Learning tool for tomorrow’s competent physicians:

1. Learning tool for tomorrow’s competent physicians: The eFolio

2. DEFINTION OF PORTFOLIO • N. 1. A flat, portable case (as a briefcase, a large heavy envelope, or loose-leaf binder) for carrying papers or drawings. • 2. The office and functions of a minister of state or member of a cabinet. • 3. The securities held by an investor or the commercial paper held by a bank or other financial house Webster’s Third International Dictionary

3. Definition of e-folio Educational tools for documenting learner achievement of competence and fostering reflection on practice with the intent of improvement. • Longitudinal record of professional growth • Documents learning • Self-assessments • Assessment by others

4. State of e-folios • Many different eFolios under development • UME Collaborative • ACGME Portfolio Project • We are poised to create a fragmented collection of tools that are not portable and cannot communicate.

5. Interest in a National eFolio Framework • Colloquium(AAMC, NBME) May 2007 • Invitational Conference (AAMC, ACGME, FSMB, NBME) October 2007 • Aim – focus attention nationally on development of transportable, inter-operable efolios that meet the needs of the individual physician and local programs

6. Potential purposes of efolio • Designation of learning objectives and expectations • Documentation of learning experience (case and procedure logs) • Performance measures and processes of care • Patient outcomes • Self-assessment (e.g. knowledge, skills, behaviors) • Reflection and self-appraisal • Mentoring • External assessment of competencies • Evaluation of programs • Targeting of CME/CPD and maintaining CME/CPD logs • Transparency for consumer choice

7. Proposed design principles • For physicians and their needs, regardless of national origin, site of training, experience, status of licensure and certification • Non-punitive system for private learning, self-assessment and self-improvement • State-of-the-art security and confidentiality

8. Proposed design principles • Individual physician controls access to data and can authorize transmission of select data to demonstrate proficiency or satisfy external mandates • Inter-operability across settings and transportability across the continuum of education and practice

9. Service and Functions

10. Private learning environment for the physician in practice • Self-assessment • Self-appraisal and reflection • ?Mentoring • Planning for self-improvement • Finding and tracking CME • ?Expunge data when no longer contributory

11. Documenting proficiency to public • Basic credentials (CV) for different purposes • External validation of data reported from private learning environment • Maintenance of certification • Record of CME • Licensure application • Clinical privileges • Facility accreditation

12. Challenges and Issues • Balancing learning and evaluative uses • Two structural layers – private and public • Protecting the private layers • Connecting efolios across the continuum • Managing efolio content at transitions along the education – practice continuum • Financial responsibility for the system

13. Challenges and Issues • Infrastructure to prepare both teachers and learners to use the efolio • Infrastructure to assist practicing physicians to use the efolio • IMGs • Strategies and tools to stimulate skills of self-assessment

14. The Hope for E-folios • Connect medical education competencies across the curriculum • Function as epr- electronic physician record for the individual • Facilitate reflective practice (competency of practice-based learning and improvement) • Manage longitudinal data about individual physician’s patient outcomes