Tag Archives: Education

Progress

Things have been a little quiet on the site lately, and you would be forgiven for wondering whether I have lost interest in the NHS ePortfolio. You may have started to think that nothing is being achieved, and therefore not bothered to comment or contribute to the discussion.

Don’t believe it!

Progress may be slow, but real change takes time. Quick fixes are great and can have a major impact on functionality. Remember the problems with being unable to link to multiple curriculum items? Fixed! See the tech improvement shopping list for other modifications that have already happened. Quick fixes are also visible and keep up enthusiasm and morale. But they don’t address the route causes of problems and don’t change systems. Changing systems takes time.

A major breakthrough has been the creation of an ePortfolio reference group at the Royal College of Physicians. You can apply to be a member of this panel and get your voice heard directly by the College. Not a member of the RCP? Then ask your own College if they have a user group you can join. And if they don’t have one, ask why not. The systems imposed on trainees are currently not fit for purpose, and we need to make sure people in charge understand this.

Dont forget that NES, the group who run the NHS ePortfolio used by Physicians, Paediatricians and others, is holding feedback events. I’m sure that this is in no small part due to pressure from this site and discussions on Twitter. If you can, go along and make your voice heard.

People are listening.  I have meetings coming up with the Royal College of GPs who use a different ePortfolio system but share common needs. I am also having a follow-up meeting at the Royal College of Physicians. We must clarify the commissioning and costs of the ePortfolio in order to collaborate across Colleges and effect change. When money is scarce we need to make it go further. The Academy of Medical Royal Colleges Trainee Doctor Group are gathering data on the systems in use by all specialities which will be essential is informing this discussion.

It could be so much better! Please keep up your support.

Acronym Soup: RCP, JRCPTB, WPBA, SLE, AoP, AoMRC ATDG

The Royal College of Physicians

This week I met with the Royal College of Physicians in London to discuss the NHS ePortfolio. After the many discussions I have had with trainees and trainers on this blog, on Twitter and in person I felt well prepared. I was sure the RCP should be taking a keen interest in the ePortfolio and it’s place in the wider context of Postgraduate Education, and through some brief email conversations I felt we were likely to have common ground. But as I walked through the falling leaves of Regent’s Park, I wondered what they would make of me and my graffiti-decorated blog…

It would have been unrealistic to expect to leave the meetings with all the answers, but I truly believe we have taken the first step towards a better solution. There are lots of details to work out, and I found myself discussing things like commissioning and procurement – yet another new language to learn! What was so positive was that there was an acknowledgement that trainees (and trainers) are dissatisfied with the ePortfolio, and that the concerns being raised are not idle complaining, but are educationally valid.

This is an important issue because it affects thousands of doctors, and because it relates to other areas of Postgraduate Training. The RCP wants to support trainees in their professional development and acknowledge that the ePortfolio is part of this process. There is also a realisation that technology has moved on, that the ePortfolio was not future-proofed, and that it is important to take stock and think about how to move forward. Financial contraints will impact on these plans and we need to be both realistic and imaginative in our decision making. The fact that the new RCP revalidation tools for Consultants have no interface or link with the trainee ePortfolio is another example of a lack of joined up thinking which we must avoid in future.

I was happy to hear that the RCP have almost finalised the details of the new ePortfolio User Reference group, which will have several trainee representatives. Hopefully this will not only impact on decision making, but also improve communication, so that we don’t in future have changes appear with no warning. It was also encouraging to hear more about the research being done on WPBAs/ SLEs. The RCP are putting considerable time and resources into reviewing the use and utility of WPBAs and the results of this research is likely to have a significant impact on the assessment systems for all medical specialties and shape training for the next 10 years. This is a great opportunity to engage with the College and have a real impact on Postgraduate Training.

There are many questions that do not yet have answers, in particular the question of funding and commissioning ePortfolio systems in the future. All doctors have a core set of common needs and I believe it is essential that we define these together and press for collaboration across Colleges, and open-ness in every part of the process.  The Trainee Roadmap is a first attempt at this, and I encourage you to contribute. The RCP seem to truly be putting trainees’ needs at the heart of what they do, and are (slowly) responding to the concerns of the thousands of you who have visited this site. But the structures of these organisations are complex and my attempts to find a way through the committees and funding streams of the RCP, the JRCPTB and others is already bringing on a headache.

We need to make sure this stays at the top of the agenda for the College, and I look forward to follow-up meetings in the future. I hope the other Colleges are watching, and are considering their own strategies. Otherwise they may find their trainees asking questions they can’t answer….

The Academy of Medical Royal Colleges Trainee Doctor Group

Coincidentally, in the same week I also went to give a presentation at the AoMRC ATDG (seriously, the number of acronyms in the world of medical education is mind-boggling).

