Abstract
Objective
To determine whether the integration of an automated electronic clinical portfolio into clinical clerkships can improve the quality of feedback given to students on their patient write-ups and the quality of students’ write-ups.
Design
The authors conducted a single-blinded, randomized controlled study of an electronic clinical portfolio that automatically collects all students’ clinical notes and notifies their teachers (attending and resident physicians) via e-mail. Third-year medical students were randomized to use the electronic portfolio or traditional paper means. Teachers in the portfolio group provided feedback directly on the student’s write-up using a web-based application. Teachers in the control group provided feedback directly on the student’s write-up by writing in the margins of the paper. Outcomes were teacher and student assessment of the frequency and quality of feedback on write-ups, expert assessment of the quality of student write-ups at the end of the clerkship, and participant assessment of the value of the electronic portfolio system.
Results
Teachers reported giving more frequent and detailed feedback using the portfolio system (p = 0.01). Seventy percent of students who used the portfolio system, versus 39% of students in the control group (p = 0.001), reported receiving feedback on more than half of their write-ups. Write-ups of portfolio students were rated of similar quality to write-ups of control students. Teachers and students agreed that the system was a valuable teaching tool and easy to use.
Conclusions
An electronic clinical portfolio that automatically collects students’ clinical notes is associated with improved teacher feedback on write-ups and similar quality of write-ups.
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Acknowledgements
This work was funded in part by a grant from the National Library of Medicine (LM007450-04).
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Appendix
Appendix
Teacher questionnaire:
-
1.
Compared to prior rotations, the number of this student’s written notes (H&P’s, progress notes) I evaluated was more, the same, or less.
-
2.
Compared to prior rotations, the detail of feedback that I gave on this student’s written notes was more, the same, or less.
-
3.
Compared to prior rotations, the satisfaction I have in the feedback I provided to this student on his/her notes is more, the same, or less.
-
4.
If the Learning Portfolio System was used, the system made it easier for me to view and comment on student’s notes.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
-
5.
If the Learning Portfolio System was used, the system allowed me to provide better feedback on student’s notes.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
Student Questionnaire:
-
1.
I received feedback on this percentage of my H&P write-ups:
<25%
25–50%
51–75%
>75%
-
2.
I received insightful feedback (in any form) concerning my write-ups:
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
If you were in the Portfolio Group:
-
3.
The system is a valuable teaching tool.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
-
4.
Having my write-ups on Portfolio increased the amount of feedback I received.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
-
5.
The system was easy to use.
Strongly disagree
Disagree
Neutral
Agree
Strongly agree
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Spickard III, A., Gigante, J., Stein, G. et al. Automatic Capture of Student Notes to Augment Mentor Feedback and Student Performance on Patient Write-Ups. J GEN INTERN MED 23, 979–984 (2008). https://doi.org/10.1007/s11606-008-0608-y
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DOI: https://doi.org/10.1007/s11606-008-0608-y