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Learning tool for tomorrow’s
competent physicians:
The eFolio
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
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
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.
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, interoperable efolios that meet the needs of
the individual physician and local
programs
Potential purposes of efolio
• Designation of learning objectives and expectations
• Documentation of learning experience (case and
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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
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
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
Service and Functions
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
Documenting proficiency to public
• Basic credentials (CV) for different purposes
• External validation of data reported from private
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learning environment
Maintenance of certification
Record of CME
Licensure application
Clinical privileges
Facility accreditation
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
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
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