Building a portfolio
BMJ 2011; 343 doi: https://doi.org/10.1136/sbmj.d4942 (Published 15 September 2011) Cite this as: BMJ 2011;343:d4942
- Alyson Williamson, education services manager
- alyson.williamson{at}nuth.nhs.uk
Abstract
Starting early ensures successful outcomes, Alyson Williamson concludes
A portfolio is “a purposeful collection of work that exhibits a student’s or doctor’s efforts, progress and achievements in one or more areas. It includes one’s participation in selecting the contents, the criteria for selection . . . and evidence of self reflection.”1 A portfolio allows an individual to define who and where they are on the journey to becoming a fully trained medical practitioner. It supports a process of continuing professional development and provides a vehicle for demonstrating this to another person.
It is a mistake to consider a portfolio a tick box exercise. Throughout your career you will undergo regular appraisals and, as a specialist (general practitioner or consultant), you will need to undergo revalidation with the General Medical Council (GMC).2 Revalidation is the process by which licensed doctors in the United Kingdom regularly demonstrate to the GMC that they are up to date and fit to practise. It requires collection and presentation of evidence through a portfolio. Understanding the value of portfolios, gathering and presenting evidence, and using reflective practice will benefit you throughout your career and as a senior clinician.
Portfolios are made up of a wide range of documentation (box 1). They provide evidence that the intended learning, both curriculum driven and personal objectives, has occurred, and it is a process that supports the professional requirement for doctors to commit to lifelong learning.
Not just another CV
A curriculum vitae (CV) is different from a portfolio with respect to depth, detail, and structure. A CV provides a short summary of your employment history, qualifications, and personal details. It is usually used to select suitable applicants for an employment interview. The emphasis of a CV is often changed so that the information is most relevant to the position you are applying for, and it will describe information in the most complimentary terms to sell your skills to a future employer.
In contrast, a portfolio ultimately showcases your evidence of achievement of the competencies required for training. Your portfolio is reviewed annually to confirm that you can move to the next stage of training.
Public accountability
The demonstrable achievement of competencies through building a portfolio of evidence is a requirement of a doctor to meet public accountability to assure patients that all doctors have current evidence of their ability to practise in accordance with the standards in the GMC’s Good Medical Practice.2
Most postgraduate specialties now require trainees to keep a portfolio of documentation to show completion of all elements of the relevant curriculum. Many of these portfolios are electronic, such as the portfolio required by UK junior doctors, the foundation programme portfolio. Other portfolios can be paper based, and those developed for revalidation purposes should be modelled on the domains in Good Medical Practice.
Throughout undergraduate and postgraduate education, portfolios have become a staple in evaluating one’s progress. Some medical schools have introduced portfolios as a process for students to show they have achieved the specific learning outcomes. You may also be asked to present a portfolio at a selection panel for higher specialty training to help in the choice of suitable candidates for postgraduate training.
Becoming capable doctors
Sturmberg and Farmer noted: “Teachers want students to focus on their learning to become capable doctors; yet students primarily want to focus on passing their exams.” They believed “a well structured capability portfolio, regularly presented and reviewed, will be a useful tool to guide the journey and should have the potential to help drive deep learning and allow the assessment of capabilities that are hard to assess using conventional approaches.”3
Medical students without experience of portfolios are anxious about the process and find it an added burden to an already stressful first year of practice.4 Students would be wise to develop portfolio building and reflective practice skills early to give them an advantage.
Box 1: What should be included
Personal and professional development plan
Record of meetings with your educational and clinical supervisor
Workplace based assessments
Reflective reports
Sign-off documents
Interesting cases
Teaching/learning/courses attended
Audits and presentations undertaken
Certificates of e-learning modules
An early start
An early start is essential even while you are at medical school. Get yourself organised and spend at least 15 minutes a week on your portfolio. Make sure you know what the mandatory elements for your programme are, and take notice of the advice given as it is there to help guide you. Many postgraduate schools and trust postgraduate education departments provide valuable advice and guidance on the competencies you are required to meet, so don’t be afraid to ask for help.
