Posts Tagged competency

30 June #meded chat transcript: Portfolios

This week’s #meded chat was on portfolios and competency.  The discussion started online ahead of the twitter chat and you can see the comments generated on Anne Marie’s post that posed some questions to get the debate going.  There are clearly some strong views on the portfolio and these also came out in the Twitter chat with the focus more on the use of portfolios post qualification than in the undergraduate curriculum.

You can catch up with the discussion in the transcript embedded below and leave a comment if you want to put in your tuppence worth into the mix.  We haven’t decided on next week’s #meded chat topic yet, if you’ve got any suggestions tweet me @nlafferty or @amcunningham with your suggestions.

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Portfolios and Competency: Pre #meded chat

One hour before our planned #meded chat my quickly written blog post has generated comments from 25 different participants. They are just as varied as you would imagine. Please do that the time to read through them all but I’d like to summarise the main points I have taken away so far.

  • Can the most important learning be codified? Do text based reflections miss out on some of the learning that takes place in face-to-face discussions and feedback, therefore diminishing their authenticity? Not everyone wants to share their innermost thoughts. Are we obliged to be open?
  • Is the main function of a portfolio to act as aid to learning or to demonstrate competency in what has been learned already? Many report that it feels more like the latter and that this leads to resentment that time is being spent documenting rather than learning. Two US students have given wonderful accounts of the impact of their portfolios on their learning. Yes, it has taken a lot of effort on their part and that of their mentors but it has been worth it. They now feel in control of their education, but are keen to point out that ticking of a list of competencies is not part of the process.
  • Some doctors do feel that progress and skills achieved should be documented. Why? But they are also concerned that a tick-box approach may not reflect real-world competency. (In a time-based, apprenticeship model it would not be assumed that you would stop performing a task because you had mastered it. You might perform it more often, honing the skill.)
  • One student reflects on the painfulness of having to get feedback on how the simplest of tasks could be performed better. Is this a too reductionist concept of a skill? What about considering why the test is needed in the first place and how the results will be interpreted? How can we use portfolios to develop the situational understanding which is so essential to being a capable professional?
  • What is the place of global assessment in assessing competency? Is there any evidence that breaking down competence into checklists is any more reliable or valid than the global assessment of a skilled colleague who has had many hours contact with the student or doctor? Have we introduced checklists because we are not sure that these mentoring relationships still exist?
  • There are mentions of ‘clunky’ interfaces too. Improving the front-end of portfolio tools may help, but it will not resolve deeper issues around engagement and belief in the underlying constructs.
  • How can we ensure that portfolios are truly about aspiring to excellence and development?

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Portfolios and Competency

On Thursday evening our #meded chat will be on the topic of portfolios and demonstrating competency. In advance of our discussion it would be good to use this space to write a little about your experience as a student, or doctor (and other health professionals are welcome too!) How do you feel about the rise of the competency model of medical education which is replacing the apprenticeship model? What are the benefits, if any? What are the main problems with the way portfolios are executed? Have you had any positive experiences through portfolios?
It’s often stated that a competency model is needed to satisfy the demands of wider society. Do you think that there is any truth in this? Why do you think portfolios and competency have been accepted by the leaders of medical education with seeming enthusiasm, whilst many on the ground seem disappointed and disillusioned with the experience?

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