How does portfolio use support self-regulated learning during general practitioner specialty training? A qualitative focus group study.

Autor:	van der Gulden R; Department of Primary and Community Care, Radboudumc, Nijmegen, Netherlands rozemarijn.vandergulden@radboudumc.nl., Timmerman AA; Department of General Practice, Maastricht University, Maastricht, Netherlands., Sagasser MH; Network of GP Specialty Training Institute, Utrecht, Netherlands., Kramer A; Department of Public Health and Primary Care, Leiden Universitair Medisch Centrum, Leiden, Netherlands., Scherpbier-de Haan N; Department of General Practice and Elderly Care Medicine, Academic Hospital Groningen, Groningen, Netherlands., Thoonen B; Department of Primary and Community Care, Radboudumc, Nijmegen, Netherlands., Heeneman S; Department of Pathology, Maastricht University, Maastricht, Netherlands.
Jazyk:	angličtina
Zdroj:	BMJ open [BMJ Open] 2023 Feb 10; Vol. 13 (2), pp. e066879. Date of Electronic Publication: 2023 Feb 10.
DOI:	10.1136/bmjopen-2022-066879
Abstrakt:	Objectives: Portfolios are used to support self-regulated learning (SRL), but the research literature is still inconclusive on their effectiveness. This study explored experiences with portfolio use among different stakeholders, to answer the research question: How does portfolio use support SRL during general practitioner (GP) specialty training? Design: We used a qualitative research design, based on phenomenology. Setting: Three of the eight training institutes of Dutch GP specialty training participated in this study. Participants: The three stakeholder groups that use the portfolio were included in nine homogenous focus groups: trainees (n=16), supervisors (n=16) and faculty (n=17). All participants had at least 6-month experience with portfolio use. Results: Three themes were identified: SRL with(out) the portfolio, stakeholder dynamics and ambiguities. Respondents were doubtful about the learning benefits of portfolio use, as most trainees used their portfolio to 'check off' what was considered required. Stakeholder dynamics contributed to checking off behaviour in two ways. First, trainees experienced documenting learning activities to be superfluous, since the close relationship with their supervisor already supported SRL sufficiently. Second, faculty often (unintentionally) took portfolio ownership away from trainees, as they instructed trainees to deliver portfolio content that was valuable for assessment. Without ownership, trainees struggled to use the portfolio for SRL. Besides, ambiguities related to portfolio use amplified checking off behaviour. Conclusions: Portfolio use did not support SRL in our setting. The multipurpose use of the portfolio (for the support of SRL and assessment) was identified as the primary obstacle. Underlying is a conflict that is often present in current medical curricula: agency versus accountability. If the support of SRL is considered a valuable and attainable purpose of portfolio use, it is important to realise that deliberate attention for this purpose is required during the design, guidance, assessment and evaluation of the portfolio. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2023. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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