You will be building your portfolio while undertaking a busy clinical job. Therefore give yourself plenty of time to gather the information and choose a wide range of assessors who are sufficiently experienced to assess your competencies and provide you with formative feedback to improve your skills.
Your clinical assessors will be familiar with assessment tools and you should not be nervous about asking them to conduct an assessment. Telling people in advance that you would like to do an assessment—for example, at the beginning of a ward round or before a supervision meeting—makes it easier for people to set aside the time and prepare themselves. Let them know which curriculum domain you hope to use the assessment for and ask them to comment specifically on that area.
You will have an educational supervisor throughout the year and a clinical supervisor for each attachment. Remember that the educational supervision process is trainee driven and so it will be up to you to seek out your supervisor and be clear on what support you require from them.
Individualising your portfolio
Make the most of your personal library to individualise your portfolio by providing supplementary evidence for curriculum competencies—for example, journal club articles, scans of e-learning, and other certificates or presentations. The relevance is considerably enhanced by including a brief summary of their value, what you have learnt, and what you will do in the future. BMJ Learning modules5 provide easy access to a wide variety of topics relevant to your training, and the BMJ Portfolio5 is a useful tool which helps you keep track of what learning you have undertaken.
You should personalise your portfolio to reflect your own experiences, skills, and attributes and aim to excel by achieving more than the minimum requirements. However, ensure you are able to meet all mandatory elements of the curriculum before focusing your attention on personal goals and supplementary experiences.
Reflective practice is the driving force of an effective learning portfolio and stimulates self awareness (box 2).
Box 2: Reflection is a process for recording
Reflect on:
What you have done
What you have learnt that will lead to a change in future
What evidence you have of application of that learning
What further learning needs you have
Action plan for meeting those learning needs
A launch pad
A contemporaneously completed portfolio will act as a launch pad when completing job application forms and preparing for interviews and will help you stand out from the other applicants. Specialty trainers are looking for trainable doctors and the best way to show this is a well organised, personalised portfolio that reflects your commitment to engaging in the educational process.6
An incomplete portfolio will not impress the person reviewing your portfolio. Regularly review your portfolio and take out unnecessary or repetitive pieces of evidence. Link your evidence to the curriculum domains as you go along to see what you have already achieved and what areas need developing.
Remember that evidence added retrospectively weakens the value of your portfolio and, as every item you enter is dated, it will be clear if you have just crammed your assessments together near the deadline. Don’t ignore your portfolio, and if you do fall behind, take decisive action and ask for help to get back on track (see table).⇓
Linking the evidence
When you prepare your portfolio for an end of the year review, you need to link evidence to each competency within the curriculum. You should view your portfolio as a filing cabinet of your learning experiences throughout that year. However, when it comes to presenting your portfolio for review, you should ensure that it contains the best pieces of evidence that most effectively demonstrate your achievement of each competency. Independently assessed evidence from experienced assessors is the strongest evidence for clinical care domains.
You can improve the strength of your portfolio by carefully considering the quality and detail of the evidence that you provide (see table).⇑
Not another hurdle
The learning portfolio is not just another hurdle. To develop into a safe, independent practitioner, you will undergo a continuous cycle of reflection, planning, and action, and a portfolio is a vital tool. It will take considerable time and effort for you to produce an effective portfolio, but the results are worth it. Motivation is helped by understanding the purpose, the potential to personalise it, and its potential as a powerful tool to monitor your progress and drive your learning forward.7
Box 3: Top tips for success
Be clear on the key requirements
Review the curriculum competencies and list things that are harder to achieve
Reflect how you can evidence them and get advice from your educational supervisor
Break down the list into small steps
Be organised and spend at least 15 minutes a week on your portfolio
Do more than the minimum and excel
Personalise your portfolio by showcasing your experiences, training, skills, knowledge, and professionalism
Maximise your chances of success by early engagement
Notes
First published as Student BMJ 2011;19:d4942
Footnotes
Competing interests: None declared.
From the Student BMJ.