How does e-portfolio use in medical school enhance the reflective practice of final year medical students? – a realist evaluation.

Problem

Portfolios are widely used in medical education, but their effectiveness varies (Driessen et al., 2007). Portfolios may be electronic (e-portfolio) or paper-based and are often used to encourage learners to reflect on their experiences. The value of reflective practice for the personal and professional development of healthcare professionals amongst other benefits is widely reported. Writing reflections helps develop reflective proficiency (Bolton and Delderfield, 2018). Portfolios can foster reflective practice amongst medical students (which they will continue to use for lifelong learning and professional development as doctors) provided certain conditions are met. A study carried out by Driessen et al. (2005) in which they interviewed mentors highlighted conditions for the successful reflective use of portfolios in undergraduate medical education. They also called for more studies amongst the learners themselves. Thus, the research participants in our study are medical students who have used an e-portfolio to reflect during medical school. Further research has also called for studies into the variable success of the portfolio system in promoting reflective practice especially with regards to the influence of the context in which the portfolio is used (Driessen et al., 2007). Our study addresses this issue of context and aims to extend current knowledge by explaining how e-portfolio use in medical school enhances the reflective practice of medical students to gain an understanding of what works, for whom, why and in what circumstances.

Approach

We used a realist evaluation methodology to answer the research question because of the complex and context-sensitive nature of the e-portfolio system in different medical schools. A qualitative approach is employed because the e-portfolio in this setting does not generate numerical data as reflections are not scored. One to one semi-structured interviews are being held with purposively sampled final year medical students to test and refine initial programme theory developed using findings from a focused literature review and an expert panel discussion. Interview data will be analysed for context-mechanism-outcome configurations which will then be utilised to produce a refined programme theory.

Findings

Data collection is currently ongoing, results analysis will be presented at the conference.

Consequences

It is anticipated that the underlying mechanisms by which the e-portfolio use in this medical school enhances (or hinders) reflective practice will be unravelled. It goes beyond answering the question ‘does e-portfolio use in medical school enhance the reflective practice of medical students’ to gaining an understanding of ‘how’. These findings could inform medical educators in this and other settings on how to maximise the potential of the e-portfolio to enhance the reflective practice of medical and other healthcare students.