學習歷程檔案於醫學生臨床教育之初期使用經驗

Physicians' clinical competency greatly impacts on the quality of medical care. However, it is a great challenge to teach and assess comprehensively clinical competency, especially the ability to reflect and to self-directed learning. A learning portfolio is an instrument used to accumulate and assess a student's learning process and their achievements, through reflection and in terms of their planned learning. To date, no studies have reported on the use of such portfolios in Taiwan. Purpose: The aim of this study was to develop a learning portfolio that would facilitate students to reflect and learn. The portfolio would report the perceptions of the students, teachers, and staff toward teaching, the assessment values and the feasibility of a portfolio. The reasons for the various opinions were also explored. Methods; During the second half of 2007, interns its the Department of Internal Medicine, Surgery, Pediatrics and OBS/GYN at Taipei Medical University WanFang Hospital used a portfolio to assist their learning. Questionnaires about the Portfolios were distributed to the students, teachers and staff. Results: Data from 57 interns, 21 teachers and 3 staff were analyzed. Regarding the learning values when the portfolio and passport were compared, students perceived no difference, with teachers believed the portfolio was better than the passport for the items ”helping memory”, ”enhancing organization, ”planning to learn”, ”recognizing weaknesses and 'understanding students' opinion”. In terms of assessment, students thought that there was no difference between the portfolio and passport, and some suggested that the portfolio created a problem due to its size. Both teachers and staff thought the portfolio was better than the passport as an assessment, although not significantly. Many subjects gave a positive feedback, and the negative responses were in the area of ”paper work” and ”inadequate preparation for implementation”. In conclusion, this research suggests that implementing a portfolio system would be a useful improvement. The successful use of portfolios will facilitate the physicians' ability to reflect and self-direct their own learning, as well as helping other ACGME clinical competencies. Overall, portfolios should improve medical education in terms of clinical competencies.