MedEdPORTAL (Sep 2006)
Graduate Medical Education (GME) Showcase Portfolio Assessment
Abstract
Abstract Introduction Presently, a nationwide effort by residency education programs to more objectively assess and document resident performance within the ACGME General Competencies is in progress. Residents in the University of Arkansas for Medical Sciences psychiatry residency program annually submit a portfolio as part of their yearly comprehensive evaluation. The portfolio requirement began as a pilot effort in 1999 and was officially incorporated into the residency program in 2000. A committee of faculty and residents within the department identified 13 important general psychiatric skills to be reflected within individual portfolios. All psychiatry residents must demonstrate competence in each of these areas. Methods A resident selects his/her best work within each area to showcase in a portfolio. The portfolio consists of individual entries demonstrating the resident's abilities within each of the 13 skill areas. An entry in the portfolio is a collection of documents reflecting actual resident work within a skill area and may comprise chart documentation, laboratory or radiology records, literature searches, and various other relevant data. Also included in an entry is a cover letter that is an exercise in self-evaluation and an opportunity to explain how the entry demonstrates the resident's best work and to clarify, acknowledge, or justify any potential shortcomings of the entry. Portfolios are independently rated by two board-certified psychiatrists who are blinded to the identity of residents, patients, and attending psychiatrists. Results While our sample is small, we have performed a number of validity studies. We found that portfolio scores correlated with the Psychiatry Resident In-Training Examination scores. We also found no correlation with global ratings, a trend toward the highest portfolio scores with our most senior residents, and an association of portfolio scores with evidence within the portfolio for the ACGME competencies. In a qualitative study, we found that graduates reported the portfolio experience as encouraging them to be more self-critical and reflective about their work. Discussion It is essential to sustain a regularly-meeting work group to discuss issues such as implementation, assessment guidelines, rater calibration, scholarly products, and logistic organization. Our group meets weekly for 90 minutes. As accreditation and other forces affect graduate medical education, we have recognized the opportunity to modify our program to better adapt to these forces. By keeping an open mind, we can use the residents' portfolios to recognize weaknesses in our own educational program.
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