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The goal of this study is to examine how to facilitate cross-cultural groups in problem-based learning (PBL) using video triggers and computer-based technology tools. Medical students from Asia and North America participated in two sessions and watched physicians deliver bad news to a patient in two video cases. Experienced facilitators help support collaboration in the two PBL sessions. An expert facilitator provided advice using a chat box in the video conferencing system. This study examines strategies and challenges in facilitating PBL across distance and cultures using both an inductive analysis and Community of Inquiry analysis scheme. Several conjectures were developed for future research.