The checklist, developed for assessing trainees' performance of ward rounds in internal medicine, showed high content validity. Construct validity was supported by the higher scores of experienced doctors compared to those with less experience and the significant correlation between the observer's and nurses' global scores. The developed checklist should be valuable in guiding and assessing trainees on ward round performance.

discourse about current thinking and future approaches and challenges to research in, and application of, problem-based learning (PBL) in the learning environment. Diana Dolmans:Many claims are made for problem-based learning (PBL), which has been implemented worldwide across many schools. But what are these claims and what evidence is available so far? Does PBL enhance domain-specific knowledge acquisition? Does PBL enhance the application and transfer of domain-specific knowledge? Does PBL enhance the development of generic lifelong learning competencies? Does PBL enhance deep learning? Under which conditions is PBL effective and for what kinds of students? What are the working ingredients of PBL and why does PBL work or not work? There are many questions to be answered about PBL. You have conducted several reviews that shed light on some of the issues raised here and therefore I wonder what your opinions are on some of the claims made for PBL and on how to advance research in this domain. David Gijbels:Thank you for inviting me to this discussion and for sharing your questions with me. In a contribution on student achievement in PBL, 1 we looked at the numerous reviews of research into PBL that have been conducted since the influential review by Albanese and Mitchell 2 and came to the same conclusion as Strobel and van Barneveld 3 in their meta-synthesis of meta-analyses comparing PBL with learning in conventional classrooms: (i) traditional learning approaches tend to produce better outcomes on assessments of basic science knowledge, but don't always do so, and (ii) PBL approaches tend to produce better outcomes in terms of clinical knowledge and skills. The more recent meta-analyses point to the important roles of several mediating variables such as the type of problem tasks 4 and the level of assessment 5 in explaining the effects of PBL. In my opinion, when implementing or investigating PBL, much more attention should be paid to the conditions under which the effects of PBL can be maximised. This also links to the question of what should be considered as PBL and what learning environments should be labelled otherwise. In other words: what kind of learning environment are we talking about when we use the PBL label? When writing reviews on PBL myself, I noted that although a learning environment may be labelled as PBL in a research paper, important information about the details of the learning environment is often lacking. (For example: what kinds of problems are used? How many students are enrolled in a group? What is the role of the tutor? How much time is allocated to discussion? How are students assessed?) Furthermore, individual differences in students are not taken into account enough in discussions of the effects of learning environments such as PBL. 6 To conclude, assessing a PBL versus a conventional lecture-based learning environment (or, more broadly, assessing whether the claims of PBL are justified) is probably less important than the following question: what kind of learning environment works ...

An essential part of problem-based learning (PBL) is group learning. Thus, an in depth understanding of the theoretical underpinnings of group learning in PBL allows educators to bridge theory and practice more effectively thus providing ideas and tools to enhance PBL practices and research. The theory-driven applications examined in this article establish grounds for future research in PBL. The purpose of this article is to describe and examine two theoretical perspectives of group learning in PBL and their potential applications to improve educational practice. They include: (1) social interdependence theory and the meaning of positive interdependence, (2) socio cognitive theory of networked expertise and the concept of knowledge creation in innovative knowledge communities (IKC). Potential applications include the following: development of instructional material to foster positive interdependency using concept maps; formal and structured use of peer feedback throughout PBL courses to promote individual and group accountability; creation and sharing of new knowledge about different topics within and across IKC; and use of rotating students with hybrid abilities across PBL groups to foster distributed cognition.

Group interactions in seminar groups are dominated by the posing of questions by teachers to students. The moderate occurrence of group interactions as perceived by students and teachers may be explained by the inadequate preparation of teachers and students to stimulate group interactions.

Background: Team-based care models (TBC) have demonstrated effectiveness to improve health outcomes for vulnerable diabetes patients but have proven difficult to implement in low income settings. Organizational conditions have been identified as influential on the implementation of TBC. This scoping review aims to answer the question: What is known from the scientific literature about how organizational conditions enable or inhibit TBC for diabetic patients in primary care settings, particularly settings that serve low-income patients? Methods: A scoping review study design was selected to identify key concepts and research gaps in the literature related to the impact of organizational conditions on TBC. Twenty-six articles were finally selected and included in this review. This scoping review was carried out following a directed content analysis approach. Results: While it is assumed that trained health professionals from diverse disciplines working in a common setting will sort it out and work as a team, co-location, and health professions education alone do not improve patient outcomes for diabetic patients. Health system, organization, and/or team level factors affect the way in which members of a care team, including patients and caregivers, collaborate to improve health outcomes. Organizational factors span across seven categories: governance and policies, structure and process, workplace culture, resources, team skills and knowledge, financial implications, and technology. These organizational factors are cited throughout the literature as important to TBC, however, research on the organizational conditions that enable and inhibit TBC for diabetic patients is extremely limited. Dispersed organizational factors are cited throughout the literature, but only one study specifically assesses the effect of organizational factors on TBC. Thematic analysis was used to categorize organizational factors in the literature about TBC and diabetes and a framework for analysis and definitions for key terms is presented. Conclusions: The review identified significant gaps in the literature relating to the study of organizational conditions that enable or inhibit TBC for low-income patients with diabetes. Efforts need to be carried out to establish unifying terminology and frameworks across the field to help explain the relationship between organizational conditions and TBC for diabetes. Gaps in the literature include research be based on organizational theories, research carried out in low-income settings and low and middle income countries, research explaining the difference between the organizational conditions that impact the implementation of TBC vs. maintaining or sustaining TBC and the interaction between organizational factors at the micro, meso and macro level and their impact on TBC. Few studies include information on patient outcomes, and fewer include information on low income settings. Further research is necessary on th...