ABSTRACT

Introduction: Education in medical residencies requires a solid assessment system, based on objective criteria. It is fundamental to establish the acquisition of adequate levels of competence in the students, which can be assessed with an electronic portfolio. Material and methods: One-group pre-post test study design. Pediatric pneumology residents from the National Institute of Pediatrics in Mexico City were included. An electronic portfolio was designed in Google Sites, that included these competencies: elaboration of clinical history, medical notes, interpretation of imaging studies and professionalism. These were assessed with rubrics developed by UNAM Faculty of Medicine, before and after four months of the portfolio implementation. Wilcoxon rank test was used for analysis. Results: 11 Students participated, the total population of specialty residents in the hospital. Four women and seven men, average age of 34 years; 6 first-year and 5 second-year residents. Cronbach’s alpha of the rubrics ranged from 0.71 to 0.91. An statistically significant increase was found in the four assessed competencies, when comparing the pre with the post-test levels. Conclusions: The electronic portfolio is an instrument capable of objectively assessing clinical competencies in medical residents, can help determine their acquired competency level and also provide information useful for formative assessment.

KEYWORDS

Electronic portfolio, clinical competence, assessment, residency education.

REFERENCES

1. Carranza R. La evaluación del conocimiento en medicina. Rev Educ Sup 2008;37(147):31-42.

2. Matus BO, Torres AG, Parra PP. Utilización del portafolio en educación médica. Rev Educ Cienc Salud 2009;6(1):10-19.

3. Epstein RM, Hundert EM. Defining and assessing professional competence. JAMA 2002;287(2):226-235.

4. Morán-Barrios J. La evaluación del desempeño o de las competencias en la práctica clínica. 2a parte: tipos de formularios, diseño, errores en su uso, principios y planificación de la evaluación. Educ Med 2017;18(1):2-12.

5. Subdivisión de Estudios de Postgrado. Especializaciones. Facultad de Medicina. Programa Único de Especialidades Médicas. Neumología pediátrica. 2008. Fecha de acceso: 10 de julio de 2018. Accesible en: www.fmposgrado.unam.mx

6. Driessen E, van Tartwijk J, van der Vleuten C, Wass V. Portfolios in medical education: Why do they meet with mixed success? A systematic review. Med Educ 2007;41(12):1224-1233.

7. Van Tartwijk J, Driessen EW. Portfolios for assessment and learning: AMEE Guide no. 45. Med Teach 2009;31(9):790-801.

8. Webb C, Endacott R, Gray M, et al. Models of portfolios. Med Educ 2002;36(10):897-898.

9. Wilkinson TJ, Challis M, Hobma SO, et al. The use of portfolios for assessment of the competence and performance of doctors in practice. Med Educ 2002;36(10):918-924.

10. Swallow V. Learning in practice: But who learns from who? Nurse Educ Pract 2006;6(1):1-2. doi: 10.1016/j.nepr.2005.11.001.

11. Mathers NJ, Challis MC, Howe AC, Field NJ. Portfolios in continuing medical education-effective and efficient? Med Educ 1999;33(7):521-530.

12. Rillo AG, Palomares PP, Arceo GME. Nivel de conocimiento que poseen médicos residentes sobre Norma Oficial Mexicana del Expediente Clínico. Rev Hum Med 2008;8(2-3):1-19.

13. Ciudadano EL, Sergio L, Martinez A, Interino G, Estado DEL, Soberano LY. Marco normativo CNDH. 2015:1-28.

14. Mehrotra P, Bosemani V, Cox J. Do radiologists still need to report chest x rays? Postgrad Med J 2009;85(1005):339-341. doi: 10.1136/pgmj.2007.066712.

15. Thomas JV, Sanyal R, O’Malley JP, Singh SP, Morgan DE, Canon CL. A Guide to writing academic portfolios for radiologists. Acad Radiol 2016;23(12):1595-1603. doi: 10.1016/j.acra.2016.08.015.

16. Jarvis RM, O’Sullivan PS, McClain T, Clardy JA. Can one portfolio measure the six ACGME general competencies? Acad Psychiatry 2004;28(3):190-196.

17. Dannefer EF, Henson LC. The portfolio approach to competency-based assessment at the Cleveland Clinic Lerner College of Medicine. Acad Med 2007;82(5):493-502.

18. Miranda P, de la Fuente R, de la Cuadra JC, Corvetto M, Altermatt F. Portafolio electrónico en residencia de subespecialidad en anestesia regional y analgesia perioperatoria. Inv Ed Med 2015;4(14):e7.

19. Arnau i Figueras J, Torán Monserrat P, Martínez-Carretero JM, Forteza-Rey J, Pinilla Llorente B, Brailovsky CA. Introducción del portafolio formativo como instrumento de tutorización de residentes de Medicina Interna: Revisión de una experiencia piloto, 2005-2006. Rev Clin Esp 2008;208(9):447-454.