Alex Haig, Karen Beggs, Claire Tochel

Self-assessment is being used in an ever-widening number of contexts across the health professions, despite the fact there is little evidence of its effectiveness. With the increasing use of ePortfolios, assessment data (self and external) is far more readily analysed than in previous paper format. This paper examines a year of Scottish (Foundation) trainee doctors’ assessment data to determine if self-assessment patterns are replicated when delivered and recorded by a mandatory ePortfolio.

A total of 14,878 multi-source feedback (MSF) submissions were analysed. There were moderate parallels between the data and the patterns found in the wider literature. Discussion focuses on the implications of this and the wider potential for ePortfolios to serve as an analysis tool.

Julia O’Sullivan, Robert Morgan

Introduction: The Faculty of General Dental Practice (UK) [FGDP(UK)] at the Royal College of Surgeons of England is introducing an ePortfolio to support members to record, evaluate and produce evidence of their continuing professional development (CPD). General dental practitioners (GDPs) and dental care professionals (DCPs) are required to keep a portfolio for a number of purposes, such as registration with the UK regulator, the General Dental Council (GDC), foundation training and contracting with the UK NHS primary care trusts. This paper outlines the findings from the pilot phase of the project in spring 2010.

Pilot phase: Between February and May 2010 a total of 150 volunteers signed up to the pilot project to evaluate the ePortfolio. They were asked to complete 10 specific tasks, thereby providing a structure to the process. The pilot was evaluated from formal feedback collected twice during, and once at the end of the pilot. The informal feedback was also collected and analysed.

Results: The pilot tasks provided a structured learning approach and were useful for building a portfolio online. They aided the navigation which improved with familiarity. The ePortfolio is an excellent CPD tool, facilitating reflection and planning. The ability to keep all CPD information in one place and update assets (records) are important features of the system. The evaluation process provided positive and critical qualitative feedback which is being used for further development and customisation of the system.

Future activity: The ePortfolio will be used for FGDP(UK) educational programmes and assessments in the future. It will also be used by the FGDP(UK) divisions for online discussion forums, communication with fellow professionals and organising professional events, all of which are designed to improve the quality and safety of patient care.

Summary: The introduction of the ePortfolio is a work in progress. The pilot exercise described has provided data to inform development of a career-long ePortfolio for dentistry to manage CPD activity. The evidence can be validated as a measure of demonstrating improved performance for the benefit of patient care.

Simon Cotterill, Paul Horner, David Teasdale, Janice Ellis, J Mark Thomason, Chris Vernazza, Philip Bradley, John Peterson, Gordon Skelly, Steve Ball

The extent to which ePortfolios and Personal Development Planning (PDP) are embedded in medical and dental education curricula can be an important factor in engagement. This paper identifies different ways in which ePortfolios can be embedded and integrated with the curriculum. This draws on the wider literature and on specific case studies from undergraduate medicine and dentistry at Newcastle University (UK). We also provide early evaluation of a new approach for embedding portfolio learning within online curriculum maps. Different types of embedding and integration are identified in these case studies and most are generalizable to other contexts.

Christopher Murray, Delia Muir

The tutor role is a pivotal aspect of ePortfolio learning, but there has been very little research centred on tutor usage in comparison with the output centred on student perceptions. The tutor role is the vital bridge between the student and both their use of ePortfolio and their learning. Without tutor input and the opportunity for critical reflection, how do students develop reflective skills and identify and develop the skills required for lifelong learning and personal development planning? In the initial stages of their professional learning, how do students begin to write, organise, extract and understand the learning, in and from their collected evidence and learning journals, and begin to develop their professional identity?

A number of tutors teaching on the medical degree at the University of Leeds (UK) are using an ePortfolio (Progress File) with students in their tutor groups through the Personal and Professional Development module and another tutor is working with student ePortfolio entries across the curriculum.

This paper will outline how the Progress File is being used across the course, the impact of the use of the ePortfolio on the relationship between student and tutor, and how this relationship can be used to facilitate learning. It will present the emerging issues and the changes to course management, pedagogy and feedback provision from a tutor’s perspective.

Anne-Marie Howes

Assessment and Learning in Placement Settings (ALPS) facilitated a student led ePortfolio project to address the requirements of 16 different healthcare professions, across five universities in West Yorkshire (UK), with the aim of designing an ideal ePortfolio. This highlighted the importance of generic and specific pedagogical issues underpinning facilitation in healthcare settings and in the use of ePortfolios.

George Hogg

The teaching of effective compliance with hand hygiene has been foremost in the early education of junior medical students within the Clinical Skills Centre at the University of Dundee (UK) for the last five years. Early introduction of students to the hospital ward setting in Semester 1 of their course means that the prevention of infection is at the forefront in the minds of the teaching staff. Until September 2007 the focus of teaching was hand washing using soap and water with some reference to alcohol hand rub. The introduction of the World Health Organisation (WHO) ‘Five Moments for Hand Hygiene Model’ into the National Health Service (NHS) was an ideal opportunity to implement and evaluate this model as a new method of teaching medical students.

This paper describes an Action Research based project undertaken by the author with 165 Year 1, Semester 1 medical students. The results from Objective Structured Clinical Examination (OSCE) and focus groups demonstrate that the ‘WHO Five Moments’ is an effective base from which to improve hand hygiene compliance in a clinical skills setting.

