November 1, 2009

Learning portfolios: an opportunity for continuing professional development


By Sujin Lee, Pharm.D., BCPP, Clinical Pharmacist - Psychiatry, Johns Hopkins Hospital

Learning is a life-long process. With the changing role of the pharmacist, individuals must take an increasingly active role to ensure their continuing professional development. Continuing professional development (CPD), based on the principles of Kolb’s learning model, is a structured, self-directed, outcomes-focused cycle of learning involving reflection, planning, action, evaluation and documentation. The reflection stage requires the individual to consider their current practice and assess their knowledge, skills, and competence to identify areas of development and improvement. The planning and action stages allow the individual to create and implement a personal learning plan, addressing the needs that were identified. Goals should be specific, measurable, achievable, and relevant. Plans may include structured programs (i.e. CE programs) and informal learning opportunities and based on the individual's learning style(s). The evaluation stage assesses the effectiveness of the educational interventions and the utility and success of the plan. Although self-evaluations are important, evaluations from supervisors, peers, students and others may also provide valuable insight. Documentation of activities provides evidence that development has occurred. A portfolio allows individuals to organize their learning activities and serves as a comprehensive demonstration of their development and competency. Although there is no universally accepted format for a learning portfolio, the goal is to include documents that represent the individual stages discussed above. The contents can include reflective diary entries, presentations, evaluations, etc. The key is quality, not quantity! Ideally, the learning cycle continues by repeatedly returning to the reflection stage.

By definition, a portfolio is “a selection of work compiled over a period of time and used for assessing performance or progress.” Traditionally, a portfolio is used during annual performance evaluations. However, the portfolio has evolved so that today, with the inclusion of introspection and self-assessment, it can be used for professional development. For example, in the United Kingdom, Australia and Canada, licensing agencies require practitioners to maintain a learning portfolio as evidence of CPD to demonstrate and enhance competency. Although the portfolio is not a requirement at this time in the United States, there are pilot projects in progress. Using the experiences of our international colleagues as models, the Department of Pharmacy at CHRISTUS Santa Rosa Health Care (San Antonio, Texas) implemented a portfolio system. Submitted during annual evaluations, the portfolios were reviewed by supervisors, managers, and the director of pharmacy. Initially, individuals did not fully appreciate the value of the portfolio and most had difficulty identifying their personal learning needs, articulating professional goals, and developing a strategy. However, over time, acceptance, comfort and familiarity of the portfolio process increased and the quality and comprehensiveness of the portfolios improved.

Based on the recommendations of Accreditation Council for Pharmacy Education (ACPE), colleges of pharmacy now require students to maintain a portfolio during their academic career; residency programs also use portfolios for accreditation purposes. To assist them, many professional associations, including ASHP and APhA, are providing students and residents with tools to develop their portfolio. Unfortunately, some may view the portfolio as a “scrapbook of rotation memorabilia” and many find the initial stages difficult or tedious; however, the activities required in these early stages may provide the most benefit. The reflection and planning stages are critical to maximize the learning portfolio experience: an honest self-appraisal must occur to identify areas that require further development. The “action” phase then allows individuals to take a committed role in developing and implementing their personalized plan. By making learning more tangible, individuals are also able to reinforce the information by relating their academic and clinical assignments to the skills and knowledge that they will use in the future. Without a true investment in the learning cycle, students and residents may view the portfolio as just another assignment that they must complete.

The principles of the learning portfolio can be used by educators to assist students and residents to further their development. Although the creation of a portfolio is highly recommended, students and residents may not have the opportunity to prepare one, depending on their schedule (i.e. one month rotation vs. twelve month program). However, the principles of “continued professional development” can still be addressed. For example, the five stages of the learning cycle may be discussed with the student or resident before and after an assignment and during the midpoint and final evaluation. The entire process may be difficult for students and residents to accomplish on their own. However, with the assistance from preceptors and mentors, the student's or resident's experiences may be enhanced. Moreover, this process will ideally lead to a more reflective learner and result in a lifelong cycle of continuing professional development.

In summary, the learning portfolio may become a requirement for pharmacists in the future. Indeed, it is already part of the licensure process in many other countries. Based on the recommendations of national pharmacy organizations, portfolios have become requisites for successful completion of the Doctor of Pharmacy degree and residency training programs. However, in order for portfolios to be successful, individuals must invest themselves in the learning process; otherwise, the experience will likely be a burden rather than an opportunity for continued self growth and development.

To learn more read: Purcell K. Use of performance portfolios for pharmacy personnel. Am J Health-Syst Pharm 2009;66:801-4.

[Editor's Commentary: Reflection and planning are important ingredients to self-development. Learning portfolios can assist us in the learning process and help us meet personal and professional goals. Portfolios can take many forms. Many people continue to maintain paper-based portfolios ... but in this digital age, web-based portfolios enable us to store a wide variety of interconnected media - not just documents. I can image a day when our personal and professional development, from birth to death, is warehoused on a personal website. These sites make our reflections, plans, actions, evaluations, and outcomes of our learning readily available to our teachers and mentors anywhere in the world. If you'd like to get started building your own digital portfolio, check out Dr. Helen Barrett's eletronic portfolio site at: http://electronicportfolios.com/ and series of her presentations at: http://eportfolios.blip.tv/ Her keynote address to the National Institute for Adult Continuing Education (NIACE) is a great introduction to this topic. - S.H.]

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