Example Portfolio for students at Leicester Medical School.

LEICESTER MEDICAL SCHOOLPortfoliofor the Assessment ofProfessional Competence2011/12MB ChB

Personal DetailsStudent’s Name/ ID Number:___________________________________Age at entry into pre-registration training:________________________Gender: MALE FEMALEPLEASE TICK Professional group:e.g. medicine___________________________________Entry intake date:___________________________________Mentor/Personal Tutor Name: ___________________________________If this material is found please return to:2

ContentsPersonal details 2PageGlossary of Terms 4Purpose of this portfolio 5What is Reflective Learning 6What is Competence 8A) Professionalism in medicine 9Guidance on what to record 10Aims 11B) Interprofessionalism 12Guidance on what to record 13Aims 15Guidance on Satisfactory Completion of the Portfolio 16REFLECTIONS 17A) ProfessionalismPhase I 18Phase II 20B) Interprofessonalism 24Strand One 25Strand Two 28Strand Three 30Evidence 33Final Reflections 34Mark 37Record of Attendance 393

Glossary of TermsHEI’sHigher Education InstitutionsIPInterprofessionalIPEInterprofessional EducationIPLInterprofessional LearningIPWInterprofessional workingCAIPEUK Centre for the Advancement ofInterprofessional Educationwww.caipe.org.ukGMCGeneral Medical Councilwww.gmc-uk.orgHPCHealth Professions Councilwww.hpc-uk.org4

What is this portfolio for?This Portfolio has two purposes:i) For Learning: This Portfolio will act as a tool for recording your learning ofprofessional and interprofessional practice.ii) For Assessment: This Portfolio is designed to contain your reflective writingon significant learning events which demonstrate your developingcompetence (knowledge, skills, attitudes and behaviours) towards your futureprofessional practice. This writing will form a major part of your assessmenton professionalism.A portfolio has been defined as:“A purposeful collection of student work that exhibits the student’s efforts, progressand achievements in one or more areas.” (Paulson, Paulson, Meyer; 1991 1 )Professionalism and interprofessional working are two themes which run throughyour curriculum. There is general agreement that medical students are not ready tocommence a professional career unless they have understandings related to values,beliefs, attitudes and behaviours, concerning;a) professionalism relating to personal attributes and qualitiesandb) interprofessionalism, understandings of team working and collaborativepractice.Teaching and learning related to professionalism and interprofessionalism are thefoundations for your personal development towards becoming a competent doctor.These qualities are strongly related to you becoming a safe practitioner. Until thelast decade it was assumed that these competencies were acquired whenshadowing doctors and other practitioners during clinical rotations. However,evidence suggests that medical schools should provide explicit learning experiencesand assessments on professional competencies, as attitudes acquired as anundergraduate, can persist in the longer term.Does this learning count towards my qualification?Yes. You must complete the required reflections throughout your training and beready to hand in your work when requested. Your Portfolio must be completed to asatisfactory level by the end of your training. Keep this document in a safe place andtake it to all relevant teaching sessions so that tutors can sign to confirm attendance.This is because you will need evidence, often tutors signatures, that you attendedthe events and participated. In addition we advise you to keep all your reflectivewriting, electronically. We confirm that this Portfolio will be assessed during yourtraining and you must pass this element of medical training before beingprogressed as successful following the final professional examination.1 Paulson, F. L., Paulson, P. R., & Meyer, C. (1991). What makes a portfolio a portfolio? Educational Leadership,48(5), 60-63.5

