Accepted Manuscript Title: Portfolios for post graduate psychiatry residents: potentials and pitfalls Author: Vikas Menon PII: DOI: Reference:
S1876-2018(14)00196-8 http://dx.doi.org/doi:10.1016/j.ajp.2014.08.008 AJP 641
To appear in: Received date: Accepted date:
6-8-2014 10-8-2014
Please cite this article as: Menon, V.,Portfolios for post graduate psychiatry residents: potentials and pitfalls, Asian Journal of Psychiatry (2014), http://dx.doi.org/10.1016/j.ajp.2014.08.008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
TITLE PAGE 1. Title: Portfolios for post graduate psychiatry residents: potentials and pitfalls 2. Running Title: Portfolios for postgraduates
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3. Author: 1. Dr Vikas Menon MBBS, MD (Psychiatry), DNB (Psychiatry)
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Assistant Professor
us
Dept. of Psychiatry
Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER)
an
Puducherry-605006, India
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4. Address of institution where work was carried out: Jawaharlal Institute of Post Graduate Medical education and Research (JIPMER), Dhanvantary Nagar
d
Puducherry-605006, India
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5. Corresponding author: Dr Vikas Menon
Assistant Professor
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1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Dept. of Psychiatry JIPMER, Dhanvantary Nagar Puducherry-605006, India Mob: +91-9894410296 Email: [email protected] Fax: +91413-2272067 (ATTN: Dr VIKAS MENON)
7. Declaration of interests: None
Page 1 of 4
Sir, In recent times, there has been a growing demand from the general public and competent professional bodies that doctors display generic competencies apart from core knowledge of their subject (Van Tartwijk and Driessen, 2009). These so called „soft skills‟ include communication
ip t
skills, empathy and teamwork, all of which are included within the ambit of the term „professionalism‟. Though such skills are required in all disciplines, they appear to be
cr
particularly relevant to the practice of psychiatry. Increasingly, psychiatrists are expected to be leaders of multi-disciplinary teams handling complex psycho-social, behavioral and emotional
us
disorders which require them to have reasonable communication, man management and troubleshooting skills. It is fairly clear that our present day training does not focus on these
an
aspects. In such a scenario, a portfolio based approach could address some of these issues and counteract the reductionist approach to medical education.
M
Briefly, a portfolio is a “collection of student‟s work, which provides evidence of the achievement of knowledge, skills, appropriate attitudes and professional growth through a process of self-reflection over a period of time” (Davis et al., 2009). Implied in this definition is
d
the central process of reflection which helps the learner to purposefully revisit an experience to
te
extract the learning points from it. It is now recognized that this process happens best when the trainee is paired with a mentor, who having gone through this experience, will be better placed to guide the trainee to reflect appropriately (Challis, 1999). This process of reflection is also what
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
differentiates a portfolio from a conventional log book. To give an example, suppose a resident encounters a suspected case of catatonia in the emergency room and is unsure whether to initiate benzodiazepines. All he needs to do is just jot down brief details of the case, which is used to identify learning gaps in discussion with the mentor, and see how they can be filled. Apart from allowing for in-depth exploration of a clinical problem this process also addresses things which are not normally taught or assessed such as a doctor‟s feelings of inadequacy when faced with a doubtful clinical situation. Other components of a student portfolio could be video recordings of consultations which could be played back for giving feedback on communication skills, reflections on seminars and tutorials to identify areas for further learning, audits, project work and anything else the candidate thinks is relevant (Thomas, 1998). Although traditionally paper based, portfolios can also be conveniently maintained in an electronic format which removes the
Page 2 of 4
encumbrance of paperwork. However there are some methodological issues in implementing a portfolio. Clear guidelines and comprehensive support should be given to both mentors and students on their usage. Issues of confidentiality and access to contents need to be paid utmost care and attention considering the personal nature of information in a portfolio. Additionally,
ip t
there are ongoing concerns about the negative impact of formal assessment on material collected (Ingrassia, 2013). Owing to the flexibility of reporting and documentation offered, it is difficult
cr
to standardize the contents of a portfolio and make objective comparisons in order to rank the students. It may be difficult to verify the accuracy and honesty of students in reporting an
us
incident that has not gone too well for them. The assessment of a portfolio is labor and time intensive. Hence, the current consensus seems to be that portfolios are best used as additions to
an
illustrate aspects of personal growth that cannot be covered by traditional teaching and assessment methods. Studies on student perceptions in multiple settings have highlighted the positive impact of portfolios in helping them to understand and reflect better on exit learning
M
outcomes (Davis et al., 2009).
