Portfolios

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Using Portfolios to Assess Professional Competence and Development in Medical Laboratory Sciences

Abstract

Background

Portfolios have been recommended for the assessment of professional development. To stimulate engagement and assess professional development during laboratory training, portfolio assessment was proposed for the final year BMLS and DMLT programmes in Kampala International University.

Work Done

The students undergoing clinical laboratory training in teaching hospitals, and engaged in routine laboratory services under supervision of qualified Medical Laboratory Scientists, composed a portfolio detailing their daily experiences, work done, and lessons learned. Their supervisors and facilitators provided daily feedback and endorsed their entries. The portfolios were examined at the end of training by faculty staff and external examiner through oral presentation and interviews. Rating rubric considered quality of presentation, portfolio content, demonstration of progressive development, and ability to make professional judgment. Students' and assessors' acceptance of this instrument was determined with questionnaire.

Results

72 % of the students and assessors accepted the method. Many students reported that it improved commitment to training, encouraged reflection, and allowed for frequent feedback. Many believed that it was a rational assessment, but it was time consuming. 88 % of the participants would welcome it as a supplement to the standard tests.

Conclusions

The portfolio assessment was well accepted, rational, and provided a valid assessment of student engagement and progression during professional training.

Take Home Message

The inclusion of portfolio assessment in Medical Laboratory Sciences Education provided valid assessment of students' engagement in training and professional development over time.

Introduction

The use of portfolios in health professions education has increased dramatically over the years. The enthusiastic acceptance of this principle is in part born out of the ever growing interest in outcomes based education in all divisions of health science.1 The curricula of most health sciences schools now emphasize authentic experiences, promote self direction and reflection in learning, and outcomes based assessment. Portfolios not only stimulate professional development and reflective learning, they also provide opportunity for self direction, and avenues for feedback from faculty.2, 3 Portfolios have been recommended for the assessment of professional development in medical education,4 and several reports document their successful use in assessment of competence at both undergraduate and postgraduate levels.5,6 To stimulate engagement and to assess professional development during clinical laboratory training, portfolio development and assessment was proposed for the final year Bachelor of Medical Laboratory Sciences and the Diploma in Medical Laboratory Technology students of the Kampala International University, Uganda in 2008. This article reports the experience of the use of portfolios to assess professional development in these programmes.

Methods

Institutional approval for the study was obtained from the IREC. Eighteen final year students who were undergoing clinical laboratory training in the teaching hospitals at the Kampala International University Teaching Hospital Ishaka and the Mulago Hospital in Kampala and participating in routine daily laboratory work were requested to compose and maintain a portfolio comprising details of their daily experiences, work done and lessons learnt during their training. Their supervisors and programme facilitators provided daily feedback on their work and endorsed all entries. At the end of their clinical laboratory training, the portfolios were examined by the four faculty staff and an external examiner. The students were also required to make a 15 minutes presentation based on the portfolio content, and take interview on lessons learned and overall impact of the training on their development. A rating rubric used for the assessment considered the quality of student's presentation, portfolio content, demonstration of student's progressive development over time, and their ability to make professional judgment. Questionnaires were used to determine the students' and raters' views on the acceptability, convenience, and usefulness of this method of assessment. The data were analyzed quantitatively and qualitatively.

Table 1: Rubric for the assessment of the students' portfolios

Standard met

Standard not met

1

Presentation was complete in 15 minutes

2

Quality of presentation

3

Student showed progressive development over time

4

Student reflected on experiences and could make good professional judgment

5

Portfolio content was adequate

6

Overall assessment

Pass

Fail

General comments:

Results

The result showed that seventy two per cent (72 %) of the students and assessors accepted the method as a valid and effective means of assessing professional competence. Many students (15 of the 18) reported that it improved their commitment to the laboratory training, and encouraged them to reflect on their daily experiences. Both faculty and students reported that it allowed for frequent feedback and more engagement in the programme. Many believed that it was a rational assessment as it captured development over time, but it was time consuming and quite tasking on both students and staff. Eighty eight per cent (88 %) were of the view that it should be a supplement and not a substitute for the standard written and practical tests.

