The “Structured Portfolio”: A framework For Outcomes-Based Evaluation

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Portfolios have long been used in education to document the activities and progress of the learner. Portfolios are usually collections of work, evaluations, and products of the learner over time. In contrast to the traditional “learning portfolio,” in which a trainee determines the contents, the contents of a “structured portfolio” are defined by both the training program and the trainee to maximize outcomes-based evaluation. A portfolio does not function as a single evaluation “tool” but represents a framework and process for collecting, analyzing, and documenting the successful acquisition of the general competencies. This process requires active engagement of the trainee in their own evaluation processes.

The principal characteristics of a structured portfolio are that it:

  • Employs a multifaceted approach to evaluation. Research has shown repeatedly that an evaluation system heavily weighted toward global faculty evaluations overestimates resident competency. Global evaluations often suffer from poor validity and reliability and fail to accurately assess domains such as communication skills, practice-based learning, and systems-based practice. Educational Evaluations in US visit here

  • Uses the principle of “triangulation.” Evaluation methods, if used effectively and properly, can be used to evaluate more than one general competency.

  • Is longitudinal and comprehensive in scope and truly represents a composite of a trainee’s competence and performance.

  • Includes evidence of trainee self-assessment and reflection.

  • Contains trainee contributions, demonstrating evidence of professional growth and performance to the structured portfolio. Keep in mind that the resident should have full access to the portfolio.

  • Evaluates all 6 general competencies by more than one method per competency.

  • The minimal components for a structured portfolio would include at least one method of evaluation from each of the following 4 broad evaluation methodologies:

  • Foundational Evaluations: The longitudinal global ratings and monthly evaluations by faculty. These evaluations should represent a robust composite of multiple assessments by faculty.

  • Direct Observations: Observation of the trainee’s clinical, communication, and interpersonal skills.

  • Practice and Data-Based Learning: Active application by the trainee of personal performance data and system information to improve his or her practice. One example would be a medical record audit of patients accompanied by self-assessment, reflection, and a quality improvement plan.

  • Multi-Source Evaluations: The perspective of patients and nonphysician health care providers should be included as part of the portfolio.

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