Advances in Health Sciences Education

, Volume 15, Issue 4, pp 547–558 | Cite as

First year specialist trainees’ engagement with reflective practice in the e-portfolio



Doctors in specialist training posts in the Mersey Deanery are expected to reflect on their clinical practice and to document their learning experiences in an e-portfolio. This study aims specifically to explore how they have engaged in reflection on their practice and how they utilise their learning portfolio to document evidence of this. A modified Delphi technique was used to develop a grading system to indentify the level of reflection recorded by participants in the e-portfolio. Transcripts of the reflective accounts were then analysed using a qualitative approach which involved coding and categorising the data. This study demonstrated a wide variation in both the quantity and quality of reflection. Of particular note in the qualitative data analysis were themes relating to clinical knowledge and skills, learning in practice, communication, feelings, types of learning experience reflected on and wider aspects of medical practice. Findings indicate there is variation is the extent to which doctors both engage in and document evidence of reflection. Further research is needed to explore factors that enable or inhibit the use of the e-portfolio for reflection and whether recorded reflection is a true picture of the cognitive process involved.


Depth of reflection E-portfolio Post-graduate medical education Reflection Written reflection 


  1. Aukes, L. C., Geertsma, J., Cohen-Schotanus, J., Zwierstra, R. P., & Slaetsj, P. J. (2007). The development of a scale to measure personal reflection in medical practice and education. Medical Teacher, 29, 177–182.CrossRefGoogle Scholar
  2. Corcoran, J., & Nicholson, C. (2004). Learning portfolios–evidence of learning: an examination of students’ perspectives. Nursing in Critical Care, 9(5), 230–237.CrossRefGoogle Scholar
  3. Driessen, E. W., Overeem, K., Van Tartwik, J., Van Der Vleuten, C. P. M., & Muitjens, A. M. M. (2006). Validity of portfolio assessment: Which qualities determine ratings? Medical Education, 40, 862–866.CrossRefGoogle Scholar
  4. Driessen, E. W., Van Tartwijk, J., Overeem, K., Vermunt, J. D., & Van Der Vleuten, C. (2005). Conditions for successful reflective use of portfolios in undergraduate medical education. Medical Education, 39, 1230–1235.CrossRefGoogle Scholar
  5. Driscoll, J., & Teh, B. (2001). The potential of reflective practice to develop individual orthopaedic nurse practitioners and their practice. Journal of Orthopaedic Nursing, 5, 95–103.CrossRefGoogle Scholar
  6. Endacott, R., Gray, M., Jasper, M., Mcmullan, M., Miller, C., Scholes, J., et al. (2004). Using portfolios in the assessment of learning and competence: The impact of four models. Nurse Education in Practice, 4, 250–257.CrossRefGoogle Scholar
  7. Francis, D. (2004). Reconstructing the meaning given to critical incidents in nurse education. Nurse Education in Practice, 4, 244–249.CrossRefGoogle Scholar
  8. Gannon, T. F., Draper, P., Watson, R., Proctor, S., & Norman, I. J. (2001). Putting portfolios in their place. Nurse Education Today, 21, 534–540.CrossRefGoogle Scholar
  9. Gibbs, G. (1988). Learning by doing: A guide to teaching and learning methods. Oxford: Further Education unit, Oxford Brookes University.Google Scholar
  10. Holloway, I., & Wheeler, S. (2002). Qualitative research in nursing (2nd ed.). Oxford: Blackwell Science.Google Scholar
  11. Hrisos, S., Illing, J. C., & Burford, B. C. (2008). Portfolio learning for foundation doctors: Early feedback on its use in the clinical workplace. Medical Education, 42, 214–223.CrossRefGoogle Scholar
  12. Jasper, M. A., & Fulton, J. (2005). Marking criteria for assessing practice-based portfolios at masters’ level. Nurse Education Today, 25, 377–389.CrossRefGoogle Scholar
  13. Kjaer, N. K., Maagaard, R., & Wied, S. (2006). Using an online portfolio in postgraduate training. Medical Teacher, 28(8), 708–712.CrossRefGoogle Scholar
  14. Lawson, M., Nestel, D., & Jolly, B. (2004). An e-portfolio in health professional education. Medical Education, 38(5), 569–570.CrossRefGoogle Scholar
  15. Mamede, S., & Schmidt, H. G. (2004). The structure of reflective practice in medicine. Medical Education, 38, 1302–1308.CrossRefGoogle Scholar
  16. Mamede, S., Schmidt, H. G., & Penaforte, J. C. (2008). Effects of reflective practice on the accuracy of medical diagnosis. Medical Education, 42, 468–475.CrossRefGoogle Scholar
  17. McMullan, M., Endacott, R., Gray, M. A., Jasper, M., Miller, C. M. L., Scholes, J., et al. (2003). Portfolios and assessment of competence: A review of the literature. Journal of Advanced Nursing, 41(3), 283–294.CrossRefGoogle Scholar
  18. Moon, J. (2004). A handbook for reflective and experiential learning. London: Routledge Falmer.Google Scholar
  19. Moon, J. (2005). Critical thinking. Bristol: ESCalate.Google Scholar
  20. Rees, C. (2005). Letter to the editor: The use (and abuse) of the term portfolio. Medical Education, 39, 463.Google Scholar
  21. Scholes, J., Webb, C., Gray, M. A., Endacott, R., Miller, C., Jasper, M., et al. (2004). Making portfolios work in practice. Journal of Advanced Nursing, 46(6), 595–603.CrossRefGoogle Scholar
  22. Schuwirth, L. W. T., & Van Der Vleuten, C. P. M. (2004). Changing education, changing assessment, changing research? Medical Education, 38, 805–812.CrossRefGoogle Scholar
  23. Snadden, D., & Thomas, M. L. (1998). The use of portfolio learning in medical education. Medical Teacher, 20(3), 192–199.CrossRefGoogle Scholar
  24. Spence, W., & El-Ansari, W. (2004). Portfolio assessment: Practice teachers’ early experience. Nurse Education Today, 24, 388–401.CrossRefGoogle Scholar
  25. Stark, P., Roberts, C., Newble, D., & Bax, N. (2006). Discovering professionalism through guided reflection. Medical Teacher, 28(1), E25–e31.CrossRefGoogle Scholar
  26. Taylor, B. J. (2006). Reflective practice: A guide for nurses and midwives (2nd ed.). Maidenhead: Open University Press.Google Scholar
  27. Tiwari, A., & Tang, C. (2003). From process to outcome: the effect of portfolio assessment on student learning. Nurse Education Today, 23, 269–277.CrossRefGoogle Scholar
  28. Tochel, C., Haig, A., Hesketh, A., Cadzow, A., Beggs, K., Colthart, I., et al. (2009). The effectiveness of portfolios for post-graduate assessment and education: BEME guide no 12. Medical Teacher, 31(4), 299–318.CrossRefGoogle Scholar
  29. White, S., Fook, J., & Gardner, F. (2006). Critical reflection in health and social care. Maidenhead: Open University Press.Google Scholar

Copyright information

© Springer Science+Business Media B.V. 2010

Authors and Affiliations

  • Helen McNeill
    • 1
  • Jeremy M. Brown
    • 1
  • Nigel J. Shaw
    • 1
    • 2
  1. 1.Faculty of HealthEdge Hill UniversityLancashireUK
  2. 2.Mersey Deanery School of MedicineLiverpoolUK

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