Introducing a reflective portfolio based assessment: UsydMP year 1 and MMEd.
See also:
Driessen EW et al. Use of portfolios in early undergraduate medical training. Medical Teacher 2003; 25: 18-23
Aims of the portfolio:
This needs discussion.
á To assess outcomes that are difficult to assess by other means
á To encourage and facilitate studentsÕ reflection
á To collect evidence of meeting learning outcomes
á To bridge the gap between theory and practice
á To be part of the assessment of PPD (UsydMP)
á To enable Masters students to record their learning needs, and evidence of meeting these
á To be a record of the learning journey
á To help integrate work/theory/practice through the years of training
There are many definitions of portfolios. One is Ôa purposeful collection of workÕ. With regards to PPD it would be a collection of material, which may be written or submitted in other formats (?), that provides evidence that learning has taken place (this learning could be in the form of a change in behaviour or attitude). In particular evidence that the aims and objectives of PPD have been attained for the year 1 students.
The portfolio should be structured in such a way that it does not become just a checklist of outcomes achieved nor with such little guidance as to completion that students are unsure what is expected of them. I would envisage that the portfolio becomes less structured through years 1 – 4. ÔStudent ownership is an important contributor to successful stimulation of reflection.Õ Combining assessment and reflection is difficult. When students realise the importance of the assessment procedure it may inhibit them from producing honest and personal work. Students will produce evidence of achieving outcomes and then reflect on the process of gathering it. It is this second component which is difficult to assess fairly. Students are likely to work out what is required to obtain a good grade and write accordingly. They are unlikely to submit work that demonstrates weakness, unless they really understand the nature of the reflective process. Students (and tutors?) will need to decide which reflective pieces are private to the student, which are for formative and which for summative assessment purposes.
Reliability of marking is a difficult issue. The less structured a piece of work the more difficult to ensure reliability. One way round this is to double mark all portfolios! This will be impossible for time and financial reasons.
Ideally the portfolio would be assessed both formatively and summatively and this assessment should be transparent, involving ongoing feedback. It should not just be considered as something that is assessed solely at the end of each year.
In the Maastricht model in the paper above, 20 students are ÔmentoredÕ through the process by one tutor. This is probably a good idea in year 1 – but could be done on line. But by whom?
Reflection should include thinking about how the experience has affected the student as a person and a student doctor. Have his/her attitudes changed as a result of the experience? Have his/her views been challenged? Have he/she been surprised by prejudice in self or others?
Reflection can be helped by reading, discussion and writing. If the whole process is facilitated and the student is given feedback, the experience becomes even more powerful. Learning from experience also needs to be linked to theory and knowledge, links that can be helped by facilitator/tutor/mentor.
We need to look at the elements of PPD in year 1 (with Merrilyn) that can be evidenced by the contents of an e-portfolio. Plus triggers in the course for reflection.