1. Evaluation of the use of portfolios in the assessment of learning and competence in nursing, midwifery and health visiting Christine Webb Professor of Health Studies, University of Plymouth, UK

2. Issues in the literature Authenticity and verification Validity Reliability Usefulness in assessment of critical reflective development and competence Role of academics in facilitation and guidance

3. Conflict between summative assessment function and learning value?

4. How did students use portfolios? Deconstruction of learning outcomes what do they mean? overlap/repetition Reconstruction to give teachers what they expected re-writing history? artificiality

5. Transforming the material? Shopping trolley Toast rack Spinal column Cake mix

6. Specialist practice programmes One-to-one relationship with assessor Continuity informed assessor judgements Direct observation Knowing the student

7. Pre-registration programmes Multiple placements Short duration Nature of practice on wards

8. Midwifery – the exception? Teachers had strong relationships with clinical staff One-to-one supervision Motivation Not a ‘small cohort’ factor

9. Issues Size/bulk of portfolios Complexity of structure Time needed for completion The tail wags the dog Process or outcome? ‘Faking it’? Being critical?

10. Clinical assessors assessed students’ practice NOT their portfolios. The portfolio provided SUPPORTING evidence Practice assessment tools need to be developed, in collaboration between teachers and assessors

11. Providing structure Need to introduce students to incrementally more complex models of reflection as students progress through the programme Otherwise, writing skills may determine the quality of what is written

12. Discrimination between students Monitoring process were in place – double marking, internal moderation Teachers and assessor could identify weak students BUT failure/discontinuation on the basis of the portfolio was rare/non-existent

13. Feedback to students Tripartite meetings Personal tutor feedback

14. Preparation Students Teachers Assessors

15. Role of External Examiners Sampling portfolios Examination Board

16. Assessing rigour? Validity and reliability – quantitative research Criteria for qualitative research

17. Recommendations: Policy Sufficient time in each placement to build up student-assessor relationship Recognition of implications of assessment in RN workloads Greater investment in assessor training Retain PTA/CPT role in specialist practice Develop practice assessment tools

18. Recommendations: Portfolios Balance evidence and workload Appropriate structure Include non-assessed ‘development’ section Preparation of all parties Tripartite meetings Transformation of evidence

19. Use incrementally more complex models of reflection Reconsider criteria used to assess portfolios Make competency statements more realistic, user-friendly and valued