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Evaluation of the effects of PBL learning in comparison to traditional instructional learning have proved to be a challenge.
Various factors can influence the implementation of PBL: extent of PBL incorporation into curriculum, group dynamics, nature of problems used, facilitator influence on group, and the motivation of the learners.
There are also various outcomes of PBL that can be measured including knowledge acquisition and clinical competence ( Schmidt & Moust, 2000 ; Neville, 2009 ).
Additional studies are needed to investigate all the variables ( Neville, 2009 ) and technological scaffolds ( Henry, Tawfik, Jonassen, Khanna and Winholtz, 2012 ) that may impact the efficacy PBL.

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