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E-portfolio

Treat your eportfolio as a pet for the duration of your training. To keep it healthy, you need to feed it regularly with log entries, not forgetting that it needs a well-balanced diet of varied curriculum coverage. You must also make sure that its PDP is well groomed. Invest time and affection and you will find that it has a lot to offer you in return but for those of you who neglect it, it has a nasty bite. An epotfolio is for the lifetime of your training and certainly not just for Christmas. 

Far-fetched metaphors aside, the eportfolio is used regularly throughout your training to record your progress. To pass this part of your assessment, you must have regular, reflective Learning Log entries, a current Personal Development Plan (PDP) as well as the right number of other assessments and reviews. The onus is on YOU to create an eportfolio that demonstrates enough clear evidence to pass your Work Place Based Assessment (WPBA). Once you get in the habit of using the eportfolio regularly as a means of reflecting, it can be surprising how valuable it becomes.

The Eportfolio goes in for acronyms and jargon in a big way, so here's a Beginner's Guide to what the important bits are and what you need to do. 

Learning Log

  • The Learning Log is a place for you to record and reflect on your experiences to support your learning. Some FAQs are answered below.

  • Question: "How many learning log entries do I need to do?"

    Answer: The answer is not as simple as you might imagine. Firstly, the number of learning logs required will depend on the quality of entries that you are writing (no matter how many superficial and descriptive entries you write, this will still not be enough). Secondly, you need to ensure that your learning log reflection demonstrates good curruiculum coverage (an enormous number of entries all focused on the same domains will still not be enough). 

    However, the following should give you a loose indication of the number of good quality, highly reflective entries that are likely to be needed to demonstrate learning.

In ST1-2 there should be a minimum of 50 log entries for each year.

In ST3 there should be a minimum of 100 log entries for the year.

In ST1-2 you should add a minimum of 1 linked log entry for each Competence Area per six month rotation  (total 2 per year)

In ST3 you should add a minimum of a further 4 linked log entries for each Competence Area throughout the year (giving an overall minimum total of 8 per Competence)

Each Curriculum Heading should have at least 5 linked entries by the end of ST3.

At least 50% of log entries should be clinical.

Remember, you need evidence across all 25 curriculum areas and 13 competences so these should be treated as bare minimums and the focus should be on how much evidence you have in each area.

  • Question: "What makes a "Good" Learning Log Entry?"

    Answer: Writing a good Learning Log entry doesn't come easily straight away but it's important to get the hang of it as soon as possible. Make sure that you aren't just recounting events or repeating facts but try to reflect more deeply on the experience and think carefully about what you have learnt. Try to identify your learning needs and then consider how you are going to tackle these. When you are in hospital posts, try to remember that you are a GP trainee still and look for the relevance of what you encounter for primary care.

    The following is a guide to the level of reflection that you should be aiming for.

    Most Reflective Entry
    Analysis and critical thinking
    Considers feelings of self and others
    Strong evidence of learning
    Evidence of action planning for the future
    Contextual information provided
    Relates learning to literature

    Intermediate Entry
    Some evidence of critical thinking and analysis
    Limited emotional involvement
    Some description
    Evidence of learning
    Some self-awareness
    Some action planning
    May or may not consider others

    Least Reflective Entry
    Entirely descriptive/narrative in style
    No evidence of analysis
    No evidence of learning
    Incomplete form or missing information
    Appears rushed
    Does not appear to value reflection or see learning opportunitites
                                                                                                                         from McNeill et al (2008)

  • Question: "When should I write my entries?" 

    Answer: Try to write your entries as soon after the event as possible. In a busy shift or during an arduous week this may be difficult but even if you only have time to create a one line entry, do write this. You can come back to it to complete it later, and at least you will have a reminder to prompt you.

    Once you have written a learning log entry, you must "share" it, so that it can be read by your trainer ) as well as the Programme Directors and ultimately your examiners). Sometimes your trainer will comment on what you have written. 

    Your trainer will not thank you for saving up large numbers of entries and then sharing them all at once, as they will be reading the logs of a number of trainees at different stages of training. 

    Remember that the eportfolio records when an entry was created and when it was shared. Examiners will look very closely at this when they make their assessment. It will be very obvious if you have written a large number of entries all in one go just before a deadline and this really is frowned upon.

  • Question: "How do I know how that I am on track to pass my WPBA?"

    Answer: Your trainer will regularly write comments on your eportfolio entries. These will comment not only on your experiences and learning but also give you feedback on the nature and style of your reflection. You should always be able to approach your trainer to ask how your learning log is looking from their perspective.

    On a monthly basis, the number of entries that you have written and shared will also be monitored by the Programme Director team. Those not meeting the standard required will be asked to meet with the Programme Director to discuss this.

    Six monthly there will also be a review of a sample of entries for every trainee. You will be invited to put forward your preferred entries but if you do not do so, the sampling will be random. This aim of this process is to give you feedback on the quality of your reflection (in addition to the feedback you are already getting from your trainer).