To conclude, a portfolio is a written record of accomplishments during a training period.
d
Although best used probably as formative teaching tools to provide timely feedback and
te
correction, they also have the potential to be used as summative assessment tools provided a few methodological issues are sorted out. This letter is intended to be a sensitizer for institutes in Asia to initiate the use of portfolios at a postgraduate level, where the concept, unlike in the
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
West, is relatively new and yet to gain traction. References:-
Challis, M., 1999. AMEE Medical Education Guide No. 11 (revised): Portfolio-based learning and assessment in medical education. Med. Teach 21 370–386. Davis, M.H., Ponnamperuma, G.G., Ker, J.S., 2009. Student perceptions of a portfolio assessment process. Med. Educ 43 89–98. doi:10.1111/j.1365-2923.2008.03250.x Ingrassia, A., 2013. Portfolio-based learning in medical education. Adv. Psychiatr. Treat 19 329– 336. doi:10.1192/apt.bp.111.009480 Thomas, D.S.M., 1998. The use of portfolio learning in medical education. Med. Teach 20 192– 199. doi:10.1080/01421599880904
Page 3 of 4
Van Tartwijk, J., Driessen, E.W., 2009. Portfolios for assessment and learning: AMEE Guide no.
te
d
M
an
us
cr
ip t
45. Med. Teach 31 790–801.
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Page 4 of 4
S1876-2018(14)00196-8 http://dx.doi.org/doi:10.1016/j.ajp.2014.08.008 AJP 641
To appear in: Received date: Accepted date:
6-8-2014 10-8-2014
Please cite this article as: Menon, V.,Portfolios for post graduate psychiatry residents: potentials and pitfalls, Asian Journal of Psychiatry (2014), http://dx.doi.org/10.1016/j.ajp.2014.08.008 This is a PDF file of an unedited manuscript that has been accepted for publication. As a service to our customers we are providing this early version of the manuscript. The manuscript will undergo copyediting, typesetting, and review of the resulting proof before it is published in its final form. Please note that during the production process errors may be discovered which could affect the content, and all legal disclaimers that apply to the journal pertain.
TITLE PAGE 1. Title: Portfolios for post graduate psychiatry residents: potentials and pitfalls 2. Running Title: Portfolios for postgraduates
ip t
3. Author: 1. Dr Vikas Menon MBBS, MD (Psychiatry), DNB (Psychiatry)
cr
Assistant Professor
us
Dept. of Psychiatry
Jawaharlal Institute of Post Graduate Medical Education and Research (JIPMER)
an
Puducherry-605006, India
M
4. Address of institution where work was carried out: Jawaharlal Institute of Post Graduate Medical education and Research (JIPMER), Dhanvantary Nagar
d
Puducherry-605006, India
te
5. Corresponding author: Dr Vikas Menon
Assistant Professor
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Dept. of Psychiatry JIPMER, Dhanvantary Nagar Puducherry-605006, India Mob: +91-9894410296 Email: [email protected] Fax: +91413-2272067 (ATTN: Dr VIKAS MENON)
7. Declaration of interests: None
Page 1 of 4
Sir, In recent times, there has been a growing demand from the general public and competent professional bodies that doctors display generic competencies apart from core knowledge of their subject (Van Tartwijk and Driessen, 2009). These so called „soft skills‟ include communication
ip t
skills, empathy and teamwork, all of which are included within the ambit of the term „professionalism‟. Though such skills are required in all disciplines, they appear to be
cr
particularly relevant to the practice of psychiatry. Increasingly, psychiatrists are expected to be leaders of multi-disciplinary teams handling complex psycho-social, behavioral and emotional
us
disorders which require them to have reasonable communication, man management and troubleshooting skills. It is fairly clear that our present day training does not focus on these
an
aspects. In such a scenario, a portfolio based approach could address some of these issues and counteract the reductionist approach to medical education.
