25 Jul, 12 | by BMJ
Am I the only member of the ePortfolio fan club? If the recent vitriol on Twitter is anything to go by, one would be forgiven for thinking that the fan club comprises n=1. The most notable tweet about ePortfolio was from an anaesthetic trainee who said, “The portfolio is the medical profession’s equivalent of Mao’s cultural revolution—detainees given diaries to write down their own faults.”
Is it really this bad? I think much of the negative publicity around ePortfolio is unfair. Having returned to clinical practice after time working in the private sector and the civil service, I for one, find it useful. My experience of CPD and personal development outside medicine is a mixed bag. I found myself veering from high-quality leadership development courses to sub-optimal sessions on presentation skills. There is no formal “curriculum” in many non-medical jobs. No one holds your hand and asks if you have done a certain number of presentations to clients or says, “You don’t really have experience of skills in this area, how can we ensure your sub-speciality training is tailored to include this?” You are expected to learn on the job, attend in-house courses, be appraised, and seek out career development opportunities in your own time. The ultimate result of this is your standing in the annual promotion cycle and performance bonus.
Medics in training endlessly complain about the curriculum, ePortfolio, deanery teaching courses, Royal College fees etc. The truth is we just don’t realise how good we’ve got it. I wonder if we would be complaining as much if we had to compete for promotion to various registrar grades once already within a post-ST3 specialist training programme?
Of course, the ePortfolio is far from perfect. The end user is typically generation Y and expects technology to have the beautiful aesthetics and seamless functionality of their i-products.
Improving functionality e.g. linking curriculum items to assessments, and aesthetics is essential for an improved ePortfolio. Forced ePortfolio reflection is another bone of contention. True reflective practice is useful and the reality is that most of us reflect. Our tweets, blogs, and discussions in the mess are all reflection. Allowing ePortfolio to include free text reflection and links to social media might be a way of improving this.
Does the ePortfolio encourage a tick-box culture that drives mediocrity, rather than excellence? Furthermore, where is the evidence that a portfolio-based documentation and reflection produces good doctors? Perhaps educationalists could work with the relevant educational bodies to elucidate the evidence behind the learning theory. And finally, what is the portfolio without the incessant workplace based assessments? Many supervisors need training and skills on how to do these appropriately. It seems that an ePortfolio culture shift of increased transparency and trainee engagement is needed.
Many early career doctors could easily have taken the route of investment banking or management consultancy. They chose instead to work in the NHS. As a cohort of intelligent, motivated young people, we are able to take responsibility for adult learning, but need to be treated like adults in order to do so. If the ePortfolio gods are listening—engage with us, take constructive feedback, and try to improve the portfolio to inspire the medical generation Y.
Fiona Pathiraja is a specialist registrar in radiology, based in London. She has previously worked as a healthcare management consultant and entrepreneur, and she spent two years seconded to the Department of Health, where she was clinical adviser to the NHS medical director. Follow her on Twitter @dr_fiona