PORTFOLIO AS A LEARNING TOOL FOR MEDICAL STUDENTS

1. PORTFOLIO AS A LEARNING TOOLFOR MEDICAL STUDENTS Kirsti Lonka, Ph.D., Professor of Medical Education, Centre for Cognition, Understanding, and Learning (CUL) Department of LIME Karolinska Institute, Stockholm, Sweden

2. THE CUL VISION • ”BestEvidence Medical Education”-Practices should be based on best possible evidence and innovative thinking.

3. SOME KEY ACTIVITIES OF CUL • Starting research groups • Faculty development of the teachers of Karolinska Institutet • KAROLINSKA INSTITUTET PRIZE FOR RESEACH IN MEDICAL EDUCATION (50 000 €, 2004) NOVEMBER 3, 2004! • International and National Research and Development Projects • Evaluation and assessment • KI Learning Lab

4. VAD ÄR REFLEKTION? • Att ha ett kritiskt förhållningssätt till sina handlingar • Att ta emot och ge feedback • Att ha distans till sig själv • Att ifrågasätta sina egna metoder

5. Integrated Competence • Knowledge • Skills • Ethics • Communication • Emotions -> Expert thinking and professional practice

6. Traditional approach to assessment in medical education? 60 % - of what?

7. PROBLEM IN MEDICAL EDUCATION? • Too much action, not enough reflection! • Overwhelming experiences that are never processed • Reflective practice calls for possibilities for systematically learning from the experience

8. TO SUPPORT LEARNING self-assessment students’ own development motivation for life-long learning are the central goals being met? formative TO CONTROL THE OUTCOMES grading, scoring performance, competing to please the teacher, to continue studies what are the criteria for passing? summative TWO AIMS OF ASSESSMENT (that may disturb each other)

9. WRITING SHAPES THINKING Research shows that writing is a powerfool tool for enhancing learning • The act of writing is an aid to students’ learning, a tool to be used in acquiring mastery over new information, and a means of revealing present understanding of a given subject • Properly implemented writing activities are effective in fostering good writing, and also encouraging more reasoned and disciplined thinking about the topics themselves. P.Tynjälä, L. Mason, & K. Lonka (Eds.) Writing as a Learning Tool: Integrating theory and practice. Studies in Writing, Vol. 7. Dordrecth, The Netherlands: Kluwer Academic Publishers.

10. WHAT DO WE KNOW ABOUT EFFECTIVE STUDY STRATEGIES? In Learning-from-text tests: • Only copying information is not efficient • Writing by own words or constructing visual maps enhances learning from text – especially when problem solving is called for • Students who only read texts without any note taking activity were the least successful in any kinds of tasks • (Lonka et al, 1994, Slotte & Lonka, 1999ab; 2001ab)

11. WHAT IS A PORTFOLIO? • PRODUCT: ”A collection of products of student work showing student reflection and progress or achievement over time in one or more areas” (Bryant & Timmins, 2002) • PROCESS: Using writing as a tool for reflection and systematic analysis of learning

12. WHY TO USELEARNING PORTFOLIOS? • to support and clarify professional development • helps to make the learning goals clear and to follow how they are achieved • an aid to students’ learning and knowledge • an aid for constant self-reflection and self-assessment • to support the learning process rather than control the learning outcomes • reveals the strengths and weaknesses of training, and helps developing better ways of learning

13. BEFORE book exams indirect criteria competing, product reproduction evaluating one course at a time concentrating on present state NOW course work, projects, portfolios cooperation, processes competencies, skills holistic evaluation previous and future potential looked at CURRENT TRENDS IN ASSESSMENT

14. Lonka, K. Slotte, V., Halttunen, M., Kurki, T., Tiitinen, A. Vaara, L. & Paavonen, J. (2001) Portfolios as a learning tool in obstetrics and gynaecology undergraduate training.Medical Education, 35, 1125-1130. • A special structured portfolio booklet for medical students in gynaecology training . • Objectives: 1 ) to support the learning process of the students. 2 ) to get information for enhancing the quality of teaching • 91 medical students who completed the portfolio during gynaecology training course.

15. RESULTS(Lonka et al, 2001) • The amount of text written in the portfolios correlated with success in a final exam • Using portfolio enhanced the learning process during the course • Portfolios also acted as learning logs, where students could report all procedures they carried out • Students appreciated the departmental interest in their development and feedback

16. The amount of text in a portfolio N Mean S.D. F-value Not much 16 65,80 9,31 In average 30 69,79 11,27 Much 37 77,16 10,95 4.17* Total 83 72,12 11,49 * = p< 0.001.

17. WHY NOT USE PORTFOLIOS? Using portfolios • challenges our traditional ways of thinking about teaching, learning and assessment • call for changing the learning culture for both teachers and students • Require team work and collaboration among academic and hospital staff • Provide fundamentally new kinds of knowledge about our students’ thinking and development – they are not stupid after all!