The thesis as a whole takes a constructivist approach to knowledge and to the reality around us. In these studies most knowledge was constructed together with the participants [
6]. For the development of an evaluation instrument a post-positivistic paradigm was applied, whereby the truth of teamwork was sought at a specific moment in time. The first study explored how clinical teachers themselves talk about their experience of teamwork in postgraduate medical training. The lived experiences of clinical teachers were studied using six focus groups (
n = 50) within a qualitative, phenomenological approach. The second study continued to build on the findings of the first study, in order to develop a valid and reliable instrument to evaluate the teamwork of clinical teachers. We conducted a mixed methods study with a Delphi procedure (
n = 40 experts), pilot tested the initial instrument (
n = 116 teaching teams), and performed various statistical analyses, such as principal component analysis, estimation of internal consistency reliability coefficient and computation on the number of evaluations needed to obtain reliable estimates. The mixed methods approach enabled us to identify measurable items based on the literature and the opinion of the experts, and to develop a reliable instrument based on investigating the psychometric qualities of the tool. We intended to develop an instrument to facilitate clinical teachers in making the shift from discussing the
teamwork constructs to contemplating the
results of evaluation as a first step in improving teamwork. The third study clarified the role of programme directors in the teaching team using a phenomenographic, qualitative approach in which ‘strategic leadership’ was used as the theoretical framework. This framework defines three key features of strategic leadership: (i) designing the organization, (ii) developing collectivity by providing information and (iii) collaborative learning. Using interviews (
n = 14) programme directors’ experiences with strategic leadership were examined [
7]. The fourth and final study added depth to the insights on teamwork by studying team communication during a formal teaching meeting. For data collection and analyses we used the behaviours of speaking up as theoretical framework: asking questions, seeking feedback and help, discussing mistakes and sharing information [
2]. It was a modified ethnographic study applying observations of the formal meetings, followed by interviews with the programme directors (
n = 10 teaching teams), based on audio fragments of the meeting.