O'Sullivan Patricia, Greene Constance
University of Arkansas for Medical Sciences, Little Rock, AR 72205-7199, USA.
Acad Emerg Med. 2002 Nov;9(11):1305-9. doi: 10.1111/j.1553-2712.2002.tb01592.x.
Portfolios are an innovative approach to evaluate the competency of emergency medicine residents. Three key characteristics add to their attractiveness. First, portfolios draw from the resident's actual work. Second, they require self-reflection on the part of the resident. Third, they are inherently practice-based learning since residents must review and consider their practice in order to begin the portfolio. This paper illustrates five different applications of portfolios. First, portfolios are applied to evaluating specific competencies as part of the training of emergency physicians. While evaluating specific competencies, the portfolio captures aspects of the general competencies. Second, the article illustrates using portfolios as a way to address a specific residency review committee (RRC) requirement such as follow-ups. Third is a description of how portfolios can be used to evaluate resident conferences capturing the competency of practice-based learning and possibly other competencies such as medical knowledge and patient care. Fourth, the authors of the article designed a portfolio as a way to demonstrate clinical competence. Fifth, they elaborate as to how a continuous quality improvement project could be cast within the portfolio framework. They provide some guidance concerning issues to address when designing the portfolios. Portfolios are carefully structured and not haphazard collections of materials. Following criteria is important in maintaining the validity of the portfolio as well as contributing to reliability. The portfolios can enhance the relationship between faculty and residents since faculty will suggest cases, discuss anomalies, and interact with the residents around the portfolio. The authors believe that in general portfolios can cover many of the general competencies specified by the ACGME while still focusing on issues important to emergency medicine. The authors believe that portfolios provide an approach to evaluation commensurate with the self-evaluation skills they would like to develop in their residents.
档案袋是评估急诊医学住院医师能力的一种创新方法。其具有三个关键特性，使其更具吸引力。首先，档案袋取材于住院医师的实际工作。其次，档案袋要求住院医师进行自我反思。第三，档案袋本质上是基于实践的学习，因为住院医师必须回顾和思考自己的实践才能开始建立档案袋。本文阐述了档案袋的五种不同应用。首先，档案袋被应用于评估特定能力，作为急诊医师培训的一部分。在评估特定能力时，档案袋涵盖了一般能力的各个方面。其次，本文举例说明了如何将档案袋用作满足住院医师评审委员会（RRC）特定要求的一种方式，比如随访。第三是描述如何利用档案袋评估住院医师会议，以体现基于实践的学习能力以及可能的其他能力，如医学知识和患者护理能力。第四，本文作者设计了一个档案袋作为展示临床能力的一种方式。第五，他们详细说明了如何在档案袋框架内开展持续质量改进项目。他们提供了一些在设计档案袋时需要考虑的问题的指导。档案袋是经过精心构建的，并非随意收集的材料。遵循标准对于维持档案袋的有效性以及提高可靠性很重要。档案袋可以增强教员与住院医师之间的关系，因为教员会建议病例、讨论异常情况，并围绕档案袋与住院医师进行互动。作者认为，总体而言，档案袋可以涵盖毕业后医学教育认证委员会（ACGME）规定的许多一般能力，同时仍专注于急诊医学的重要问题。作者认为，档案袋提供了一种评估方法，可以与他们希望在住院医师中培养的自我评估技能相匹配。
