Portfolios to Train Interactions between Patients and Doctors-to-be: Making It Work

Aims: Portfolios are used more and more in medical education, especially in Western countries, and lately, also in the Middle East and Asia. This is the first portfolio to be included in the curriculum of preclinical medical education in Germany. The aim of the study is to present the developed portfolio as well as data on the acceptance and effort by the students, time needs of staff, and on the assessment.
Study Design: Cohort study.
Place and Duration of Study: Department of Psychiatry and Psychotherapy, Friedrich-Alexander-University Erlangen-Nuremberg, Medical Psychology and Medical Sociology, between October 2011 and July 2012.
Methodology: The Erlangen Portfolio was developed to teach doctors-to-be interaction with patients and reflective abilities in the context of curricular education in Medical Psychology and Medical Sociology. An evaluation system was developed; the mandatory portfolio constitutes a substitute for a classical written exam. It is anchored in the time-line of the 2nd to the 4th semesters of the medical curriculum at the Friedrich-Alexander-University Erlangen-Nuremberg. N = 136 students were surveyed with written questionnaires in July 2012 after completing their portfolios. Quantitative data were collected, and 161 portfolios of this cohort were analyzed concerning success according to the assessment criteria.
Results: The majority of the students had a positive attitude toward the portfolio after completion (72%) and preferred this competence-based assessment over a written exam (86%). On average, it took 23 hours for a student to develop a portfolio. The assessment showed that 15% of the students passed right away and 85% needed to improve their portfolios after the first evaluation. Reflecting on one’s own communication, according to Roger’s dimensions of conversation, required the most improvement. For the majority of the students, the anamnestic interview was the most difficult part of the portfolio.
Conclusions: Even though it is time-consuming, data and feedback from students suggest that portfolios are a teaching method for undergraduate medical students that is accepted, assessable, and useful in the field of curricular medical education.