Stage Three – So What? (Meaning and Application)Being able to describe something and figure out why it happened is not enough; areflective practitioner needs to see the overall meaning of events. Consider thefollowing questions:Why did this seem like a significant event to reflect on?What have I learned from this? How could I improve?How might this change my future thinking, behaving, interactions?What questions remain?Stage Four – Now What? (Implications for Action)It is in this stage that reflection moves into action planning. What are theimplications of what you have discovered from the preceding steps? Consider thefollowing questions:What will I do differently?Cycle of Reflective Learning1. ExperienceA learning eventWhat is going on? When did ithappen? Who was involved?4. Take forward yourthinkingWhat now? Design newways of doing things.As a result of this experience Iwill now…?2. ReflectionAnalysis of the learningevent in relationship to thelearning outcomesWhy did this happen? Werethere any contributory factors?3. Challenge past learningMeaning and Application.Reconstruct your knowledgeand understanding.Could this be done differently?Please go to blackboard to see some examples of poor and excellent reflections.7

What is Competence?In this Portfolio you are expected to reflect on your developing competence towardsprofessional and interprofessional practice. So what do we mean by competence?A competent professional has an ability to handle a complex situation by combining:Knowledge or cognitive domain ~ the learning of specific factsSkills or psychomotor domain ~ the practice of knowledgeAttitudes or affective domain ~ the development of feelings oremotions or appropriate values demonstrated through professionalbehaviour (Miller GE, 1990 4 ).Competency is perceived as a dynamic concept. It is not merely the understandingof new knowledge, or the acquisition of a clinical skill, but an ability to use thesecomponents together and ensure a component professional performance (Verma,Paterson and Medves 5 ). This implies that it is more than a set of specific knowledge,skills and attitudes; it is a coordination of a persons cognitive and affective abilities.Throughout your learning journey in the medical school you are taught on theknowledge components of your curriculum. These relate to the doctor as a;i) scholar and scientist e.g. anatomyii) practitioner e.g. how to take a historyiii) professional e.g. ethical principles and team working theory.Once you have the knowledge you then begin to practice the skill of doing e.g. theskill of effective communication, or taking a blood pressure. In addition you will beasked to complete these skills using a set of positive attitudes and values. As youbegin to work in clinical environments you will consider how to apply science,conduct clinical skills and act professionally ensuring to relate your work to otherrelevant colleagues. These separate components will be combined in your clinicallearning environments when working alongside practitioners and engaging withpatients in the community or in hospital. In this way the separate aspects of yourcompetence come together. This Portfolio is concerned with how you apply yourknowledge, skills and attitudes to be professional and interprofessional. We haveseparated out the individual aspects of the components of being professional andinterprofessional and expect you to start to combine these components together asyou progress towards qualification. However, this journey will span your career.Today’s doctors must work professionally in the following contexts:With patientsWithin clinical healthcare teamsAcross care pathwaysWithin healthcare organisations4 Miller GE. (1990). The assessment of clinical skills/competence/performance. Academic Medicine, 65 (9): S63-S675 Verma, S, Paterson, M & Medves, J (2006). Core competencies for health care professionals:What medicine, nursing,occupational therapy, and physiotherapy share. Journal of Allied Health, 35, 109 - 115.8

A) Professionalism in MedicineAlthough there are different interpretations of what ‘being a professional doctor’means there is strong agreement that it relates to the quality of the doctor which is acombination of relevant; knowledge, skills, and attitudes or values based on soundjudgements and integrity. In today’s modern practice arena’s doctors are required towork in partnership with the patient and their family/carers to negotiate and thenagree, how to manage their care.We expect that during your training the following aspects of being professional e.g.knowledge; skills and attitudes/values and related behaviours will be acquired topractice safely and competently during Foundation Training and beyond:ProfessionalismTeaching to ensure a set of values, behaviours and relationships that ensurepublic trust in doctorsKnowledgeTheoretical understanding of what constitutes a profession including regulationMorality and spiritualityEthical practiceSocial responsibility and advocacyHumanitiesLaw and accountabilityConfidentiality and consentDealing with unprofessional behaviourSkillsIntegrityAltruismCommunicationCompassion and empathyRespect of cultural and ethnic diversityInteractions with patients to demonstrate, confidentiality, consent, capacityLeadershipCoping with stress and uncertaintySelf awareness and insightContinuous improvement and commitment to lifelong learningValues/attitudesAppreciation of the values and attitudes required for positive professional practiceRecognise need for on-going personal developmentBehavioursPut into practice above learning when working with patients and other colleaguesAppropriate personal and interpersonal behavioursNon-judgmental practicePersonal conduct and behaviour throughout medical school training including attendance9

