Document Detail


The unintended consequences of portfolios in graduate medical education.
MedLine Citation:
PMID:  19858808     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
Portfolios have emerged in graduate medical education despite lack of consensus on their definition, purpose, or usefulness. Portfolios can be used as a tool for residents to record their accomplishments, reflect on their experiences, and gain formative feedback. This exercise may help prepare physicians for lifelong learning as well as enhance patient care. The Accreditation Council for Graduate Medical Education has endorsed and may soon require the use of portfolios as an assessment tool to evaluate resident competence. However, using portfolios for summative evaluation purposes such as making high-stakes decisions on resident promotion or matriculation may deter resident candidness. In addition, the use of portfolios in clinical settings raises issues unique to the health care setting such as patient privacy, disclosure of clinical information, and professional liability exposure of physicians. It is not clear that peer-review statutes that sometimes protect educational materials used in teaching and evaluation of residents would also bar disclosure and/or evidentiary use of portfolio contents. Is the teaching institution, resident, or graduate vulnerable to requests and subpoenas for the portfolio contents? If so, then a resident's documentation of insecurities, suboptimal performance, or bad outcomes would be ripe for discovery in a medical malpractice lawsuit. If embraced too quickly and without sufficient reflection on the nuances of implementation, this well-intentioned initiative may present unintended legal consequences.
Authors:
Alisa Nagler; Kathryn Andolsek; Jamie S Padmore
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  Academic medicine : journal of the Association of American Medical Colleges     Volume:  84     ISSN:  1938-808X     ISO Abbreviation:  Acad Med     Publication Date:  2009 Nov 
Date Detail:
Created Date:  2009-10-27     Completed Date:  2009-11-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8904605     Medline TA:  Acad Med     Country:  United States    
Other Details:
Languages:  eng     Pagination:  1522-6     Citation Subset:  AIM; IM    
Affiliation:
Office of Graduate Medical Education, Duke University Hospital, Durham, North Carolina 27710, USA. alisa.nagler@duke.edu
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MeSH Terms
Descriptor/Qualifier:
Clinical Competence / legislation & jurisprudence,  standards,  statistics & numerical data*
Education, Medical, Graduate / legislation & jurisprudence,  standards,  statistics & numerical data*
Educational Measurement*
Humans
Illinois
Internship and Residency* / legislation & jurisprudence
Job Application*
Peer Review
Societies, Medical
United States

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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