The medical educational environment has been studied extensively in the past decades

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Study 1 - In-depth search for theoretical frameworks
Following the Cochrane Library and the Best Evidence Medical Education (BEME) guidelines, we performed a thorough search for articles describing the development of medical educational environment instruments (Moher et al., 2009; Best Evidence Medical Education Collaboration, 2003). Starting with the included publications, we applied a snowballing technique – comparable to the method applied by Teunissen and Westerman (2011) – in order to find a theoretical framework, which defines the essential concepts that should be measured to ascertain the quality of the educational environment. The first step was to explore whether the medical educational environment instruments were constructed using previously developed educational environment instruments. To ease the readability of our text, we will call the latter underlying instruments. The second step involved the examination of which theoretical frameworks, if any, were used to construct these underlying instruments. Subsequently, we repeated step 1 and 2 for all underlying instruments until arriving at their origins.

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