What should you record?Learning events should meet the following criteria:Align to the GMC recommendations of professional practice and show amotivation to strive to achieve theseDemonstrate a commitment to wanting to seek to improve and to be able tocritically appraise performanceLearning moments are related to experiences or situations either undertakenin the medical school and or other training setting or in clinical practice.Phase IYou may choose to write on a reflection relating to your personal developmentrelating to any of the following learning:Graduates: Aspects of professional practice from the block Patient CentredClinical Practice (PCCP)Reflection following a lecture on professionalismExperiences during the clinical skills consultation skills foundation courseSemester 4 related to Health and Disease in Society (HaDSoc)Reflections on the GMC documents relating to professionalism in medicineReflections on any articles you read on professionalism in medicine.Phase IIYou must choose two situations for reflection from your clinical blocks. We suggestone from your junior rotation and one from your senior rotation.These must include:a) Reflections on something you have done which shows positiveprofessional practice, or, something you have done where you couldimprove on your professional practice.b) Reflections of your observations of a doctor who has behavedprofessionally.10

Aims of your Professional LearningYour learning at medical school relating to your future professional practice, aims toensure that on graduation you will behave according to ethical and legal principles ofyour regulatory body the General Medical Council.Phase I: You will be expected to:Explore what is meant by professionalism as outlined by the General MedicalCouncil and apply relevant theory and policyUnderstand and apply professional behaviour e.g. being polite, considerate,trustworthy and honestPrepare for patient-centred clinical care which shows respect for theindividual and their circumstancesAppraise the importance of maintaining confidentialityShow respect for those you learn with, and from, during your trainingincluding academics, practitioners and students from other professions.Phase II: You will be expected, under supervision, to:Appreciate and apply good standards of clinical care ensuring evidencebased practicePractice personal professional behaviours to ensure patient-centred clinicalcareAnalyse the pivotal position of medicine to enable good working relationshipswith colleagues and in teaching othersAnalyse what it means to consider moral and ethical issues in clinical careReflect on your developing professional competence while in practice.11

B) InterprofessionalismToday’s doctors do not practice single handedly and quality of patient care is mainlya collective endeavour, crossing many professional boundaries, statutory and nonstatutoryorganisations. Working in teams poses new challenges for collectivedecision making and requires leaders who will take on accountability. These leadersare not necessarily doctors. Being interprofessional will require you to know yourweaknesses within a team setting and ensure they are matched by others strengths.InterprofessionalismTeaching that prepares doctors to be practice-ready to work within a team andcollaboratively to improve health outcomes.KnowledgeTheoretical understanding of team working dynamicsPsychological and sociological principles of team workingUnderstanding of the roles and responsibilities of other professions, voluntary sector andprivate sectorTeam based communicationLeadership/managementEthical principles, stereotypingConstituents of safe team-based practiceSkillsNegotiationInterprofessional communicationLeadershipPartnership workingExchange of skills and teachingPatient-centred careEmotional intelligence (in a team context)Recognise limits (in a team context)Values/attitudesAppreciation of the values and attitudes required for positive inter-professional practiceRecognise need for on-going personal developmentBehavioursPut into practice above learning when working with patients and other colleaguesRecognise the scope of other disciplines practiceTreat other colleagues with respect and dignity etc12

