The perceived strengths and weaknesses of the General Practice training e-portfolio: A case study exploration of General Practitioner (GP) trainers’ perspectives
Background : General Practitioner (GP) trainers spend considerable time completing their trainees’ e-portfolios, yet there is a paucity of research into their views This study aimed to illuminate their perspectives and propose modifications. Additionally, a recent law-suit has highlighted tensions over written reflections in training e-portfolios being used in a court of law and this paper contributes to the conversation
Methods: Case study methodology was adopted. A survey permitted purposeful selection of six GP trainers for interview and informed the interview schedule. Semi-structured interviews provided the data and thematic analysis was employed for data analysis. Credibility indicators included member-checking and cross-checking.
Results: Strengths and weaknesses of the e-portfolio were identified. Strengths lay in the ability to demonstrate accountability for a rigorous educational process, and intrinsic educational aspects of the e-portfolio. Weaknesses lay in the time spent by GP trainers in documentation, perceived by them as excessive, and the threats to credibility conferred both by burdensome documentation and the requirement for written reflection on clinical errors.
Conclusions and Recommendations: There is a risk of GP trainers endangering their work-life balance and clinical performance by the time spent on the e-portfolio. Participants proposed reducing documentation with fewer competencies and log-entries. They suggested that written reflection on clinical imperfections should not be expected, whilst learning from researching knowledge gaps should, and that they, as GP trainers, should be more involved in e-portfolio evolution.
 GP trainers are GPs who have undergone extra training in education, often involving obtaining a Post Graduate Certificate in Education.
Cleland, J. et al. (2014) ‘Resisting the Tick-box Culture: Refocusing Medical Education and Training’, British Journal of General Practice, 64 (625), pp. 422-423.
Cohen, D. (2017) ‘Back to blame: the Bawa-Garba case and the patient safety agenda’, British Medical Journal. Available at: https://doi.org/10.1136/bmj.j5534 (Accessed December 14 2017).
Costley, C. Elliott, G. and Gibbs, P. (2010) Doing Work Based Research. London: Sage.
Creswell, J. (2014) Research Design Qualitative, Quantitative and Mixed Methods. 4th edn. Thousand Oaks: Sage.
Department of Health (2004) Modernising Medical Careers (ROCR Ref: Gateway Ref: 2893). Available at: http://webarchive.nationalarchives.gov.uk/20130107105354/http:/dh.gov.uk/prod_consum_dh/groups/dh_digitalassets/@dh/@en/documents/digitalasset/dh_4079532.pdf (Accessed: 12 December 2017).
Driessen, E.W. (2009) ‘Portfolio Critics: Do they have a point?’, Medical Teacher, 31(4), pp. 279-281.
Driessen, E. W. et al. (2007) ‘Portfolios in medical education: why do they meet with mixed success? A systematic review’. Medical Education, 41: pp.1224-1233.
Eve, R. (2003) PUNs and DENs: Discovering Learning Needs in General Practice. Oxford: Radcliffe.
Ferguson, J., Wakeling, J. and Cunningham D.E. (2014) ‘General practice training in Scotland: the views of GP trainers and educators’. Education for Primary Care, 25, pp. 211-220.
Foulkes, J. Scallan, S. and Weaver, R. (2013) ‘Educational supervision for GP trainees: time to take stock?’ Education for Primary Care 24, pp.90-92.
Furmedge, D. (2016) ‘Written reflection is dead in the water’. BMJ Careers. Available at: http://careers.bmj.com/careers/advice/Written_reflection_is_dead_in_the_water (Accessed September 16 2016).
General Medical Council (2013) Good Medical Practice. Available at: http://www.gmc-uk.org/guidance/good_medical_practice.asp (Accessed: 21 March 2017).
Goodyear, H.M., Bindal, T. and Wall, D. (2013) ‘How useful are structured electronic Portfolio templates to encourage reflective practice? ’, Medical Teacher, 35, pp. 71-73.
Honey, P. and Mumford. A. (1986) Using Your Learning Styles. 2nd edn. Maidenhead: Honey.
Hrisos, S., Illing, J.C. and Burford, B.C. (2008) ‘Portfolio Learning for foundation doctors: early feedback on its use in the clinical workplace’, Medical Education, 42, pp. 214-223.
Jenkins, L., Mash, B. and Derese, A. (2013a) ‘The national portfolio for postgraduate family medicine training in South Africa: a descriptive study of acceptability, educational impact and usefulness for assessment’, BMC Med. Educ., 13(101), doi: 10.1186/1472-13-101.
Jenkins, L., Mash, B. and Derese, A. (2013b) ‘The national portfolio of learning for postgraduate family medicine training in South Africa: experiences of registrars and supervisors in clinical practice’, BMC Med. Educ., 13 (149), doi: 10.1186/1472-6920-13-149.
Johnson, G. et al. (2008) ‘Feedback from educational supervisors and trainees on the implementation of curricula and the assessment system for core medical training’. Clinical Medicine, 8(5), pp. 484-489.
Kilminster, S.M. and Jolly, B.C. (2000) ‘Effective supervision in clinical practice settings: a literature review’. Medical Education, 34, pp. 827–40.
Kolb, D.A. (1984) Experiential Learning. Englewood Cliffs, NJ: Prentice Hall.
Lewis, J. (2014) Qualitative research practice: a guide for social science students and researchers. 2nd edn. Edited by Jane Ritchie, Jane Lewis, Carol McNaughton Nicholls and Rachel Ormston. London: Sage.
Makris, J. et al. (2010) ‘Consultants’ attitudes to the assessment of GP specialty trainees during hospital placements’, Education for Primary Care, 21, pp. 236-242.
