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Example 1
Scenario: Using portfolio development to enhance the Professionalism and Practice-based Learning and Improvement abilities required to address emotionally difficult medical situations.
Your oncology rotation provides residents many opportunities to learn about the professional attitudes, skills, and knowledge required to address emotionally difficult medical issues with patients and their families. You believe that such learning could be enhanced if the residents reflected on these experiences and understood the impact of these experiences on their practice.
The illustration below describes how portfolio development may be used to address Professionalism and Practice-based Learning and Improvement objectives during your rotation. Your learning objectives are that residents will be able to: 1) reflect on difficult encounters and analyze how their values, skills, and knowledge are affecting their care of patients with challenging and/or terminal illnesses; and 2) use information about weaknesses to plan learning needed to care effectively for patients with challenging and/or terminal illnesses.
Illustration:
You know that self-reflection is an important component of Professionalism and Practice-based Learning and Improvement, but that it is unlikely to occur systematically in the absence of any expectation or mechanism to do so. To create a structure for self-reflection, you ask residents to complete a biweekly journal that would comprise a series of portfolio entries. To structure their writing, you ask them to address the following areas: 1) Briefly describe the most difficult patient encounter you experienced during the past 14 days; 2) How well do your current abilities help you to address difficult encounters? 3) What do you need to learn in order to provide more effective care for patients with challenging and/or terminal illnesses? You set up the journal so that it can be completed electronically or on hard copy. You use the journal entries to stimulate discussion during monthly meetings with your residents about critical self-reflection and its role in professional development. To prepare for these discussions, you ask residents to review their entries and identify, compare, and contrast issues that emerge over time.
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