Learning tool for tomorrow’s competent physicians: The eFolio

DEFINTION OF PORTFOLIO • N. 1. A flat, portable case (as a briefcase, a large heavy envelope, or loose-leaf binder) for carrying papers or drawings. • 2. The office and functions of a minister of state or member of a cabinet. • 3. The securities held by an investor or the commercial paper held by a bank or other financial house W ebster’s Third International Dictionary

Definition of e-folio

Educational tools for documenting learner achievement of competence and fostering reflection on practice with the intent of improvement.

– Longitudinal record of professional growth – Documents learning – Self-assessments – Assessment by others

State of e-folios

• Many different eFolios under development • UME Collaborative • ACGME Portfolio Project • We are poised to create a fragmented collection of tools that are not portable and cannot communicate.

Interest in a National eFolio Framework • • • Colloquium (AAMC, NBME) May 2007 Invitational Conference (AAMC, ACGME, FSMB, NBME) October 2007 Aim – focus attention nationally on development of transportable, inter operable efolios that meet the needs of the individual physician and local programs

Potential purposes of efolio • • • • • • • • • • • Designation of learning objectives and expectations Documentation of learning experience (case and procedure logs) Performance measures and processes of care Patient outcomes Self-assessment (e.g. knowledge, skills, behaviors) Reflection and self-appraisal Mentoring External assessment of competencies Evaluation of programs Targeting of CME/CPD and maintaining CME/CPD logs Transparency for consumer choice

Proposed design principles • • • For physicians and their needs, regardless of national origin, site of training, experience, status of licensure and certification Non-punitive system for private learning, self-assessment and self-improvement State-of-the-art security and confidentiality

Proposed design principles • • Individual physician controls access to data and can authorize transmission of select data to demonstrate proficiency or satisfy external mandates Inter-operability across settings and transportability across the continuum of education and practice

Service and Functions

Private learning environment for the physician in practice • • • • • • Self-assessment Self-appraisal and reflection ?Mentoring

Planning for self-improvement Finding and tracking CME ?Expunge data when no longer contributory

Documenting proficiency to public • • • • • • • Basic credentials (CV) for different purposes External validation of data reported from private learning environment Maintenance of certification Record of CME Licensure application Clinical privileges Facility accreditation

Challenges and Issues • • • • • • Balancing learning and evaluative uses Two structural layers – private and public Protecting the private layers Connecting efolios across the continuum Managing efolio content at transitions along the education – practice continuum Financial responsibility for the system

Challenges and Issues • • • • Infrastructure to prepare both teachers and learners to use the efolio Infrastructure to assist practicing physicians to use the efolio IMGs Strategies and tools to stimulate skills of self-assessment

The Hope for E-folios • • • • Connect medical education competencies across the curriculum Function as epr- electronic physician record for the individual Facilitate reflective practice (competency of practice-based learning and improvement) Manage longitudinal data about individual physician’s patient outcomes