distinct dimensions and present several salient issues and questions that warrant further investigation. The paper will conclude with some brief reflections concerning the wider implications of the increased centrality of mobility flows and place consumption practices in today's cities. These, it will be argued, not only challenge the way we think about tourism. Rather, they also raise fundamental questions concerning our understanding of cities and neighbourhoods, the ‘legitimacy’ of particular claims over them, as well as several traditional precepts of modern urban planning and management.

Home Is Where Mother Is: Ideals and Realities in Australian Family Houses of the 1950s

ABSTRACTFollowing the austerity of war, Australians in the 1950s were keen to pursue their inter-related ambitions of building families and homes. Architectural design was heavily influenced by modernism and focused particularly on the perceived needs of mothers and children, imagined to be ever-present in the home. Architects recommended modernising and centralising the kitchen so that the mother could efficiently complete chores while supervising her children. They advised designing children’s bedrooms to provide privacy and stimulate creativity, as well as incorporating indoor and outdoor play areas. While these ideals were promoted in housing magazines, analysis of other sources reveals that the reality of 1950s housing was more complex. Many Australians lived in dwellings representing the design conventions of previous eras. For those building new houses in the 1950s, postwar shortages and personal finances often constrained aspirations. Others disliked the fact that modernism challenged traditional spatial and social precepts. Even for that minority residing in newly constructed, architecturally designed housing, families did not always inhabit domestic spaces in the manner anticipated by architects. Attention to a range of historical sources allows a fuller understanding of the broad spectrum of postwar housing and the diverse ways in which 1950s Australian families dwelt in their homes.

Informed Consent for Comparative Effectiveness Research Should Include Risks of Standard Care

Recent research controversies and debate have called into question whether existing ethical norms and regulatory structures adequately address the challenges of comparative effectiveness research (CER). CER studies generally make head-to-head comparisons of commonly accepted medical treatments to compare outcomes between patient-subjects. Much of the debate about CER has been over consent—the kind of disclosures necessary for the consent of research subjects to be considered properly informed, but even whether obtaining consent is or should be required. But this debate is also part of a larger conversation about whether certain traditional precepts of research ethics remain valid. This article explains that comparative effectiveness research (CER) must continue to be regulated as research, rather than treated as clinical care, and that informed consent for randomized CER must include risks of standard care. Uncertainty about which standard treatment is “better” does not mean a study is minimal risk and does not obviate the need for informed consent. Using the controversial SUPPORT Study, which altered the breathing therapies of premature infants, the article explains how and why disclosures of risks of standard care in CER are legally and ethically required.

Evaluation of a novel tablet application for improvement in colonoscopy training and mentoring (with video)

Endoscopic training can be challenging for the trainee and preceptor. Frustration can result from ineffective communication regarding areas of interest. Our team developed a novel tablet application for real-time mirroring of the colonoscopy examination that allows preceptors to make annotations directly on the viewing monitor. The potential for improvement in team proficiency and satisfaction is unknown. The on-screen endoscopic image is mirrored to an Android tablet and permits real-time annotation directly on the in-room endoscopic image display. Preceptors can also "freeze-frame" an image and provide visual on-screen instruction (telestration). Trainees, precepted by a GI attending, were 1:1 randomized to perform colonoscopy on a training phantom using the application with traditional precepting or traditional precepting alone. Magnetized polyps (size< 5mm) were placed in 1 of 5 preset location scenarios. Each trainee performed a total of 10 colonoscopies and completed each location scenario twice. During withdrawal, the trainee and the attending identified polyps. Outcome measures included number of polyps missed and participant satisfaction after each trial. Fifteen trainees (6 novice and 9 GI fellows) performed a total of 150 colonoscopies where 330 polypsin total were placed. Fellows missed fewer polyps using the tablet versus traditional precepting alone (4.2% vs 12.5%; P= .04). There was no significant difference in missed polyps for novices (12.5% vs 18.8%; P= .66). Overall, fellows missed fewer polyps when compared with novices regardless of the precepting method (P= .01). The attending and all trainees reported reduced stress with improved communication using the tablet. Fellows missed fewer polyps using the tablet when compared with traditional endoscopy precepting. All trainees reported reduced stress, quicker identification of polyps, and improved educational satisfaction using the tablet. Our application has the potential to improve trainee plus attending team lesion detection and to enhance the endoscopy training experience for both the trainee and attending preceptor.

