Students’ reflections in a portfolio pilot: Highlighting professional issues

Abstract

Background: Portfolios are highlighted as potential assessment tools for professional competence. Although students' selfreflections are considered to be central in the portfolio, the content of reflections in practice-based portfolios is seldom analysed. Aim: To investigate whether students' reflections include sufficient dimensions of professional competence, notwithstanding a standardized portfolio format, and to evaluate students' satisfaction with the portfolio. Methods: Thirty-five voluntary final-year medical students piloted a standardized portfolio in a general practice (GP) attachment at Lund University, Sweden. Students' portfolio reflections were based upon documentary evidence from practice, and aimed to demonstrate students' learning. The reflections were qualitatively analysed, using a framework approach. Students' evaluations of the portfolio were subjected to quantitative and qualitative analysis. Results: Among professional issues, an integration of cognitive, affective and practical dimensions in clinical practice was provided by students' reflections. The findings suggested an emphasis on affective issues, particularly on self-awareness of feelings, attitudes and concerns. In addition, ethical problems, clinical reasoning strategies and future communication skills training were subjects of several reflective commentaries. Students' reflections on their consultation skills demonstrated their endeavour to achieve structure in the medical interview by negotiation of an agenda for the consultation, keeping the interview on track, and using internal summarizing. The importance of active listening and exploration of patient's perspective was also emphasized. In students' case summaries, illustrating characteristic attributes of GP, the dominating theme was 'patient-centred care', including the patient-doctor relationship, holistic modelling and longitudinal continuity. Students were satisfied with the portfolio, but improved instructions were needed. Conclusions: A standardized portfolio in a defined course with a limited timeframe provided ample opportunities for reflections on professional issues. Support by mentors and a final examiner interview contributed to the success of the portfolio with students. The interview also allowed students to deepen their reflections and to receive feedback.

Nurses’ Perceptions of e-Portfolio Use for On-the-Job Training in Taiwan

“…Results revealed that the students liked portfolios that presented their strengths and weaknesses in a structured manner, and they were satisfied that the system contained a mechanism for instructor feedback to improve their reasoning skills. 13 Current challenges lie in how to continue recording student grades and provide evidence of their abilities to assess and evaluate learning outcomes. 9,12 E-portfolios must be designed with an understanding of user attitudes and preferences to enable successful technology use.…”

“…12 Professional abilities involve not only knowledge accumulation, but also the nurturing of attitude and values, communication, and clinical reasoning skills. 13 Although these learning processes are not easily assessed using traditional pen-and-paper methods, e-portfolios can record these learning experiences. In one study, mixed-methods research was used to investigate final-year medical students' satisfaction with e-portfolio.…”

Non-medical prescribing assessment – An evaluation of a nationally agreed multi method approach

“…A study of 114 dietetic students from 11 English universities, viewed portfolios as a satisfactory method of assessment (Brennan and Lennie, 2010). In a qualitative analysis of portfolios submitted by 35 post graduate doctors in Sweden, it was suggested that this method of assessment provided an opportunity for reflection on professional and ethical issues (Haffling et al, 2010). In the context of non-medical prescribing, studies have reported that students have felt prepared for practice on qualification (Boreham et al, 2013) and have discussed approaches to prescribing assessment (Nuttall, 2013;McEwan and Taylor, 2007) but none of these reported the effectiveness of assessment in the context of safe prescribing practice.…”

Students reflecting on test performance and feedback: an on-line approach

“…Reflection can build 'mindfulness' about feedback received (Bangert-Drowns et al 1991), and can also provide a mechanism for analysing learning deficits (Marton, Hounsell, and Entwistle 1984). Models of reflective practice (Schön 1987) apply across many professional contexts (Connaughton and Edgar 2011), including the health professions such as nursing, psychology, physiotherapy and medicine (Haffling et al 2010). Schön's conceptualisation of reflection as falling into three stages, namely conscious reflection, criticism and action, has influenced the incorporation of reflective journal entries (Boud 2001;Boyd 2002;O'Connor and Hyde 2005) or group discussion processes (Platzner, Blake, and Ashford 2000) into university curricula.…”