Mann, K., Gordon, G. and Macleod, A. (2009) ‘Reflection and reflective practice in health professions education: a systematic review’, Advances in Health Sciences Education, 14 (4), pp. 1573-1677.
Mohanna, K. and Tavabie, A. (2008) General Practice Specialty Training, Making it happen, London: Royal College of General Practitioners.
Murray, C. and Smith, A. (2007) ‘From application to graduation and beyond: Exploring user engagement with e-portfolios and the e-advantage’, European Journal of Open, Distance and E-Learning. Available at: http://eurodl.org/materials/contrib/2007/Murray_Smith.htm (Accessed: 13 April 2015).
Pereira-Gray, D. (1993) ‘Portfolio-based learning in General Practice: report of a working group on higher professional education’, Occasional paper, Royal College General Practitioners, 63, pp. 1-22.
Sandars, J. (2009) ‘The use of reflection in medical education’, AMEE guide no. 44. Medical Teacher, 31(8), pp. 685-695.
Schön D. A. (1983) The Reflective Practitioner. London: Temple Smith.
Sexton, J.B.et al. (2016) ‘The associations between work–life balance behaviours, teamwork climate and safety climate: cross-sectional survey introducing the work–life climate scale, psychometric properties, benchmarking data and future directions’, BMJ Quality and Safety. Available at: http://dx.doi.org/10.1136/bmjqs-2016-006032 (Accessed: March 22 2017).
Shaw, B. et al. (2014) ‘An investigation of factors affecting the outcome of the clinical skills assessment (CSA) in general practice specialty training’, Education for Primary Care, 25, pp. 91-95.
Snadden, D. (1999) ‘Portfolios: attempting to measure the unmeasurable?’, Medical Education, 33, pp. 478-479.
Snadden, D. et al. (1996) ‘Portfolio-based learning and general practice vocational training’, Medical Education, 30 (2), pp.148-152.
Tavabie, A. (2009) ‘Overview of GP specialty training’, in Mohanna, K. and Tavabie, A. (eds.) General Practice Specialty Training. London: Royal College of General Practitioners, pp. 1-10.
Tailor, A. Dubrey, S. and Das. S. (2014) ‘Opinions of the ePortfolio and workplace-based assessments: a survey of core medical trainees and their supervisors’, Clinical Medicine, 14 (5), pp. 510-516.
Van Tartwijk, J. and Driessen, E.W. (2009) ‘Portfolios for Assessment and learning’, AMEE Guide no. 45. Medical Teacher, 31 (9), pp. 790-801.
Wiener-Ogilvie, S. Jack, K. and Lough, M. (2008) ‘General practice trainers’ views on the newly introduced General Practice Specialist Training Programmes in Scotland’, Education for Primary Care, 19, pp. 366-75.
© The Author(s). 2018 Open Access This article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.
AJPP requests that, as the creator(s)/author(s) of the manuscript you are submitting, that you assign certain rights to the manuscript to the AJPP in exchange for undertaking to publish the article in electronic form and, in general, to pursue its dissemination throughout the world. The rights the AJPP requests are:
- The right to publish the article in electronic form or in any other form it may choose that is in keeping with its role as a scholarly journal with the goal of disseminating the work as widely as possible;
- The right to be the sole publisher of the article for a period of 12 months;
- The right to make the article available to the public within a period of not more than 24 months, as determined by relevant journal staff of the AJPP;
- The right to grant republication rights to itself or others in print, electronic, or any other form, with any revenues accrued to be shared equally between the author(s) and the journal;
- The right to administer permission to use portions of the article as requested by others, seeking recompense when the AJPP sees it as warranted;
- The right to seek or take advantage of opportunities to have the article included in a database aimed at increasing awareness of it;
- As the author(s), the AJPP wishes you to retain the right to republish the article, with acknowledgement of the AJPP as the original publisher, in whole or in part, in any other pbulication of your own, including any anthology that you might edit with up to three others;
- As the author(s), the AJPP wishes you to retain the right to place the article on your personal Web page or that of your university or institution. The AJPP askes that you include this notice: A fully edited, peer-reviewed version of this article was first published by the Advanced Journal of Professional Practice, <Year>, <Volume>, <Issue>, <Page Numbers>.
- You retain the right to unrestricted use of your paper for yourself or for your own teaching purposes.
BY AGREEING TO THE FOREGOING, YOU CONFIRM THAT THE MANUSCRIPT YOU ARE SUBMITTING HAS NOT BEEN PUBLISHED ELSEWHERE IN WHOLE OR IN PART, AND THAT NO AGREEMENT TO PUBLISH IS OUTSTANDING.
SHOULD THE ARTICLE CONTAIN MATERIAL WHICH REQUIRES WRITTEN PERMISSION FOR INCLUSION, YOU AGREE THAT IT IS YOUR OBLIGATION IN LAW TO IDENTIFY SUCH MATERIAL TO THE EDITOR OF THE AJPP AND TO OBTAIN SUCH PERMISSION. THE AJPP WILL NOT PAY ANY PERMISSION FEES. SHOULD THE AJPP BE OF THE OPINION THAT SUCH PERMISSION IS NECESSARY, IT WILL REQUIRE YOU TO PURSUE SUCH PERMISSSION PRIOR TO PUBLICATION.
AS AUTHOR(S), YOU WARRANT THAT THE ARTICLE BEING SUBMITTED IS ORIGINAL TO YOU.
Provided the foregoing terms are satisfactory, and that you are in agreement with them, please indicate your acceptance by checking the appropriate box and proceed with your submission.