Your Learning Portfolio
CPRB Standard 2.2.3 (2)
"The resident shall use a learning portfolio or equivalent to facilitate self-assessment and provide evidence of skill development over the course of the program. The learning portfolio should include preceptor assessments, monthly reports, quarterly or other summative assessments, self-assessments, career objectives, clinical activities during the rotations, awards, projects, and other documentation relating to a resident’s progress throughout the duration of the residency program."
Overview of the LEARNING Portfolio
The creation and maintenance of a Learning Portfolio (LP) is a core mechanism by which our residents engage in reflection and documentation throughout their residency year. All residency activities and learning experiences are fodder for the LP and the resident should find themselves updating their LP on a regular basis. Not only is maintaining a learning portfolio a program requirement, it is a great way to set a pattern of introspection and self-assessment that you will use throughout your career.
Your LP serves as a record of the progress you have made during the residency program and points to the direction you are going. To this end, your lP should serve as a home for:
Your personal learning objectives for the program and for your individual rotations
Your reflections on your learning experiences and how they have shaped your practice
The work that you have completed as part of the program - presentations, article summaries, project work, etc
PROCEDURE LOG: PERSONAL LEARNING OBJECTIVES OF RESIDENCY PROGRAM & INDIVIDUAL ROTATIONS
At the beginning of the residency year and prior to the start of each rotation (rotation exceptions noted below) you need to document your personal learning goals and objectives in the one45 “personal learning objective procedure log” and document how you will achieve each goal. To do so, go to your personal rotation objectives procedure log and click “create new log entry”. Select the rotation that the log entry will pertain to. To enter personal learning goals and objectives of the overall residency program, select “R Year” as the rotation from the list. It is important to complete and submit the personal learning objective log before the rotation, as this document will be forwarded to the preceptor for this rotation. The preceptor will then “sign off” on this document at the start of the rotation. The preceptor and resident should review these personal learning objectives together at the start of the rotation. Personal learning objective procedure log does not need to be completed for the following rotations: General Orientation, Clinical Orientation, Clinical Orientation Workshop, Lab Orientation/Critical Appraisal/Vancouver Didactic Week, Toxicology Week
Expectations of the Resident
In order for it to fulfill its potential as a learning tool, residents must maintain an up-to-date eP at all times during the program. This is both an Island Health program requirement and a CPRB Standard. It is far more useful and less painful to drop info into it as it happens than to try to collect your thoughts long afterward.
Below are some specific program expectations for the eP (an Example Reflection Post can also be found at the bottom of this page):
A reflection on learning should be completed for each rotation, at minimum, within three days the rotation ending. Residents are encouraged to post more frequently, even if it means shorter entries.
Occasionally, preceptors may include specific reflections in the eP as a required activity, in addition to the minimal requirement outlined above.
Each post should have a category (e.g. rotation) and a tag (e.g. CPRB competency).
Posts can be in point form or in prose, this is up to the individual resident.
There is no minimal posting length.
A typical reflection should include a brief description of important learning experiences and the salient point(s) that will influence the resident’s practice going forward.
Residents should include the URL for their eP to their next preceptor at one week prior to their next rotation.
In preparation for each upcoming rotation, residents should post any specific learning objectives that they wish to focus on during that rotation. These may be drawn from assessments done of them or from their personalized program learning objectives set at the beginning of the year.
What NOT to post on your eP:
Descriptions of what you "did" without a description of what you learned.
Patient-specific information. Bottom line...your eP is in the public domain, even if you have selected the highest security setting. You are encouraged to reflect on what you have learned in your provision of direct patient care but remember to exclude any identifiable information about any patient or caregiver.
Sharing your eP provides a basis for preceptors to tailor rotations to best meet your learning needs, avoid redundancy, and respect your learning style as much as possible. Prepare your eP for an interested audience that cares about your progress in the program.
Note also ePs have proven useful to professionals as a means to track their progress and learning, provide evidence of learning to accreditation and licensing bodies, and as an online resume or CV. Think of your eP as your personal website - you are not limited to including the required components described above.
If you have any technical difficulties with your eP inform the Program Coordinator immediately for help. Do not “let it slide” for any length of time.
Example Reflection Post
I have reached my fourth week of my critical care rotation and I have been focusing on my understanding of the use of vasopressors and intropes - when they are indicated and how to monitor for necessary dosage changes. What I've taken away is that monitoring for vasopressors is all about perfusion, or blood flow. I can monitor perfusion by considering systemic and regional markers. Sytemic markers = MAP, lactate clearance, and mixed venous oxygen saturation. Local markers = CNNS (GCS), cardiac (ECG, cardiac echo), gastrointestinal (ng aspirates, abdominal distension, output), liver (transaminases, synthesis markers), renal (urine ouptut, SrCr), skin (mottling, temperature).
For my next rotation (emergency), I know that patient triage will be very important and that communicating key issues to pharmacists and other healthcare professionals will be very important. My specific learning objective for this rotation will be to succinctly summarize and communicate key issues for follow-up by the receiving healthcare professional, including specific actions that need to be done.