Key-words: Assessment - medical students - portfolio
Introduction
The period of medical training is a long one and it is quite crucial for a medical
student to document their learning, substantiate the same with evidence, and record
personal reflections to make it a long-term learning. In the field of medical education,
the portfolio of a medical student refers to the collection of evidence and reflections
on their learning to prove that learning has taken place.[[1 ]] The student can accumulate a wide range of evidence (namely photographs, certificates
of participation in academic events, appreciation letter, attendance certificates
from peripheral postings, assessment reports, audio or video recordings of the presentation
in a conference or surgery performed, etc.), and in the real sense sky is the limit.[[1 ]]
Portfolio-Tool for Learning
Portfolio-Tool for Learning
Portfolios have been identified as a tool for learning as it envisages the value of
student-centered learning, gives importance to what a learner can accomplish, and
can be used as a tool for both learning and assessment.[[2 ]] As the primary objective of the portfolio is a reflection on learning, it plays
a significant role to ensure professional growth and development and also tends to
establish the connection between theory and practice.[[1 ]],[[2 ]] The portfolio suits students with different learning styles as it has a provision
to use evidence from different settings. Owing to the collection of evidence for a
relatively long period of time, the tutor gets an impression about the overall competence
of the student, either through a quantitative or qualitative approach.[[1 ]],[[2 ]]
Paper versus E-portfolio
The portfolios can be maintained either in paper-based format or in the electronic
form as e-portfolio by the medical students.[[3 ]] E-portfolios have been preferred by most of the medical institutions, as it gives
a provision of hyperlinking that establishes linkages between overview, supporting
evidence, and the reflection of students. Moreover, e-portfolios are user-friendly
both for the student (namely easy to update, not bulky, allows the accumulation of
a wide range of evidence, easy to share with the teacher, long-term storage, etc.)
and teacher (as it facilitates the quick review, assessment, and giving feedback).[[2 ]],[[3 ]]
Portfolio in Undergraduate Courses
Portfolio in Undergraduate Courses
Since the adoption of competency-based medical education for undergraduate courses,
specific emphasis has been given toward the maintenance of logbook (and portfolio-optional)
for the documentation of learning by the medical students.[[2 ]] The incorporation of portfolios, which can act as a tool for both learning and
assessment, will significantly aid in the process of acquisition of desired competencies
by the medical undergraduate students. However, for better results, it will be really
nice, if each of the medical undergraduate students can be linked with one of the
faculty members, who keeps guiding the student about the do's and don'ts and how to
keep moving forward.[[2 ]],[[3 ]],[[4 ]]
Portfolio in Postgraduate Courses
Portfolio in Postgraduate Courses
For all practical reasons and for the sake of feasibility owing to the less numbers
in contrast to the undergraduate students, the use of portfolios in postgraduate courses
has been strongly advocated.[[5 ]] The portfolios of postgraduate students can be categorized under different subheadings,
such as seminars, daily log, patient care, performed procedures, journal club, teaching
assignments, dissertation, research, attended conferences, outreach activities, extracurricular
activities, recognitions and awards, and other notable activities. In fact, the portfolios
can be effectively used for the efficient implementation of competency-based medical
education through monitoring the progress of the entrustable professional activities
for the individual specialty. The faculty members can be instructed to give feedback
about the things maintained by postgraduate students and the aim should be to encourage
students to reflect on their learning. This will eventually aid both teachers and
postgraduate students to formulate shared action plan to bridge the prevailing lacunae
and gradually move forward in the Dreyfus model of skill acquisition toward mastery.[[4 ]],[[5 ]]
Assessment of Portfolios
In fact, portfolios have been considered as a part of both formative and summative
assessment, wherein the development of competencies can be monitored by the teacher.[[1 ]],[[3 ]] The assessment of the portfolio can be carried out in a transparent fashion based
on the predetermined criteria and the intended learning objectives.[[1 ]],[[3 ]] In the undergraduation period, the portfolio can be used to assess the reflective
ability and communication skills of the students, while it has more scope for postgraduates,
wherein workplace-based assessments are being employed.[[5 ]] The assessment can be done either with the objective of selection (ascertaining
suitability of a candidate for a new job), or diagnosis (for monitoring the learning
progression), or certification (to justify whether the student has attained the competencies
required for certification). The assessment of the portfolio can be done either by
the mentor or department faculty members or by a panel appointed by the institution
periodically.[[2 ]],[[3 ]],[[4 ]]
Acknowledging the importance of the portfolio, different regulatory bodies after the
adoption of competency-based education has recommended for the maintenance of portfolio
for medical students. At Sri Balaji Vidyapeeth Deemed to be University, Puducherry,
e-portfolios have been introduced since 2016 for all the postgraduate students in
its both constituent colleges – Shri Sathya Sai Medical College and Research Institute
and Mahatma Gandhi Medical College and Research Institute. The postgraduate students
have been encouraged and motivated to regularly update their e-portfolio accounts
with their learning, document proofs and reflections. Further, a faculty member has
been assigned for the students to ensure that a constructive dialogue happens between
the learner and the teacher.
Potential Factors for Successful Implementation
Potential Factors for Successful Implementation
In order to enhance the success of the portfolio in medical education, it is a must
to specify the objectives for which the portfolio has to be maintained and the same
needs to be communicated to the faculty member as well.[[1 ]] It is the responsibility of the student to create, maintain, and ensure that it
meets the specified objectives. However, some flexibility must be given to the student
to give them an opportunity to showcase their development.[[1 ]],[[2 ]] It is essential to assess the portfolio periodically, otherwise we lose the opportunity
to guide and mentor the student to pace their learning.[[3 ]] Moreover, the successful implementation of e-portfolio will essentially require
infrastructure support from the administration, technical assistance, and training
of the teachers and medical students.[[2 ]],[[3 ]],[[5 ]]
Conclusion
Advocating the use of a portfolio among medical students is the foundation stone for
lifelong learning and ensures continuous professional development. It is the need
of the hour that all the medical colleges should implement the maintenance of the
portfolio within their settings based on a framework that clearly defines the purpose
for the same and its periodical assessment.
