15 August 2010, Vol. 2, No. 1 AJHPE Article The use of portfolios in health professions education has increased dra- matically over the years.1-3 The enthusiastic acceptance of this principle is in part born out of the ever-growing interest in outcomes-based education in all divisions of health science.2 Portfolios not only stimulate profes- sional development and reflective learning, they also provide opportunity for self-direction, and avenues for faculty feedback.1 Portfolios have also been recommended for the assessment of professional development in medical education,3 and several reports document their successful use in the assessment of competence at both undergraduate and postgraduate levels.4 To stimulate engagement and to assess professional development during clinical laboratory training, portfolio development and assessment was proposed for final-year students for the Bachelor of Medical Labora- tory Sciences and the Diploma in Medical Laboratory Technology, Kam- pala International University, Uganda, in 2008. This article reports the experience of the use of portfolios to assess professional development in these programmes. Methods Institutional approval for the study was obtained from the Institutional Review and Ethics Committee. Eighteen final-year students undergoing clinical laboratory training in the teaching hospitals and participating in routine daily laboratory work were requested to compose and maintain a portfolio detailing their daily experiences, work done, and lessons learnt during their training. Their supervisors and programme facilitators pro- vided daily feedback and endorsed all entries. At the end of their training, the portfolios were examined by a team of faculty and an external exam- iner. The students were also required to make a 15-minute presentation based on their portfolio, and to participate in an interview. A rating rubric (Table I) used for the assessment considered the quality of a student’s presentation, portfolio content, demonstration of development over time, and ability to make professional judgement. To obtain a pass, a student is expected to meet all the criteria in the rubric in the collective judgement of the assessors. Questionnaires were used to determine the students’ and raters’ views on the usefulness of this method of assessment. The data were analysed quantitatively and qualitatively. Results Seventy-two per cent of the students and assessors accepted the method as a valid and effective means of assessing professional competence. Fifteen of the eighteen students reported that it improved their commit- ment to laboratory training, and encouraged reflection. Both faculty and students were of the opinion that it allowed for frequent feedback and Using portfolios to assess professional competence and development in medical laboratory sciences Christian C Ezeala, PhD, MSc, MICR (UK), CSci (UK), AIMLS, Lecturer, Department of Health Sciences, Fiji School of Medicine, Fiji National University, Suva, Fiji Islands; Formerly Senior Lecturer/HOD, Medical Laboratory Sciences, Kampala International University, Uganda Mercy O Ezeala, BA, MA, Faculty of Arts and Law, University of the South Pacific, Suva, Fiji Islands Ephraim O Dafiewhare, MB BS, MWACFP, Senior Lecturer, Department of Medicine, Kampala International University, Ishaka, Uganda Correspondence to: Christian Ezeala (christian40ezeala@yahoo.com) Table I. Rubric for the assessment of portfolios Criteria Criterion met Criterion not met 1. Presentation was complete in 15 minutes (Student completed presentation in 15 minutes) 2. Quality of presentation (Text readable from 2 meters (minimum font size 32); good organisation; student communicated with audience) 3. Student showed progressive development over time (Portfolio showed student development from dependent trainee to independent professional) 4. Student reflected on experiences and could make good professional judgement (Student could make decisions relevant to his work) 5. Portfolio content was adequate (Length and scope of portfolio showed adequate experience) 6. Overall assessment Pass (all the criteria were met) Fail (some or all of the criteria were NOT met) General comments: Article 16 August 2010, Vol. 2, No. 1 AJHPE more engagement in the programme. Many believed that it was a rational assessment as it captured development over time, but it was time con- suming and quite tasking on both students and the staff. Eighty-eight per cent were of the view that it should be a supplement and not a substitute for the standard written and practical tests. Discussion The evolution of a portfolio as a tool for the assessment of professional competence and development offers several advantages over the tradi- tional standard tests which, to a large extent, are ‘reductionist’ and do not capture progression over time.3 Application of portfolio assessment in medical laboratory sciences education is not widespread, and only a few reports are available in the literature.4 This study has demonstrated that portfolio development and assessment is well accepted in the Medical Laboratory Sciences programme. An important aspect of medical edu- cation is the matching of assessment methods with learning mode,5 as assessment drives learning. Portfolio assessment aligns well with com- petency-based education. Tenets of the latter include learner centredness, formative feedback, developmental process, reflection, and multiple types and sources of assessment.1 This study demonstrated it clearly as it promoted student /staff engagement in the clinical laboratory training programme, students’ ownership of their training, and reflective learn- ing. Although its introduction extends the methods of assessment in med- ical laboratory sciences, the study showed that many of the participants would not welcome it as the only mode of assessment. Rather it would be a valuable addition to the traditional methods of assessment of com- petence. The limitations of this study include the small sample size. It is recommended that a larger sample of students be included in a more elaborate study, possibly over a longer period. To ease the burden of as- sessment, using a structured interview to assess the portfolio as recom- mended by Burch and Seggie,6 could be helpful. References 1. Driessen EW, van Tartwijk J, Overeem K, Vermunt JD, van der Vleuten CPM. Conditions for successful reflective use of portfolios in undergraduate medical education. Med Educ 2005; 39: 1230-1235. 2. Davis MH , Amin Z , Grande JP, et al. Case studies in outcome-based education. Medical Teacher 2007; 29(7): 717-722. 3. Friedman BDM, Davis MH, Harden RM, Howie PW, Ker J, Pippard MJ. AMEE Medical Education Guide No. 24: Portfolios as a method of student assessment. Medical Teacher 2001; 23(6): 535-551. 4. Thome G, Hovenberg H, Edgren G. Portfolio as a method for continuous assess- ment in an undergraduate health education programme. Medical Teacher 2006; 28(6): e171-e176. 5. Segers M, Dochy F. Introduction enhancing student learning through assessment: Alignment between levels of assessment and different effects on learning. Studies in Educational Evaluation 2006; 32(3): 171-179. 6. Burch VC, Seggie JL. Use of a structured interview to assess portfolio-based learn- ing. 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