Using an ePortfolio to encourage independent learning, self-evaluation and peer review Jim Aiton Julie Struthers School of Medicine University of St Andrews

Tomorrows Doctor and the Scottish Doctor

The Importance of the Portfolio The Scottish Doctor - A foundation for competent and reflective practitioners GMC Item 61 Delivering the curriculum – Clinical logbooks and personal portfolios, which allow students to identify strengths and weaknesses and to focus their learning appropriately, can provide such information. –Using these will emphasise the importance of maintaining a portfolio of evidence of achievement, which will be necessary once they have become doctors and their licence to practise is regularly revalidated.

Medical student portfolio at St Andrews Provides a framework for independent learning –Changes learning style Introduces the concept of professional development –Required for CPD, audit, reflection, career development etc

Presentation outline Curriculum Portfolio philosophy Training programme –Reflect –Record –Plan Evaluation Conclusions

Curriculum Pre - HonoursHonours Year 1 MD2000Year 3 MD4000Year 2 MD3000 Foundations of Medicine 1 Musculo-skeleta l Cardiovascular Renal Nervous System Research Dissertation Applied Medical Science Respiratory Reproductive Gastrointestinal Endocrine Patient Strand, Communication skills, Clinical Skills, Health Psychology, ePortfolio, Ethics, Public Health Medicine, Generic Research Skills Family interview GP Attachments Hospital Electives A & E General Surgery Community Health Attachments Foundations of Medicine 2 Introduction to Medicine

Portfolio philosophy Record evidence of learning Plan learning Reflect on learning Learning outcome

ePortfolio – implementation strategy REFLECT: Embed reflective practice Significant learning experiences GP attachments Community medicine attachments Research project RECORD: Document knowledge and skills acquisition Log clinical skills acquisition Evidence competency Showcase work PLAN: Encourage independent learning Determine personal learning objectives Time and project management The ePortfolio is used to:

MD2001 Portfolio training tasks MD2001 Week 0Lecture theatrePresentationIntroduction Week 1WorkshopRecordGetting started with the ePortfolio Week 2WorkshopReflectUsing your learning diary – first visit to DR Week 4Guided studyReflectiveGood / Bad reflection –paper based Week 5Guided studyPlanClinical Skills Tool Week 6Guided studyReflectGroup work/dynamics Week 3 -12Guided studyReflectGP attachment Week 12Guided studyReviewReview and reflect on S1 work and the use of portfolio tools OSPE STATION

MD2001 Example Reflective tasks Early experience in the dissection room - Early experience in the dissection room - Self reflection – [ words] To explore the emotions felt during the first visit to the DR. Recognising Good Reflection - Recognising Good Reflection - Learning to reflect To read examples of reflective writing styles and to review and assess a reflective piece from a peer. Group Dynamics - Group Dynamics - Learning from reflection - [ words] To understand the dynamics of your clinical group, your role within the group and your relationship to the group.

MD2002 Reflective tasks Second/third GP attachment Aim of task [ words] Reflection on learning To reflect on your first experiences of taking histories from real patients Group Dynamics Aim of task [ words] Reflection on reflection To re-appraise how your group is working. Has the dynamics of the group changed, are you more confident and how different personalities are influencing the group dynamics?

MD3001 Portfolio tasks MD3001 Week 1WorkshopIntroductionReminder of the role of the ePortfolio Week 1 (ongoing)Guided studyPlanSet goals for knowledge, skills and attitudes from patient scenarios Week 2 (ongoing) Guided studyRecordRecord staff and peer review of key clinical skills Week 5Guided studyReflectWrite a reflective piece on loyalty to colleagues Week 3 -12Guided studyReflectReflect on the experience gained in the Community Health attachment scheme OSPE STATION

Reflective writing in MD3001 Loyalty to colleagues – Bristol Heart Inquiry - Loyalty to colleagues – Bristol Heart Inquiry - Reflection on judgement [ words] Use the experience gained from studying the Bristol Heart Inquiry to reflect on whether loyalty and sympathy for your colleagues outweighs the commitment to question and act upon substandard practice? Community Medicine Attachment Scheme - Community Medicine Attachment Scheme - Reflection on learning - [ words] Use the experience gained from working in, and with the community health services to reflect on the importance of public health medicine

School of Medicine ePortfolio

ePortfolio in St Andrews

Patient Scenarios: Sanjay Sharma

New material in the scenario

Setting learning goals

Associated clinical skills

Modifying skill set

Peer and staff review of clinical skills

Logging knowledge, skills and attitudes

Public and Private folders

Content of the Public folder

Reflective folder

Clinical skills folder

Share list

Monitoring and assessment: when and how? Formative Summative MD2001MD2002MD3001MD3002 MD4001MD4002MD4003 Personal tutors/staff acting as a facilitators to confirm completion of tasks and provide feedback Summative assessment of Honours project (SSC) entry OSPE

Evaluation

What we try to do with the portfolio? Set realistic goals for the students Develop a structured training programme Adopt a light touch to assessment Involve personal tutors Ask for, but not demand compliance

The 2010 challenge Partner clinical schools –Aberdeen –Dundee –Edinburgh –Glasgow –Manchester