Learning tool for Learning tool for tomorrow’s competent tomorrow’s competent

physicians:physicians:

The eFolioThe eFolio

DEFINTION OF PORTFOLIODEFINTION OF PORTFOLIO

• N. 1. A flat, portable case (as a briefcase, a large N. 1. A flat, portable case (as a briefcase, a large heavy envelope, or loose-leaf binder) for carrying heavy envelope, or loose-leaf binder) for carrying papers or drawings. papers or drawings.

• 2. The office and functions of a minister of state or 2. The office and functions of a minister of state or member of a cabinet. member of a cabinet.

• 3. The securities held by an investor or the commercial 3. The securities held by an investor or the commercial paper held by a bank or other financial housepaper held by a bank or other financial house

WWebster’s Third International Dictionaryebster’s Third International Dictionary

Definition of e-folioDefinition of e-folio

Educational tools for documenting Educational tools for documenting learner achievement of competence learner achievement of competence and fostering reflection on practice and fostering reflection on practice with the intent of improvement.with the intent of improvement.– Longitudinal record of professional growthLongitudinal record of professional growth– Documents learningDocuments learning– Self-assessmentsSelf-assessments– Assessment by othersAssessment by others

State of e-foliosState of e-folios

• Many different eFolios under Many different eFolios under developmentdevelopment

•UME CollaborativeUME Collaborative

•ACGME Portfolio ProjectACGME Portfolio Project

• We are poised to create a fragmented We are poised to create a fragmented collection of tools that are not collection of tools that are not portable and cannot communicate.portable and cannot communicate.

Interest in a National eFolio Interest in a National eFolio FrameworkFramework

• ColloquiumColloquium (AAMC, NBME) May 2007(AAMC, NBME) May 2007• Invitational Conference (AAMC, Invitational Conference (AAMC,

ACGME, FSMB, NBME) October 2007ACGME, FSMB, NBME) October 2007• Aim – focus attention nationally on Aim – focus attention nationally on

development of transportable, inter-development of transportable, inter-operable efolios that meet the needs operable efolios that meet the needs of the individual physician and local of the individual physician and local programs programs

Potential purposes of efolioPotential purposes of efolio

• Designation of learning objectives and expectations Designation of learning objectives and expectations • Documentation of learning experience (case and Documentation of learning experience (case and

procedure logs)procedure logs)• Performance measures and processes of carePerformance measures and processes of care• Patient outcomes Patient outcomes • Self-assessment (e.g. knowledge, skills, behaviors)Self-assessment (e.g. knowledge, skills, behaviors)• Reflection and self-appraisalReflection and self-appraisal• MentoringMentoring• External assessment of competenciesExternal assessment of competencies• Evaluation of programsEvaluation of programs• Targeting of CME/CPD and maintaining CME/CPD logsTargeting of CME/CPD and maintaining CME/CPD logs• Transparency for consumer choiceTransparency for consumer choice

Proposed design principlesProposed design principles

• For physicians and their needs, For physicians and their needs, regardless of national origin, site of regardless of national origin, site of training, experience, status of training, experience, status of licensure and certificationlicensure and certification

• Non-punitive system for private Non-punitive system for private learning, self-assessment and self-learning, self-assessment and self-improvementimprovement

• State-of-the-art security and State-of-the-art security and confidentialityconfidentiality

Proposed design principlesProposed design principles

• Individual physician controls access Individual physician controls access to data and can authorize to data and can authorize transmission of select data to transmission of select data to demonstrate proficiency or satisfy demonstrate proficiency or satisfy external mandatesexternal mandates

• Inter-operability across settings and Inter-operability across settings and transportability across the continuum transportability across the continuum of education and practiceof education and practice

Service and FunctionsService and Functions

Private learning environment Private learning environment for the physician in practicefor the physician in practice

• Self-assessmentSelf-assessment

• Self-appraisal and reflectionSelf-appraisal and reflection

• ?Mentoring?Mentoring

• Planning for self-improvementPlanning for self-improvement

• Finding and tracking CMEFinding and tracking CME

• ?Expunge data when no longer ?Expunge data when no longer contributorycontributory

Documenting proficiency to Documenting proficiency to public public • Basic credentials (CV) for different purposesBasic credentials (CV) for different purposes

• External validation of data reported from External validation of data reported from private learning environmentprivate learning environment

• Maintenance of certificationMaintenance of certification

• Record of CMERecord of CME

• Licensure applicationLicensure application

• Clinical privilegesClinical privileges

• Facility accreditationFacility accreditation

Challenges and IssuesChallenges and Issues

• Balancing learning and evaluative usesBalancing learning and evaluative uses

• Two structural layers – private and publicTwo structural layers – private and public

• Protecting the private layersProtecting the private layers

• Connecting efolios across the continuumConnecting efolios across the continuum

• Managing efolio content at transitions Managing efolio content at transitions along the education – practice continuumalong the education – practice continuum

• Financial responsibility for the systemFinancial responsibility for the system

Challenges and IssuesChallenges and Issues

• Infrastructure to prepare both Infrastructure to prepare both teachers and learners to use the teachers and learners to use the efolioefolio

• Infrastructure to assist practicing Infrastructure to assist practicing physicians to use the efoliophysicians to use the efolio

• IMGsIMGs

• Strategies and tools to stimulate skills Strategies and tools to stimulate skills of self-assessmentof self-assessment

The Hope for E-foliosThe Hope for E-folios

• Connect medical education competencies Connect medical education competencies across the curriculumacross the curriculum

• Function as epr- electronic physician record Function as epr- electronic physician record for the individualfor the individual

• Facilitate reflective practice (competency Facilitate reflective practice (competency of practice-based learning and of practice-based learning and improvement)improvement)

• Manage longitudinal data about individual Manage longitudinal data about individual physician’s patient outcomesphysician’s patient outcomes