M
Briefly, a portfolio is a “collection of student‟s work, which provides evidence of the achievement of knowledge, skills, appropriate attitudes and professional growth through a process of self-reflection over a period of time” (Davis et al., 2009). Implied in this definition is
d
the central process of reflection which helps the learner to purposefully revisit an experience to
te
extract the learning points from it. It is now recognized that this process happens best when the trainee is paired with a mentor, who having gone through this experience, will be better placed to guide the trainee to reflect appropriately (Challis, 1999). This process of reflection is also what
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
differentiates a portfolio from a conventional log book. To give an example, suppose a resident encounters a suspected case of catatonia in the emergency room and is unsure whether to initiate benzodiazepines. All he needs to do is just jot down brief details of the case, which is used to identify learning gaps in discussion with the mentor, and see how they can be filled. Apart from allowing for in-depth exploration of a clinical problem this process also addresses things which are not normally taught or assessed such as a doctor‟s feelings of inadequacy when faced with a doubtful clinical situation. Other components of a student portfolio could be video recordings of consultations which could be played back for giving feedback on communication skills, reflections on seminars and tutorials to identify areas for further learning, audits, project work and anything else the candidate thinks is relevant (Thomas, 1998). Although traditionally paper based, portfolios can also be conveniently maintained in an electronic format which removes the
Page 2 of 4
encumbrance of paperwork. However there are some methodological issues in implementing a portfolio. Clear guidelines and comprehensive support should be given to both mentors and students on their usage. Issues of confidentiality and access to contents need to be paid utmost care and attention considering the personal nature of information in a portfolio. Additionally,
ip t
there are ongoing concerns about the negative impact of formal assessment on material collected (Ingrassia, 2013). Owing to the flexibility of reporting and documentation offered, it is difficult
cr
to standardize the contents of a portfolio and make objective comparisons in order to rank the students. It may be difficult to verify the accuracy and honesty of students in reporting an
us
incident that has not gone too well for them. The assessment of a portfolio is labor and time intensive. Hence, the current consensus seems to be that portfolios are best used as additions to
an
illustrate aspects of personal growth that cannot be covered by traditional teaching and assessment methods. Studies on student perceptions in multiple settings have highlighted the positive impact of portfolios in helping them to understand and reflect better on exit learning
M
outcomes (Davis et al., 2009).
To conclude, a portfolio is a written record of accomplishments during a training period.
d
Although best used probably as formative teaching tools to provide timely feedback and
te
correction, they also have the potential to be used as summative assessment tools provided a few methodological issues are sorted out. This letter is intended to be a sensitizer for institutes in Asia to initiate the use of portfolios at a postgraduate level, where the concept, unlike in the
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
West, is relatively new and yet to gain traction. References:-
Challis, M., 1999. AMEE Medical Education Guide No. 11 (revised): Portfolio-based learning and assessment in medical education. Med. Teach 21 370–386. Davis, M.H., Ponnamperuma, G.G., Ker, J.S., 2009. Student perceptions of a portfolio assessment process. Med. Educ 43 89–98. doi:10.1111/j.1365-2923.2008.03250.x Ingrassia, A., 2013. Portfolio-based learning in medical education. Adv. Psychiatr. Treat 19 329– 336. doi:10.1192/apt.bp.111.009480 Thomas, D.S.M., 1998. The use of portfolio learning in medical education. Med. Teach 20 192– 199. doi:10.1080/01421599880904
Page 3 of 4
Van Tartwijk, J., Driessen, E.W., 2009. Portfolios for assessment and learning: AMEE Guide no.
te
d
M
an
us
cr
ip t
45. Med. Teach 31 790–801.
Ac ce p
1 2 3 4 5 6 7 8 9 10 11 12 13 14 15 16 17 18 19 20 21 22 23 24 25 26 27 28 29 30 31 32 33 34 35 36 37 38 39 40 41 42 43 44 45 46 47 48 49 50 51 52 53 54 55 56 57 58 59 60 61 62 63 64 65
Page 4 of 4