Discussion

The evolution of portfolio as a tool for the assessment of professional competence and development offers several advantages over the traditional standard tests which to a large extent are reductionist and do not capture progression over time. Application of portfolio assessment in Medical Laboratory Sciences education is not widespread and only few reports are available in literature.7 This study demonstrated that portfolio development and assessment is well accepted by both staff and students in the medical laboratory sciences programme of the Kampala International University. An important aspect of medical education is the matching of assessment methods with learning mode, as assessment drives learning. Portfolio assessment aligns well with competency based education whose tenets include learner centeredness, formative feedback, developmental process, reflection, and multiple types and sources of assessment.3 This study demonstrated this clearly as it promoted student /staff engagement in the clinical laboratory training programme, students' ownership of their training, and reflective learning which are some of the advantages highlighted by similar previous reports of the use of portfolio in other programmes.8, 9

The study also showed that many of the study participants would not welcome this form of assessment as the only mode of student assessment. Rather it would be a valuable addition to the traditional methods of assessment of competence. The limitations of this study include the small sample size used for the study. It is recommended that a larger sample of students be included in a more elaborate study possibly over a longer study period. To ease the burden of assessment, using structured interview to assess the portfolio as recommended by Burch and Seggie 10 could be helpful.

Conclusion:

The use of portfolios to assess students' progress and professional competence in Medical Laboratory Sciences is a welcome proposition. It should be used to supplement the standard written and practical tests. Its advantages include stimulation of student engagement, self direction, reflective learning, and monitoring of progress over time. It is however seen to be time consuming for the students. Its introduction extends the methods of assessment in Medical Laboratory Sciences.

References

1. Davis MHhttp://informahealthcare.com/entityImage/?code=200B‌, Amin Zhttp://informahealthcare.com/entityImage/?code=200B‌,Grande JP,O'Neill AEhttp://informahealthcare.com/entityImage/?code=200B,Pawlina Whttp://informahealthcare.com/entityImage/?code=200B‌,Thomas R. et al.Case studies in outcome-based education. Medical Teacher 2007;29(7):717-722

2. Driessen, E., Van Tartwijk, J., Overeem, K.,et al. Conditions for successful reflective use of portfolios in undergraduate medical education.Medical Education 2005;39:1230 -1235

3. Carraccio C. Portfolio Assessment: The Key to Learner Centered-Education. Downloaded from: http://innovationlabs.com/r3p_public/rtr2/downloads/Portfolios%20R3P%20Group%20Plenary.ppt. Accessed 13/01/2010.

4. Friedman Ban David M, Davis M H, Harden R M, Howie P W, Ker J and Pippard M J. AMEE Medical Education Guide No 24: Portfolios as a method of student assessment. Medical Teacher 2001;23(6):535-551

5. McCready T. Portfolios and the assessment of competence in nursing: A literature review. International Journal of Nursing Studies 2007; 44(1):143-151

6. Izatt S. Educational perspectives: Portfolios: The next assessment tool in medical education? NeoReviews 2007; 8 (10): e405

7. Thomé G, Hovenberg H, Edgren G. Portfolio as a method for continuous assessment in an undergraduate health education programme. Medical Teacher 2006; 28(6):e171-e176

8. Lim J L K, Chan N F, Cheong P Y. Experience with portfolio-based learning in family medicine for master of medicine degree. Singapore Med J 1998; 39(12): 543 - 546

9. Hadfield I, Murdoch G, Smithers J, Vaioleti L, Patterson H. Is a professional portfolio, as a record of continued professional development, the most effective method to assess a physiotherapist's competence? New Zealand Journal of Physiotherapy 2007, 35(2):72-83.

10. Burch VC, Seggie JL. Use of a structured interview to assess portfolio-based learning. Medical Education 2008;42(9): 894-900

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