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Portfolios – The 5 Ws. David Taylor School of Medical Education University of Liverpool. The five Ws. Who What Where When hoW. Why ?. There are many ways of assessing knowledge and skills But we need some way of recording activities
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Portfolios – The 5 Ws David Taylor School of Medical Education University of Liverpool
The five Ws • Who • What • Where • When • hoW
Why ? • There are many ways of assessing knowledge and skills • But we need some way of recording activities • And developing and demonstrating appropriate attitudes
Who • Our course is five years long, and is followed by two years in foundation posts before the Doctor is fully registered and allowed to practice independently.
Who (2) • We currently use portfolios in years 1,3 & 5 of the undergraduate course F1, F2 • And for consultants, academics and anyone seeking promotion
What is a portfolio • It is a collection of documents • Supported by a commentary • It can be electronic • more convenient in the University context • It can be on paper • More convenient in the clinical context
What documents? • It depends on the reason for the portfolio! • Diaries • Log-books • Case notes • Examination results • Longer discursive pieces
Dewey (1933) • Reflection is… • A purposeful form of thought provoked in learners when they recognize that their understanding is incomplete.
In order to reflect • 3 things are needed • something to reflect on • reflection time & modelling • motivation • Albanese,2006,Medical Education 40;288-290
What sort of commentary? • Technical • What and how of practice • Facts and theories • Audit • Practical • How decisions are made • Articulate concerns • Resolve professional dilemmas • Critical • Social and political context and constraints
What is included • The portfolios all include examination results and the student commentary on them. • In the first year they also include reflection on settling in and adjusting to University life. • In the third year they include reflections on professional attitudes students have experienced or observed.
What is included in later years • In fifth and subsequent years they also include reflection on particular cases/treatment regimes • In F1/F2 and beyond they will include reflection upon critical incidents
When • Right from the start and often • Habit helps • Novelty is important • So we focus on different things each year • Settling in, clinical experiences, ethical behaviour, evidence base to medical practice, audit, future plans, critical incidents • It has to be relevant • In the clinical arena it will focus on cases determined by the agreed learning outcomes
Where • Wherever the student works • In the first/second year this is often at the computer, so we use electronic portfolios • In the UK the hospital computers won’t “talk” to the internet, so where a VPN can’t be set up we use…. • Paper, and interviews, formal and informal, with the educational supervisors
How • How is it assessed? • Through discussion with a supervisor • The whole thing? • The reflective component? • Parts chosen by the student? • Parts chosen by the supervisor?
Marks? • Best practice currently is to use criteria rather than a “checklist” • The criteria need aggregating in domains • KSA • Burch, Seggie and Gary 2006 SAMJ 96;430-433 • The number of raters needed for validity depends on the criteria and the domains • Roberts et al.,2006 Med Educ 40;363-370
How (2) • It is the main form of assessment for our final year students. • They sit “finals” at the end of their fourth year. • Their final year is a clinical apprenticeship, assessed through the portfolios. • 5 different assessors (3 meetings each - plus referees in the case of difficulty/expected difficulty) • Mid-Year portfolio review (all borderline/fails and sample of others) • End of year review of borderline/fails
Benefits • Allows the student to demonstrate insight and understanding • Allows student and staff to observe development and progress • Models the “real world” • Goes one step beyond the “competencies” model – in developing professionalism • Provides a focus (and evidence) for the discussion between student and doctor