PDP (Personal Development Plan)

  • This is a part of the eportfolio to help you organise your learning needs and plan how you intend to address them.
  • As soon as your trainer has read your Learning Log entries, you can link them to your PDP.
  • Try to show that you are completing "Cycles of Learning" ie ...
    1. Reflect on an experience
    2. Identify a learning need
    3. Work on that learning need
    4. Put what you have learnt into practice and test it
    5. Reflect on the difference what you learnt made
  • Try to make PDP entries SMART ie ...
    • Specific
    • Measurable
    • Attainable
    • Relevant
    • Time-bound

COT (Clinical Observation Tool)

  • You need to complete at least 3 COTs in every 6 month post in General Practice.
  • This is a consultation that is observed by a GP and then discussed with you after to reflect on learning points. It can also be done with consultations that you have recorded on video. It is a very useful tool for improving your consultation skills, particularly as the Clinical Skills Assessment exam (CSA) approaches.
  • Read what the RCGP says about COTs here.
  • See an example COT form here.
  • The COT marking criteria can be found here.
  • If you are doing COTs by recording consultations, you need to get the patient to complete a consent form. Your practice may have its own version but if not, use the RCGP's COT Consent Form

CEX (Clinical Evaluation eXercise)

  • You need to complete at least 3 CEXs in every 6 month hospital post.
  • This is an observed patient interaction, similar to a COT, but one that happens in a hospital setting and is observed by a senior hospital doctor.
  • Read what the RCGP says about CEXs here.

CBD (Case-Based Discussion)

  • You need to complete at least 3 CBDs in every 6 month post.
  • This is a discussion with a GP or a senior hospital doctor about a specific case that you have encountered. You should present the case, reflect on it and discuss it. This is a learning opportunity for you but also a chance for the assessor to gauge your understanding. 
  • Read what the RCGP says about CBDs here.
  • See an example CBD form here.
  • Look at the RCGP guidance on what should be covered in CBDs here. (This is useful for trainers too!)

DOP (Directly Observed Procedure)

  • DOPs are no longer used so ignore this tab on your eportfolio!

CEPS (Clinical Examination and Procedural Skills)

  • These assessments replaced DOPs, they are direct observations of you carrying out an examination or procedure.
  • There is no mandatory minimum but you will need to collect one or two minimum per six months to ensure that there is enough evidence.
  • Wherever possible (and it is not always possible in hospital posts), do procedures that are relevant to the work of a GP.
  • You must, by the end of ST3, have CEPS completed for all intimate examinations as a GMC requirement.
  • Read what the RCGP says about CEPS here

MSF (Multi-Source Feedback)

  • This is an opportunity for your colleagues to give you feedback, which can be very useful. Ideally you should include 5 clinicians and 5 non-clinicians in every MSF. 
  • Read the RCGP's useful summary of How to do an MSF.

PSQ (Patient Satisfaction Questionnaire)

  • This is an opportunity for you to get feedback from your patients. It is something that needs some planning and is completely worthless if not done properly. You need to print out at least 50 copies of the PSQ form (available on your eportfolio). These then need to be given to every single patient you see, until a minimum of 40 have been completed and returned to reception.
  • It's important that you don't cherry-pick patients you think will be flattering but make sure that every patient gets one. One way of doing this is getting the receptionists to hand out the forms as the patients book in. It's also important that you don't enter the data yourself but get someone else at the practice to do it for you.
  • If you have electronic checking in, ask reception to switch it off for you for a short period of time so the patient must go to reception and the staff member can distribute your questionnaires at that point.
  • Read the RCGP's useful summary of How to do a PSQ.

CSR (Clinical Supervisor Review)

  • Your Clinical Supervisor is the consultant you work for in GP posts or the GP you are working for in Primary Care. You need to meet with them to discuss your progress towards the end of every 6 month post and they need to complete an online assessment of your progress in your eportfolio. This all needs to happen before your ESR.
  • Read what the RCGP says about the CSR here.
  • If you are starting a hospital post, then read the relevant curriculum headings and the KSS Deanery's Guidance and Self-assessment pages before you go to your CSR. Print it  out, take it with you and it can provide a focus, as you discuss how you are going to learn as much as possible in the post.

ESR (Educational Supervisor Review)

  • Your Educational Supervisor is a GP Trainer who is allocated to you for the duration of your training. He or she will be a point of contact for you and they will keep an eye on your progress, offering suggestions, support and encouragement when appropriate. The ESR is a compulsory meeting with them, where you can discuss your progress.
  • You need to arrange to meet with your Educational Supervisor before the end of every 6 month post, even when you are in hospital posts.
  • Prior to the actual ESR meeting, you need to do some preparation. Once your supervisor has initiated the review on your eportfolio, you need to complete a self-rating assessment. This involves going through the self-rating question by questionand reflecting on your progress and giving evidence for what you say (ie specific examples from your learning log, PDP and other online assessments). This takes quite a while to do properly, so don't leave it until the evening before your ESR or you'll have a sleepless night!
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