Introduction to portfolio assessment and development by Dr Madawa Chandrathilake, MBBS (Colombo), MMEd (Dundee), PhD (Dundee) Senior Lecturer in Medical Education, Faculty of Medicine, University of Kelaniya, Sri Lanka

1. An Introduction to
Portfolio Assessment
Dr Madawa Chandratilake
MBBS (Colombo), MMEd (Dundee), PhD (Dundee)
Senior Lecturer in Medical Education
Faculty of Medicine
University of Kelaniya

2. What do you think is the primary role of a
doctor in today’s context?
Dealing with uncertainty
Making clinical decisions
[e.g. Bleakley A & Marshall R (2013); Luther VP & Crandall SJ (2011)]
[Uncertainty in decision making:
Situation where the current state of knowledge is such that
• the order or nature of things is unknown,
• the consequences, extent, or magnitude of circumstances,
conditions, or events is unpredictable, and
• credible probabilities to possible outcomes cannot be assigned.
(http://www.businessdictionary.com)]
 Clinical reasoning
 Critical thinking
Our assessment should assess the ability of our trainees in dealing with
uncertainty.
Madawa Chandratilake

3. • Am I ready to practise my discipline?
• Am I progressing toward the desired
direction?
Have any of you ever
asked these questions
from yourself?

4. • What are the key requirements for
practising medicine in today’s context?

5. Reflective practice
• What is reflective practice?
– What did I do well?
– What didn’t I do well?
– How can I improve?
• Reflective practice is the corner
stone of practising medicine
• Portfolio is one of the effective
methods of encouraging reflective
practice.

6. ASSESSMENT SETTING
 increased authenticity
TREND
Madawa Chandratilake

7. What is a portfolio?
• A purposeful collection of papers and other
forms of evidence to demonstrate that
learning has taken place, annotated with the
student’s reflections on what has been
learned in terms of the learning outcomes.
[Davis MH, Friedman Ben David M, Harden RM, Howie P, Ker J,
McGhee C, Pippard MJ. & Snadden D. (2001). Portfolio assessment in
medical students’ final examinations. Medical Teacher 23: 357-366.]

8. Portfolio Log book
A collection of evidence for
learning
+
Reflection upon evidence &
learning
If portfolio is a collection of ‘work’……
=
?
A collection of evidence
of learning
They are different!

9. Key elements
• Outcomes
• Purposeful collection
• Evidence
• Reflection

10. Outcomes
• Outcomes
Doctor as a
practitioner
1. Clinical skills and patient
management
2. Communication skills
3. Population health & health systems
4. Information management
Doctor as a scientist
5. Scientific basis of Medicine
6. Critical thinking & research
Doctor as a
professional
7. Professional values, attitudes &
ethics
Outcomes of the MBBS programme

11. PGIM outcomes for Board Certification
• Subject expertise
• Teaching
• Research and audit
• Ethics and medico-legal issues
• Information technology
• Life-long learning

12. Purposeful collection
• Who should select the evidence?
–Person who maintains the
portfolio
–There can be some evidence
prescribed by the academic
staff
• Should be relevant to the
outcomes

13. Evidence
• Case reports
• Certificates
• Letters of rewards /
condemnations received
• Abstracts / articles

14. Reflection
• In relation to each outcome
 A short description of events
– What were my strengths?
– What were the challenges /
educational gaps?
– What actions did I take to bridge
those educational gaps?
– How successful were my actions?

15. Reflection
An iterative process

16. A completed portfolio

17. Frequently Asked Questions
(FAQs)

18. Is the introduction of portfolios a
fancy idea?
• No. we are already late!
• It has now become a universal
practice in all stages
(undergraduate, postgraduate,
and continuing medical
education) of medical training.

19. Why can’t you use MCQs, OSCEs,
reports, etc. rather than portfolios?
• Other assessment methods on their
own cannot assess your ability to
reflect.
• Portfolio helps make sense of all
other assessments
• Reflective practice is the
cornerstone of the practice of
medicine.

20. Can the ‘evidence’ be the same for
more than one person?
• Some evidence can be common
and other may be individualised.
• Although the evidence are the
same reflection on the evidence
SHOULD BE DIFFERENT.

21. Will I need support to complete
my portfolio?
• Definitely, YES.
• But you need to be PROACTIVE.
– The support will be provided by
‘mentors’.
– They are not your ‘assessors’.
– You need to meet mentors regularly to
get feedback when you have written
something
• Peer feedback is also acceptable.

22. Should I be good at written
English?
• Yes, but not to the level of
Shakespeare.
• English is one of the generic skills.
• Take this as an opportunity.

23. Completing the portfolio is so easy! It is
a matter of copying from somebody.
Isn’t it?
You would have thought so. BUT
• Plagiarism is an unprofessional act
and such persons should not be
allowed to practise medicine.
• Mentors and assessors can easily
detect plagiarism.

24. Will I be able to complete my
portfolio nearer the assessment
starting from scratch?
• A big mistake!
• You need to collect evidence for
the portfolio from the beginning.
• Regularly, your progress should be
discussed with your mentor.

25. Any more questions?

26. Trainee portfolio for radiology
Part III – Formative learning process
a. Case Records
(local and overseas - minimum of 5 cases from
following imaging modality per year – U/S, CT, Plain
films, Fluoroscopy, MRI and at least 2 cases from
Mammography NM and Paediatrics etc)
a. Continuous Professional Development (CPD) activities
(Seminars, conferences attended)
b. Generic skills courses
(Communication skills, Information technology, Ethics)

27. An example for Part III(a) reflection
Case 1 Case 2 Case 3 Case 4 Case 5
Background information
What did you do well?
What were the challenges
you faced?
Measures taken for
overcoming the challenges
What did you learn?
Important:
• Should not necessarily be a very ‘dramatic’ patient presentation
• It may be something very routine which you may learned out of this
• Reflection is not about blaming yourself
• Showing that you are good at reflection in practice and reflection on practice

28. Case 1
Background information 65 years old male, previously healthy, presented
trauma department with sudden circulatory
collapse with RHC pain
What did you do well? Identifying a liver mets and bleeding around the
liver with an old U/S machine
What were the challenges
you faced?
To confirm my suspicion of necrotising liver
metastasis with the old U/S machine
Measures taken for
overcoming the challenges
Did a subsequent U/S before surgery with the
same machine. Confirmed the diagnosis of NM by
identifying the increased bleeding (spreading
beyond the liver)
What did you learn? Even with old machine NM can be confirmed by
doing serial U/S scans
Should be done as soon as possible to avoid
masking by peritoneal blood

29. An example for Part III (b) and (c) reflection
• What is / are the goals / objectives of
engaging in the CPD activity?
• What did you learn?
• How did / do you use what you learned in
your practice?

30. Part IV – Innovation
• Research
• Audit
• Publications
Part V – Teaching/sharing ability
• Lectures/Teaching (local and overseas)
• Clinical presentations

31. An example for Part IV and V
• What did you do well in your research / audit /
publication?
• What areas do you think you should improve?
• What measures did / do you take to address
these needs?
• (Were your measures successful?)

32. Thank you
madawachandratilake@gmail.com
mnchandratilake@kln.ac.lk