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This study builds on three previous studies (Authors,2020,2021,2022). The first provides a snapshot of 204 PDS doctoral dissertations written between 1990 and 2018, and the second, a qualitative study of the subset of dissertations that focuses on aspects of learning in PDS. including student learning, teacher candidate learning, teacher learning, and teacher educator learning. The third study focuses on dissertations that compare PDS with non-PDS contexts and examines what can be learned from comparison studies. This fourth study focuses on teaching hospitals and what we can learn from their research that will help to inform future PDS research. Findings from this study suggest challenges and possibilities, and perhaps a direction for new research questions.