What interprofessional events can I record?Learning events must meet these criteria:There must be at least two different professions present at the learningmoment (these maybe students or qualified practitioners)The learning event must be interactive. There must be an opportunity to learnabout each other’s roles and responsibilities and to learn through theexchange of knowledge and ideas.Learning Strand OneLearning Strand TwoLearning Strand ThreeEarly classroom based learning relating to the theory ofteam workingHealth in the Community - team working andcollaborative practicePatient Safety Workshops and simulation events,Listening Workshops with service users, learning inteams about elderly care, those with mental illness,children, cancer, diabetic etc and e-learning possibilities.Increasing Interprofessional CompetenciesStrand ThreeStrand TwoStrand OneMainly Universitygroup workPatient* focussedactivity.Mostly practice basedlearning.Patient* focussedactivity.Mostly practicebased learning withan e-learning event.*Patient/service user/clientInterprofessional EducationIn 1988 the World Health Organisation endorsed interprofessional learning, “Learntogether to work together”. Effective team working benefits patients/serviceusers/clients and has been found to improve professional working lives (Borrill et al;2000 6 ; WHO 2010). These learning events will help you think and learn in differentways throughout your training.6 Borrill C, West M, Shapiro D, Rees A. (2000) Team working and effectiveness in health care. British Journal ofHealth Care Management. 6(8): 364-371.World Health Education. (2010). Framework for action on interprofessional education & collaborative practice,Geneva: WHO.13

Interprofessional Education is not separate but an integral part of youruni-professional study.14

Aims of your Interprofessional Education (IPE)STRAND ONEAimsTo explore what is meant by team working in health and social careTo begin to apply a theoretical understanding to team workTo become familiar with your chosen profession and othersTo consider the outcomes of team working for promoting person-centredcollaborative care.STRAND TWOAimsTo apply the theoretical basis of team workingTo gain a richer appreciation of roles and responsibilities of practitionersTo analyse effective collaborative team practiceTo consider your future contribution to person-centred team working.STRAND THREEAimsTo provide context(s) for applying and developing working competence topracticeAnalyse and reflect on challenging real situations to consider solutions toimprove team based careTo develop an understanding of how individual professional competenciescomplement those of other professionsTo develop an understanding of team working in modern health and socialcare and education.15

Guidance on How to Complete a Satisfactory PortfolioIn order to pass you must submit a completed portfolio containing:The required minimum number of reflections showing aspects ofprofessionalismA signed record of attendance for organised IPE to show that you haveattended a minimum of three events e.g. strand one, two and three.Completed writing which shows reflection on competence e.g. developingknowledge, skills, attitudes and behaviourProfessional writing within the word limitA completed final reflection prior to finalsThe marking criteria will be placed on blackboardWhat Support Can I Expect?Your personal tutor would be able to help with any problems and there will be IPEtutors at all organised interprofessional learning events.Reading ListGeneral Medical Council. (2006) Good Medical Practice: GMC,, London.General Medical Council. (2007). Medical students: professional behaviour and fitness to practise.Guidance from the General Medical Council and the Medical Schools Council, London, GMC.Gibbs, G.(1988). Creating a Teaching Portfolio. Technical and Educational Services Ltd, Bristol.Hammick, M., Freeth, D., Copperman, J. & Goodsman, D. (2009). Being Interprofessional. PolityPress, Cambridge.Hilton, S. & Southgate, L. (2007). Professionalism in Medical Education. Teaching and TeacherEducation, 23, 265–279.Hutchings. S., Hall, J., & Lovelady, B. (2003). Teamwork. A guide to successful Collaboration inHealth and social Care. Speechmark, Publishing LTD, Oxon.Levenson, R., Dewar, S. & Shepherd, S. (2008).Understanding Doctors- Harnessing Professionalism.London: Kings Fund : Royal College of Physicians.Levenson, R., Atkinson, S. & Shepherd,S. (2010). The Twenty First Century Doctor. Understandingthe Doctors of Tomorrow. Kings Fund: Royal College of Physicians: Kings Fund, London.McNair, R. (2005). The case for educating medical students in professionalism as the core content ofinterprofessional education. Medical Education, 39, 456-464.Miller, C., Freeman, M., Ross, N. (2001). Interprofessional Practice in Health and Social Care.Challenging the shared learning agenda. Arnold. London.Moon, J. (1999). Reflection in Learning and Professional Development, Kogan Page, London.Royal College of Physicians. (2005). Doctors in society: medical professionalism in a changing world.Report of a Working Party of the Royal College of Physicians: London, RCP.Schön, DA. (1987) Educating the Reflective Practitioner, Jossey-Bass Publishers, San Francisco.Thistlethwaite, J & Spencer, J (2008). Professionalism in Medicine. Radcliffe-Publishing Ltd. Oxen.16

