We designed a pharmaceutical care lab facility to model an ambulatory pharmaceutical care practice site. In addition to an idealized physical layout, we developed record keeping procedures and a personnel structure intended to maximize pharmacist time for patient care activities. Students in the first-year of the pharmaceutical care laboratory were trained by second-year students in the technical aspects of drug distribution such as computer data entry, preparation of patient profiles, dispensing and packaging of medications, and aseptic preparation of drugs. Students in the second year of the laboratory sequence were cultivated in the pharmaceutical care role: patient evaluation, interpretation of medication history and profile information, identification, solving and documentation of drug-related problems, and patient counseling. Students were grouped during laboratory exercises such that two first-year students provided technical support to a more advanced student who demonstrated techniques, provided coaching and then checked the technical competence of the first-year students. The levels of competency of peer-teacher-trained students and the validity of checklist evaluations by the peer teachers were assessed by the Pharmaceutical Care Lab faculty after completion of each of three technical skills units. This paper describes the training of first-year students in technical skills by students in the second year of the laboratory course as well as the exercises, logistical management and competency assessment tools used in the technical training. We conclude that peer teaching is a very useful teaching method for reinforcing technical skills and providing better instructor:student ratios in the laboratory.