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The medicine wheel is a native American form of spiritual organization. It organizes all the energies in the world as North, South, East or West. Each direction has a element, time of day, time of the year, time of life (although any one may be dominate at any point in your life) and patron totem. All though every direction has a patron totem, all totems can fit in here.
The medicine wheel has many uses. It can be used in prayer or blessing (as is shown in the Book of Shadows topic), in ritual, in the calling of sacred powers, in meditation, and, yes, as a circle in a sacred spot. As this is not it's only use, and not even THE major one (though it is A major one), however, I did not see fit to post this in the circles topic.
In the medicine wheel, there is one addition to the for directions. Center. Usually represented by quartz, it is where all things come from. This includes the other directions.
Whenever you start something useing the medicine wheel it is proper to start from the East. This is because the east is for new begginings, childhood, the morning, fire and spring. It's patron totems are Hawk and Eagle. Deer are also important totems here.
The South is where you go next. It is noon, middle life and summer. It is represented by hard work. Coyote is it's patron totem, though mouse is important as well. While Mouse stands for hard work, Coyote reminds us to laugh at ourselves. It is represented by the element of Earth, and sometimes as 'the Green Man'.
Next is the West. The West is sunset, old age and death, and the autumn. It is the time of darkness. It is water, and water is emotion. Patron totems are Bear and Snake, though Owl is important also. I personally feel awe when looking at the west and the north, as aposed to the feeling of joy I have when I think of the others. This is not to say I don't have upmost respect for them all, they just bring up diffrent emotions for me.
Finally, North. North is the time between birth and death. It is a place of spirits. It is midnight and the winter. It is endurance, as is seen in it's patron totem, the Buffalo. Several other creatures have species that stradle here. The sacred are thought of as of the North. It is a mysterious and wonderous place.

That's all I have for now. I'm no shaman, and I may correct myself later. I will try to answer any questions.

O.o Isn't that supposed to be the Fool...?

Yeah, traditionally the fool is zero. They just renamed them. I personally grew up with tarot, so that suprised me. What's the name of your deck?

That's probably it.