Using the portfolio to foster reflective practice through formative assessment of the CanMEDS professional role: Preparing residents for the competent-to-expert milestone

Abstract

Background/Objectives The transition from competent to expert practitioner is a key milestone in the first years after completing residency. Successful consultants practice life-long reflection of their practice in all CanMEDS domains. Residency programs should guide and motivate residents to develop into “reflective practitioners”. Methods A portfolio was introduced to the Anesthesia Residency Program at MUN during the 2011/12 academic year for this purpose. A key component of the portfolio is a reflection on the CanMEDS Professional role. Prior to this, an education specialist held a workshop to introduce residents to narrative reflection. The portfolio reflection follows several steps. First, they complete assigned background reading. Then they write a narrative summary of a clinical, teaching, research or other experience which impacted their thinking about professionalism. A designated faculty member guides residents to reflect on their experience, demonstrate what they did well and what they would do differently in the future. The faculty member gives formative feedback on the portfolio and completes a qualitative assessment. The program director reviews portfolios once a year. A resident interested in reflective practice acts as a resource for residents with questions, helps them initiate portfolio writing and facilitates discussion of the portfolio project among the resident group. Review and feedback are used to reflect on and improve the portfolio process. Results Feedback from residents, the resident mentor and the faculty mentor has been positive to date. Conclusions The plan is to add a new CanMEDS role each year for the development of resident portfolios as they move from PGY1-5.