MEDICAL EDUCATION

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Notes for the Primary Care Teachers
PORTFOLIO ASSESSMENT

CL Teng MMed(FamMed), FAFPM, FRACGP, AM, International Medical University, Seremban, Malaysia

Address for correspondence: Dr CL Teng, Associate Professor, International Medical University, Jalan Rasah, 70300 Seremban, Malaysia. Tel: 06-76777798, Fax: 06-7677709, Email: tengcl@gmail.com

Conflict of interest: None

ABSTRACT
The portfolio consists of a variety of documentation of a learner’s proof of learning. It has been promoted as one way to verify a learner’s personal and professional development, especially for the more mature trainees and doctors at work. It has not been widely accepted as a summative tool because the amount of time imposed on the learners may be considerable. Ways to improve the reliability of assessments on unstandardised portfolios are needed for its wider application.
Key words: Portfolio assessment, medical education
Teng CL. Portfolio assessment. Malaysian Family Physciian. 2007;2(3):125-6

WHAT IS A PORTFOLIO?

The Concise Oxford Dictionary defines ‘portfolio’ as “a set of pieces of creative work intended to demonstrate a person’s ability to a potential employer.” For an artist, his portfolios are in large folders that contain his best artworks, and, when presented to prospective clients, show that he can paint. In medical education, a portfolio is a collection of documents and materials that show what a trainee has learnt and reflects his learning. The contents of a portfolio can vary a great deal from one trainee to another (see example in Box 1).

Box 1: Types of portfolios¹

As can be seen from Box 1, portfolios include written documentation of the many learning activities of a trainee. However, these portfolios should not be merely a listing of teaching-learning activities that have been planned by a medical school or vocational training programme. Much flexibility is given to the trainees to collect various portfolios that fit into his learning plan. Also, the trainee is encouraged to write down his reflections (e.g. admitting to having difficulty in obtaining a sexual history and identifying steps to overcome this problem). These reflections can be appended to a log diary as free text entries. Alternatively it can take the form of a critical incident analysis – a case write-up focusing on negative events (e.g. a missed diagnosis or an unexpected admission) with an emphasis on the lessons learnt.

WHY INTRODUCE PORTFOLIO-BASED ASSESSMENT?

A portfolio is consistent with experiential learning and reflection as described by Kolb and Schon.² Maintenance of portfolios by trainees can lead to deep learning and achievement of learning outcomes if the trainee reflects on his deficiency and proceeds to ‘close the loop’ (demonstrating steps taken to overcome a deficiency). For medical students, a learning plan accompanied by ‘evidence’ of learning and achievement in the form of various portfolios is felt to be more holistic compared to written or clinical examinations. Furthermore, practising doctors are increasingly expected to demonstrate continuing professional development. Revalidation of doctors for a continuing licence may require the maintenance of a portfolio for the future. At the moment, most undergraduate and postgraduate medical programmes have some elements of portfolios as part of formative assessment but few, if any, rely entirely on the portfolio for the summative examination; University of Dundee being a notable exception.²