Stacy Potts, MD, FAAFP, MEd
University of Massachusetts Medical School
Introduction: Self directed lifelong learning skills are essential for physicians to provide competent medical care throughout their career. The ACGME has defined self-directed lifelong learning within the Practice Based Learning and Improvement (PBLI) competency. The purpose of this study was to investigate how well a portfolio process reflects the dimensions of the Practice Based Learning and Improvement competency objectives, how useful the process was to residents, and the feasibility of the process in residency training.
Methods: Family Medicine residents completed a survey evaluating their own use and perceived value of the portfolio system as well as their self directed learning behaviors and confidence in the domains of the PBLI competency. A rubric was used to assess resident portfolios in demonstrating the components of the PBLI competency.
Results: 65% of residents participated in the survey. Residents report frequent goal setting and self assessment. Residents found the performance evaluation of the portfolio the most useful. Specifically, residents found the procedure summary aspect the most useful component. However, most residents did not feel that the portfolios were useful in developing self-directed learning skills or achieving goals during residency.
All resident portfolios were assessed using the objective based rubric. 59% of residents met expectations for documentation of Practice Based Learning and Improvement competency. 73% of portfolios included goals set in all three available domains: monthly, long-term and health-center specific. Quality improvement competency was rarely documented in the portfolio.
Conclusion: Learning portfolios can be a useful tool for residents to demonstrate competence in Practice Based Learning and Improvement. This descriptive case study reveals early evidence that portfolios with associated self-evaluation practices are an effective means to document competence in Practice Based Learning and Improvement but attention must be paid to allow appropriate time and support to the process.
