In this article, we explore how teacher preparation programs have developed from the mid-1800s to present day, emphasizing changes in the clinical component. Drawing from the history of teacher education from the normal schools of the 19th century to present-day interest in clinically based preparation, we first review the migration of teacher preparation from normal schools into higher education. Next we discuss how accreditation has shaped programs. We then turn our attention to major initiatives in the 1980s that explicitly focused on linking school improvement with teacher education reform-partnerships that emphasized clinical aspects of teacher preparation. Finally, we discuss efforts to enhance clinical learning, highlighting instructional strategies and issues regarding design, settings, and outcomes for programs as they work to meet challenging new accreditation standards.