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      Students' attitudes towards the introduction of a Personal and Professional Development portfolio: potential barriers and facilitators

      research-article
      1 , , 1 , 1
      BMC Medical Education
      BioMed Central

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          Abstract

          Background

          Portfolios, widely used in undergraduate and postgraduate medicine, have variable purposes, formats and success. A recent systematic review summarised factors necessary for successful portfolio introduction but there are no studies investigating the views of students inexperienced in portfolio use towards portfolio learning. This study's aim was to survey student views about a prospective Professional and Personal Development (PPD) portfolio.

          Methods

          This was a qualitative, focus group study. All focus groups were taped and transcribed verbatim, and anonymised. The transcripts were analysed inductively, using framework analysis.

          Results

          Four focus groups were carried out with 32 undergraduate medical students naïve in portfolio use. Three themes relevant to portfolio introduction emerged. The first theme was the need for clear information and support for portfolio introduction, and anxieties about how this could be supported effectively. The second was that students had negative views about reflective learning and whether this could be taught and assessed, believing formal assessment could foster socially acceptable content. The third was that participants revealed little understanding of reflective learning and its potential benefits. Rather portfolios were seen as useful for concrete purposes (e.g., job applications) not intrinsic benefits.

          Conclusion

          Undergraduate medical students without experience of portfolios are anxious about portfolio introduction. They require support in developing reflective learning skills. Care must be taken to ensure students do not see portfolios as merely yet another assessment hurdle.

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          Most cited references13

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          Portfolios in medical education: why do they meet with mixed success? A systematic review.

          The move towards competence-based medical education has created a need for instruments that support and assess competence development. Portfolios seem suitable but mixed reports of their success are emerging. To examine the effectiveness of portfolios, we searched PubMed and EMBASE using the keyword 'portfol*', PsychInfo and ERIC using the keywords 'portfol*' and 'medical education' and references of retrieved papers for empirical studies on portfolios in all phases of medical education. Thirty of 1939 retrieved papers met the inclusion criteria and were analysed. Data were collated against the research question, number of subjects, design, setting, findings and limitations, purpose and content, mentoring and assessment. We analysed impact using a modified version of Kirkpatrick's hierarchy. Because differences across studies precluded statistical meta-analysis, the data were analysed by context, goals and procedure. Positive effects were strongest in undergraduate education. Important factors for success were: clearly communicated goals and procedures; integration with curriculum and assessment; flexible structure; support through mentoring, and measures to heighten feasibility and reduce required time. Moderately good inter-rater reliability was reported and global criteria and discussions among raters were beneficial. Formative and summative assessment could be combined. Without assessment, portfolios were vulnerable to competition from other summative assessment instruments. For portfolios to be effective in supporting and assessing competence development, robust integration into the curriculum and tutor support are essential. Further studies should focus on the effectiveness and user-friendliness of portfolios, the merits of holistic assessment procedures, and the competences of an effective portfolio mentor.
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            Is it me or is it them? Factors that influence the passing of underperforming students.

            Research has found that clinical assessments do not always accurately reflect medical student performance. Barriers to failing underperformance in students have been identified in other vocational settings. Is 'failure to fail' an issue for medical educators in the UK, and, if so, what are its determinants? We carried out a qualitative focus group study exploring the views of medical educators (general practitioners, hospital doctors and non-clinical tutors) from two different UK medical schools. To make sense of a potential multitude of factors impacting on failure to fail, we selected the integrative model of behavioural prediction to underpin our data collection and analysis. Ten focus groups were carried out with 70 participants. Using both theory and data-driven framework analysis, we identified six main themes relevant to the integrative model of behavioural prediction. These are: tutor attitudes towards an individual student; tutor attitudes towards failing a student; normative beliefs and motivation to comply; efficacy beliefs (self-efficacy); skills and knowledge, and environmental constraints. Many different factors impact on medical educators' failure to report underperformance in students. There are conflicts between these factors and the need to report competence accurately (i.e. duty to protect the public). Although some of the barriers identified are similar to those found in previous studies, using a theory-based approach added value in that it facilitated a richer exploration of failure to fail. Insights offered in this study will be used to plan a questionnaire study and subsequent intervention to support medical educators in accurately reporting underperformance in students.
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              Portfolios in continuing medical education--effective and efficient?

              A cross over comparison between 'traditional' continuing medical education (CME) activities and portfolio-based learning in general practice is described. Thirty-two volunteer general practitioners (GPs) were divided into two cohorts; each cohort spent six months following a 'traditional' route to postgraduate educational accreditation (PGEA) and six months following a portfolio-based learning route supported by three CME tutors. These were the submission of a completed portfolio with evidence of the completion of learning cycles and participants reflections on the educational process. Qualitative and quantitative evaluation data were collected by questionnaire, semi-structured interview, participant observation and review of completed portfolios. The themes identified by GPs as hopes for the portfolios were largely fulfilled and the anxieties generally confounded. The flexibility of the portfolio learning process was particularly important to the participants. The breadth of topics covered by the portfolios was extremely wide and comparison with the submissions for 'traditional' PGEA showed a much smaller spread of learning activities and fewer subjects of study. The use of the portfolios of critical incidents and the completion of learning cycles with application to practice provided evidence of the effectiveness of such learning. EFFICIENCY: The mean number of hours spent by GPs preparing the portfolios was 24.5 +/- 12 (SD) which was significantly more than the 15 hours of PGEA awarded. This study demonstrates that a portfolio-based learning scheme can meet the needs of GPs relevant to their professional practice; it can give learners control over how, what and when they learn and encourage active and peer-supported learning; it can build personal and professional confidence and be thought both valid and reliable by participants. Learning outcomes can also be reliably assessed by PGEA within the context of an individually created learning plan.

                Author and article information

                Journal
                BMC Med Educ
                BMC Medical Education
                BioMed Central
                1472-6920
                2009
                1 December 2009
                : 9
                : 69
                Affiliations
                [1 ]University of Aberdeen, Division of Medical and Dental Education, Polwarth Building, Foresterhill, Aberdeen, AB25 2ZD, UK
                Article
                1472-6920-9-69
                10.1186/1472-6920-9-69
                2790436
                19951406
                1ca15001-5a4b-4a27-a07b-780694b8d7b8
                Copyright ©2009 Ross et al; licensee BioMed Central Ltd.

                This is an Open Access article distributed under the terms of the Creative Commons Attribution License ( http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 30 June 2009
                : 1 December 2009
                Categories
                Research article

                Education
                Education

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