Stabilizing and Retaining a Quality Nursing Work Force Through the Use of the Married State Preceptorship Model

The nursing shortage requires new graduate registered nurses (RNs) to work at the bedside, often leading to a shortened orientation period and increased stress. In the Married State Preceptorship Model (MSPM), the preceptor and the preceptee work together as the new graduate RN transitions to the bedside while maintaining safety and quality. This study explored first-year turnover rates of new graduate RNs and new graduate RNs' and preceptors' perceptions of the MSPM in transitioning new graduate RNs to practice. Focus groups and surveys were used with 108 new graduate RNs and 100 preceptors. Four themes emerged for new graduate RNs: partnership, critical thinking, learning, and transition. A statistically significant decrease in turnover rates was seen with MSPM versus traditional precepting. Survey data found that new graduate RNs and preceptors perceived the MSPM as promoting safety and reducing anxiety. The MSPM allows organizations to retain a quality nursing work force focused on safety patient care by transitioning new graduate RNs into the practice setting.

Romanian Beliefs and Rites of Pregnancy with Special Reference to Moldova

Traditional beliefs and customs concerning pregnancy and childbirth are still numerous and vivid in Romania and among Romanian inhabitants in neighbouring countries. Fieldwork on this theme carried out over several decades has resulted in a large body of material showing the special position of a pregnant woman in traditional Romanian society. This paper deals specifically with Moldovan birth tradition and concentrates on society's view of the pregnant woman and her unborn child as indicated by the large variety of beliefs and traditions aimed at protecting her and her child. It is evident from this material, that both the prospective mother and society are expected to be aware of, and to engage with, traditional precepts concerning the healthy development of the foetus and the achievement of an unblemished birth. It is also clear that the role and influence of the former untrained midwife in the magical protection of the mother and her child are still part of cultural memory in Moldova. The idea that a pregnant woman has the ability to bring rain in times of drought seems to emanate from a traditional perception of her as embodying fertility powers linked or analogous to the earth's germinative capacity.

Retainer Medicine: An Ethically Legitimate Form of Practice That Can Improve Primary Care

Retainer medicine has become an important yet controversial form of primary care practice in the United States, coming under attack for its purported failure to measure up to professional ethics. Critics opine that retainer medicine obstructs professional commitments to health care access and social justice. Some ethicists urge that society should restrict or ban retainer medicine; professional organizations have yet to take a stand. The authors believe that retainer medicine is compatible with professional ethics and will more likely aid in solving the difficulties facing primary care rather than add to them. Although professional ethics should evolve to address new conditions, a condemnation of retainer medicine is warranted neither by traditional ethical precepts nor by contemporary developments in medical ethics. Any move to sanction retainer medicine under the banner of professionalism or professional ethics will be counterproductive. The primary care shortage will only get worse if physicians in retainer practice leave primary care altogether, a likely outcome of legal or professional condemnation of retainer practice.

Observation of Resident Clinical Skills: Outcomes of a Program of Direct Observation in the Continuity Clinic Setting

Objective To assess the feasibility of a new multi-institutional program of direct observation and report what faculty observed and the feedback they provided. Methods A program of direct observation of real patient encounters was implemented in 3 pediatric residency programs using a structured clinical observation (SCO) form to document what was observed and the feedback given. Outcome variables included the number of observations made, the nature of the feedback provided, resident attitudes about direct observation before and after implementation, and the response of the faculty. Results Seventy-nine preceptors and 145 residents participated; 320 SCO forms were completed. Faculty provided feedback in 4 areas: content, process of the encounter, patient-centered attitudes and behaviors, and interpersonal skills. Feedback was 85% specific and 41% corrective. Corrective feedback was most frequent for physical examination skills. After program implementation, residents reported an increase in feedback and a decrease in discomfort with direct observation; in addition, they agreed that direct observation was a valuable component of their education. Participation rates among faculty were high. Conclusions Direct observation using SCOs results in timely and specific feedback to residents about behaviors rarely observed in traditional precepting models. Resident competency in these clinical skill domains is critical for assessing, diagnosing, and managing patients. The SCO methodology is a feasible way to provide formative feedback to residents about their clinical skills.