REFLECTIONSSection A) ProfessionalismSection B) Interprofessionalism17

SECTION APhase IProfessional Learning: Personal DevelopmentWhen and with whom?(Enter the date)Reflections (1,000 words)What? And so what?Where?(State the locality/NHS site)REFLECTION18

Phase IIProfessional Learning: Reflections on something you havedone which shows learning towards developing good professionalpracticeWhen and with whom?(Enter the date)Reflections (1,000 words)What? And so what?Where?(State the locality/NHS site)REFLECTION20

Phase IIProfessional Learning: Observation of a doctor’s ProfessionalPracticeWhen and with whom?(Enter the date)Reflections (1,000 words)What? And so what?Where?(State the locality/NHS site)REFLECTION22

Section BInterprofessional WorkingReflections from induction weekWhen and with whom?(Enter the date and which professionstudents were working towards)Where?(State the locality/NHS site)Medical School27 th September 2011Class-room learning in medicalschoolReflections: on interprofessional working (500 words)Consider the discussions in your group. What was important for you andwhy?24

Interprofessional Learning (IPL) EventsStrand One (Phase I)When and with whom?(Enter the date and which professionstudents were working towards)Where?(State the locality/NHS site)ReflectionsWhat? And so what?What did you learn about? Brief summary only- approximately 200 words.25

How did this learning advance your developing interprofessionalcompetence? (So what?) An analytical personal reflection of approximately 1,000words26

Interprofessional Learning (IPL) EventsStrand Two (Phase I)When and with whom?(Enter the date and which professionstudents were working towards)Where?(State the locality/NHS site)ReflectionsWhat? And so what?What did you learn about? Brief summary only- approximately 200 words.28

How did this learning advance your developing interprofessionalcompetence? (So what?) An analytical personal reflection of approximately 1,000words29

Interprofessional Learning (IPL) EventsStrand Three (Phase II)When and with whom?(Enter the date and which professionstudents were working towards)Where?(State the locality/NHS site)ReflectionsWhat? And so what?What did you learn about? Brief summary only- approximately 200 words.31

How did this learning advance your developing interprofessionalcompetence? (So what?) An analytical personal reflection of approximately 1,000words32

EVIDENCE sectionDateWhat Learningexperience doesit relate toDescription of whatevidenceWhat knowledge skillsand attitudes does itdemonstratePlease insert your evidence after this page in date order and or store in a safe place33

SECTION FIVEFinal Reflections34

ProfessionalismFinal –reflections foryour futurepracticeAs a result of your journey what knowledge skills andattitudes have you developed towards becoming anProfessional Doctor and how will you use and develop thislearning in your future practice35

InterprofessionalismFinal –reflections foryour futurepracticeAs a result of your journey what knowledge skills andattitudes have you developed towards becoming aninterprofessional team member and able to engage withcollaborative working. How will you use and develop thislearning in your future practice36

Tutor comments and reflections:FINAL: Tutors Marking SheetMark:Tutor signature:Student comments:Student signature:38

Record of Attendance39

STRAND ONEWhat Date Student Signature Authorising SignatureLaunch VideoCourseexplanation27/9/11Session 1Introduction toIPESession 2Introduction toIPESession 3Graduates onlyOtherTutor/Facilitator Comment Box40

Strand TwoWhat Date Student Signature Authorising SignatureTutor/Facilitator Comment Box41

Strand ThreeWhat Date Student Signature Authorising SignatureTutor/Facilitator Comment Box42