Annette Burgess, Kirsten Black

Background: Clinical Training Associates (CTAs) teach medical students the communication and technical skills to undertake a pelvic examination and Pap smear, whilst being examined themselves. At some clinical schools of The University of Sydney (Australia) there is a doctor present in the room and at others the CTAs run the sessions alone.

Aim: To investigate the factors motivating the CTAs to take part in the teaching program and to discuss how their different roles in these sessions impact on their experience.

Methods: Eleven CTAs took part in focus group sessions that were recorded and transcribed. We use qualitative data analysis methods to undertake theme and content analysis.

Results: CTAs derived satisfaction from their role as a teacher, in creating a relaxed atmosphere, in promoting communication skills, in working as part of a team, from a sense that they were doing something good for society and from attainment of new knowledge. The women felt that these rewards were somewhat diminished when they were employed in a more passive role as the “sample patient” compared to leading the teaching with another CTA.

Conclusion: The CTAs’ motivation comes largely from intrinsic rewards. The women preferred to work in pairs without a medical presence in the room.

Kate Rowe-Jones

Having discussed the role of reflective journals to assess the learning experience from clinical placements in healthcare undergraduate programmes in a previous paper, this subsequent paper is based on an action research study that explored what strategies need to be put in place to support and elicit such authentic reflections by undergraduate students.

At Bournemouth University (UK) final year BSc (Hons) Exercise Science students are required to write a reflective journal for their Clinical Observation Unit and some students find this an uncomfortable and often extremely difficult task. The literature supports this view and there is a plethora of further literature regarding the perceptions of students on reflection. This is confounded by research which highlights the numerous influences upon reflection and confusingly advocates various process models and strategies that need to be put in place to facilitate and support such reflection.

In order to gain an insight into students’ understanding of reflection and ways in which they felt they could have been better supported, a semi-structured focus group interview was conducted. With the results of this interview and the knowledge gleaned from the literature, an action research cycle was initiated, instigating strategies to support student reflection in another student cohort across one year. Subsequently, a further focus group interview was carried out with this second cohort to ascertain if the strategies put in place had been effective.

It was found that students felt most comfortable and supported in a confidential seminar situation where effective facilitation enabled them to develop and elicit the skills required to reflect successfully. Students did not find the use of process models and guidelines helpful in their reflective activities. As clinical teachers and supervisors we are in danger of becoming too wrapped up in the psychological and intellectual facets of reflection, rather than simply allowing students to get on with it.

Loretta J Garvey, Virginia Plummer

Aims & Objectives: The aim was to identify the educational, human and organisational factors, which contribute to decision support for nurses in their graduate year. The objective was to provide information for future support in medication management for graduate nurses.

Design: A quantitative analysis of data from a retrospective, exploratory study.

Method: An anonymous survey of graduate nurses in a convenience sample was undertaken. Data collection was at a single point, 9 months into a 12 month graduate program. The survey sought to identify what factors, if any, contribute to graduate nurses’ decision-making, for nurse initiated medication. A comparison was made between graduates on 11 different wards in 3 hospitals of an Australian Health Care Network.

Results: The study reveals the positive influence of both human and organisational support for nurses initiating medication and it validates previous research findings.

Conclusion: The findings of this study inform a so far poorly researched area of nursing and highlight the need for further exploration of graduates and their decision-making in medication management.

Rachel Asghar, Kumar Abhinav

Cranial nerve examination is often perceived by some as a challenging examination which is time consuming, difficult to interpret and often involves sparsely distributed or unavailable equipment.

This paper summarises key points involved in cranial nerve examination and is intended to make junior doctors feel more confident at performing and interpreting the examination. A summary table of common cranial nerve lesions and their signs and symptoms is provided.

Noraliza Mohd Ariffin, Zulkernain Ahmad, Hilwani Kaharuddin

Introduction: Resuscitation can have long term unwanted effects on the patient’s family members, as well as the healthcare professionals involved, especially if it does not meet the targeted outcome. In view of this, health care professionals have to ensure strategies are in place to minimize unwanted effects.

Case Study: A 20 month old male was brought to the Emergency Department at Universiti Kebangsaan Malaysia Medical Centre (UKMMC) in a collapsed state due to foreign body airway obstruction. Despite resuscitation efforts, the child did not survive.

Conclusion: The holistic approach to resuscitation requires communication and management skills beyond that of advanced life support. In particular, specific skills in breaking bad news, management of family members, as well as healthcare professionals’ postresuscitation self-care skills, are essential in delivering holistic care.

David T Walker

With the advent of the 48 hour working week in the UK, time at the operating table for surgical trainees has diminished. Junior doctors are finding themselves transferred from elective operating, the traditional environment for acquiring the basic surgical skills, to providing service commitment.

We present a quick and easy way to assemble a realistic training conduit using surgical gloves. The model allows the junior trainee or medical student to practise interrupted, subcuticular and mattress suturing. Our technique is quickly assembled in almost any clinical area to allow for trainees to practise and demonstrate technique, as well as for opportunistic surgical teaching.

Learning Forum London 2010, Savoy Place, London, UK

Following the extremely successful 8th International ePortfolio Conference 2010, the International Journal of Clinical Skills is pleased to publish 10 of the best abstracts and 5 of the highest awarded papers as selected by the Conference Scientific Review Committee. A substantial number of submissions were made to the Conference (‘Track EP1 – ePortfolio in healthcare education and practice’) and all were put through a rigorous peer review selection process led by Professor Harry Owen. If you require any further information please e-mail editor@ijocs.org