Finlay I G, Maughan T S, Webster D J
Section of Palliative Medicine, University of Wales College of Medicine, Cardiff.
Med Educ. 1998 Mar;32(2):172-6. doi: 10.1046/j.1365-2923.1998.00160.x.
Portfolio learning has not previously been reported for clinical undergraduate teaching. This open randomized study aimed to assess the effect of portfolio learning in the teaching of oncology to medical students. The project aimed to provide the student with a holistic understanding of the impact of the disease and its treatment on the patient and family, and the natural history of malignant disease, through long-term personal experience of a cancer patient. All undergraduate medical students entering Clinical Studies in October 1992 at the University of Wales College of Medicine were randomized to a study or control group. Both groups continued with the standard curriculum. Each study-group student followed a patient with cancer for 9 months, supported by bi-monthly small-group tutorials. Tutors were either general practitioners or hospital consultants, not necessarily oncologists; each was supplied with a tutor's resource pack of key oncology review papers. Students recorded triggers to learning and key items in a personal learning portfolio. Students' performances in clinical examinations and the contents of their portfolio was assessed. Final assessment was by hidden questions in the objective structured clinical examination (OSCE) in the final degree examination, when students in the study group showed higher marks in factual knowledge of oncology, particularly amongst the weaker students (P = 0.01). Those submitting portfolios for formative assessment had higher overall marks than those in the study group who did not (P = 0.04), representing the more motivated students. The whole study group showed a beneficial trend in their knowledge of oncology.
临床本科教学中此前尚未报道过档案袋学习法。这项开放性随机研究旨在评估档案袋学习法在医学生肿瘤学教学中的效果。该项目旨在通过让学生长期亲身接触一名癌症患者，使其全面了解疾病及其治疗对患者和家庭的影响，以及恶性疾病的自然史。1992年10月进入威尔士大学医学院临床研究阶段的所有本科医学生被随机分为研究组和对照组。两组均继续学习标准课程。每个研究组的学生在每两个月一次的小组辅导支持下，跟踪一名癌症患者9个月。辅导教师为全科医生或医院顾问，不一定是肿瘤学家；每位教师都收到了一套包含关键肿瘤学综述论文的辅导资料包。学生们在个人学习档案袋中记录学习触发因素和关键内容。对学生的临床考试成绩及其档案袋内容进行了评估。最终评估通过期末考试客观结构化临床考试（OSCE）中的隐藏问题进行，结果显示研究组学生在肿瘤学事实知识方面得分更高，尤其是在成绩较差的学生中（P = 0.01）。提交档案袋进行形成性评估的学生总体成绩高于未提交的研究组学生（P = 0.04），这代表了积极性更高的学生。整个研究组在肿瘤学知识方面呈现出有益的趋势。
