Portfolio learning for foundation doctors: early feedback on its use in the clinical workplace

Abstract

CONTEXT: A learning portfolio was developed to support the development of trainee doctors piloting Foundation Programme prototypes across the Northern Deanery in 2004 and 2005. Trainee doctors and their educational supervisors were surveyed about their experiences of using the portfolio in the clinical workplace. METHODS: The evaluation consisted of semi-structured interviews with trainee doctors and supervisors, followed by postal questionnaire surveys in 2004 and 2005. Quantitative and qualitative data were triangulated to identify core findings. RESULTS: Questionnaires were returned from 182/305 (60%) trainee doctors and 104 out of 179 (58%) educational supervisors. The portfolio was felt to be a 'good idea' by 55% supervisors and 48% trainees. Trainees' perceptions of the educational value of the portfolio remained consistently low over 2 surveys and they described a sense of 'burden', whereby they identified problems in workload and usability and in gaining feedback on performance. However, positive trainee attitudes towards the portfolio were significantly correlated with greater perceived educational benefits (r = 0.855, P < 0.001). DISCUSSION: Learning portfolios are now an integral part of Foundation Programme training but this evaluation suggests that many trainee doctors and educational supervisors are yet to be convinced of their educational value. Gaining multi-source feedback, a substantial component of trainee doctors' portfolios, impacts on the wider clinical team and presents a significant challenge to trainees. Educational supervisors continued to rely on feedback from clinical colleagues, rather than portfolio evidence, to monitor trainee doctors' development. Such factors may serve to disengage trainees with the portfolio process by overshadowing any perceived educational gains.