Career Focus

Constructing a learning portfolio

BMJ 1999; 319 doi: http://dx.doi.org/10.1136/bmj.319.7201.2a (Published 07 July 1999) Cite this as: BMJ 1999;319:S2a-7201

A record of personal development and experience is becoming mandatory for all doctors. David Brigden advises on a technique that facilitates personal and professional development

  1. David Brigden, adviser for medical and dental education
  1. Mersey Deanery, Liverpool L3 6AL

    A learning portfolio is far more than a curriculum vitae. It is a dynamic and tailor made document that states experience alongside future objectives. It thus provides hard evidence that learning has taken place because it documents not only your experience but also your changing career objectives. A learning portfolio should be a personal summary of the learning events in your life. It may be formal, but it may also include diverse events from outside clinical work that have contributed to your development. The entire content of the portfolio need not be displayed at all times: components may be chosen for certain events. Such a document may be an important contribution to a record of in-training assessment (RITA)1 and may encapsulate more than any other assessment document (box).

    Items to include in a learning portfolio

    • Personal details, GMC certificate, exam certificates, date of qualification

    • Summary of previous posts and learning

    • Career intentions

    • Courses attended

    • Objectives in current post

    • Study leave attended and projected

    • Appraisal forms (confidential)

    • Research experience and aspirations

    • Publications

    • Case presentations

    • Audit projects undertaken and planned

    • Teaching notes and critique

    • Reading lists

    • Memorable events and patients

    • Updated and serialised curricula vitae

    • Anything else you feel may be relevant - if you feel you have learnt something from an event then you are probably right, and it should be included

    Structuring your portfolio

    The structure of your portfolio should be clear to anyone reading it, even if he or she is not familiar with your work. It should contain reflection and commentary, but this should be separated from the evidence. Use cross referencing to connect them, enabling you to use any particular piece of evidence to show competence or excellence against more than one criterion. The folder should be clearly labelled so that information can be easily accessed. The binding should be sufficiently robust so that the document does not fall apart when opened.

    Putting it together

    Unlike the physical file you construct, the process of developing your portfolio cannot be neatly labelled into phases because each of the activities relates to each other. For simplicity we might identify four activities, not too dissimilar to the Kolb learning cycle (figure) - a framework that helps the learner adopt the discipline of reflection.2

    Experience is the raw material for your portfolio. You should keep a record of learning opportunities embraced and courses attended. To make sense of your work to yourself and others you will need to reflect on what you are doing, your motivation, and your philosophy. You can then begin the collection and production phase, in which you will be looking out for work that might be included in your portfolio.

    You must be selective in the evidence you put into the portfolio. A large portfolio is not necessarily a good one. You need, therefore, to begin to select and organise the materials you have available. Through the process of reflection you may decide you need some further evidence which is not yet available. This will suggest the acquisition of further experience and the production of new evidence for your portfolio. So the cycle continues, on a lifelong path of personal and professional development.

    Key questions to ask

    Filter the evidence you include in your portfolio by considering the following questions:

    What does this evidence show? For example, a specialist registrar in accident and emergency might document the month spent as a supernumerary registrar in cardiothoracic medicine learning to perform emergency thoracotomies as an element of the portfolio.

    Is it all relevant to the career path I am pursuing? Fillet the material that is not relevant to your present course to keep your portfolio manageable and to the point.

    Does the evidence show my competence? Although certificates of attendence at, for example, ionising radiation courses are essential for any doctor using fluoroscopy equipment and should be included in the portfolio, they obviously do not show that you are an effective interventional cardiologist.

    What can I edit out? As your seniority increases, detailed records from your early career become less important and should be removed. For example, the list of skills acquired as a house officer that are no longer relevant to your present post as a specialist registrar could be omitted. Similarly, you may have attended courses in a specialty you no longer pursue, and these could be archived.

    What is missing? One of the most valuable properties of the career portfolio for a doctor in training is that it enables elements that are missing from a training programme to be identified. A psychiatry specialist registrar, for example, might seek experience of different varieties of psychotherapy, having identified the gap during a review of the portfolio.

    What are my next steps? The practical actions that flow from a review of the portfolio should be noted, and a plan devised to complete them. A general practice registrar, for example, might identify a lack of experience in dermatology and plan to write to a local consultant to arrange attendance at a series of dermatology outpatient clinics.

    Remember that a particular item of work may show more than one learning outcome. With a good cross referencing system you can use the same item of evidence to show several outcomes.

    Being self critical

    Because you need to reflect on your practice, you should include examples that show how you have learnt and improved your practice. A portfolio that seems to show that everything is perfect all the time might arouse suspicion: none of us can honestly say that everything we do works out perfectly. Instead, show how you have responded to problems that have presented themselves and evaluate how successful your response has been.

    A good portfolio shows a balance between reflection and evidence. The evidence is adequately contextualised so that the reader can understand what it shows, the circumstances from which it was derived, and who was concerned with its production. It will also include a good variety of activities and a range of evidence on different outcomes. Portfolios of high fliers will show evidence of enthusiasm, imagination, flair, and innovation. Both outcomes and processes should have clear evidence relating to them. Sources should be adequately referenced, including normal forms of academic referencing in discussion and reflective pieces.

    As the process continues, your portfolio will build an inventory of your skills and achievements, while continuing to remind you of your future aspirations. This embodies the concept of lifelong learning as outlined in recent NHS white papers.3 4

    Your portfolio is a personal document and does not necessarily have to be reviewed with anyone. Reviewing parts of it with a trainer or educational supervisor will provide a useful starting point for the assessment of your training and learning needs. This should develop into an individual learning plan, agreed between you and your supervisor.

    Portfolios are an essential learning aid for trainees, and they can be used as a reflective tool by experienced consultants and general practioners as part of their own continuing professional development.

    References

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