There were many nods of assent as I described my frustrations with the current ePortfolio, and the demands placed on trainees and trainers to complete activities with little educational value. The representatives at the ATDG come from a wide spectrum of specialities including O&G, General Surgery, Anaesthetics and Intensive Care, Emergency Medicine, Pathology, General Practice, Ophthalmology, Psychiatry, Radiology and Medicine. Various ePortfolio systems are used by these trainees and some, such as the Haematologists, have to use two systems which, of course, do not talk to each other.

There was also great enthusiasm for sharing information, and for collaboration across Colleges. There was agreement that there are common needs for tools that support learning and professional development, capture workplace learning, log assessments, and provide evidence for appraisal. These needs are shared by doctors of all specialities and span the start of FY1 to retirement (in fact, since four UK medical schools use the NHS ePortfolio, these needs span Undergraduate as well as Postgraduate training). Technical aspects were touched on, and some absolutes were identified: such as a single sign on for all systems; a set of core standards for any ePortfolio used by doctors; and the need for flexibility for Colleges/Specialities and individuals. There was enthusiasm and hope for a future in which there is a simple but flexible ePortfolio system, with mobile support, that truly supports learning, and that makes people smile not scream when they login!

This committee is unique in bringing together trainees across specialities. It’s also full of lovely and enthusiastic people. The representatives are going back to their respective College trainee groups to gather information on what systems are used, and what trainees think of them. I hope we can then finalise a Trainee Roadmap and Core Requirements document, that will help us move forward.

Watch this space!

My 15 mins of fame

I am having some brilliant and highly productive meetings about the ePortfolio this week, which I will write about as soon as I can.

In the meantime, you can see my 15mins of fame in the NHS Hackday video:

NHS Hackday 2012: Geeks who love the NHS

“It’s an amazing atmosphere when you can come with a problem as a physician and say ‘I know nothing about any of this stuff, but I know what I want to be able to do.’ And then to have a room full of people who have the know-how and the enthusiasm to go ‘we can do that.'”

I love @wai2k‘s quote, which really sums up the weekend and the project: “with collaboration between the people who create the software and the people who use the software you can potentially create something quite magical.”

The ePortfolio needs exactly this. We are getting there.

What would you ask?

As a result of this blog, and “a little help from my friends” I have a meeting next week at the Royal College of Physicians to discuss the NHS ePortfolio. I hope to articulate the discussions on this blog, and those that I have had over email, twitter and in person with many of you.

I hope to communicate the frustration felt by trainees and others about the NHS ePortfolio, along with the hope that it could be something so much better: a true educational and professional development tool to support lifelong learning. I hope to gain a better understanding of the views of the Colleges, in particular the view of the governance structures, the funding streams, and the future vision.

Broad areas I hope to discuss include:

  • lack of user input on any decisions about the ePortfolio and proposals to change this
  • poor communication of the rationale for, and timing of changes (personally, I had no warning about the change to formative and summative DOPS) and the effect this has on demoralised trainees
  • technical limitations – such as speed, which increase frustration and decrease utility
  • design limitations – such as lack of flexibility, poor organisation and visualisation of content so that it is hidden away and can’t effectively inform PDPs. These design limitations have an adverse effect on the educational utility of the ePortfolio
  • educational limitations due to lack of an app, meaning delays between a workplace-based assessment being observed, and completed online (therefore feedback becomes meaningless)
  • other limitations – lack of ability to share content with anyone other than supervisors, lack of interoperability and exportability of data for more creative uses
  • what does the College believe is the answer to the question “who owns the data in the ePortfolio?”
  • is there scope for greater collaboration between JRCPTB, RCPCH, The Foundation Programme and other groups who commission their ePortfolios through NES, to invest jointly for change – an app would be a perfect opportunity for this. The users of these systems share many basic needs, and could have individual specifics built in
  • what is the future of the ePortfolio, in technical, and educational terms, and how will this be decided?
  • how is the ePortfolio funded and commissioned? What are the plans for the future? How can we improve the process and increase transparency?
  • the concept of an ePortfolio has great potential but is not delivering what is needed. Investment is essential. User input is essential. There is a great opportunity to get this right and improve both the perception and reality of postgraduate training. Who will lead this change? Will it be the RCP?

I am very grateful to the RCP for taking the time to meet with me, and hope it will be a very constructive and positive conversation. Please let me know what else you feel is essential for me to communicate, as we begin to get closer to a process for change.

What would you ask? Please let me know by commenting below. You can also still edit the ePortfolio Trainee Roadmap

Where do we go now?

Last week I saw a film at the BFI called “Where do we go now?” The film is great, but the content is not very relevant to Postgraduate Medical Training. The title, however, got me thinking….

The Royal Colleges and NES, who make the NHS physician ePortfolio, are drawing up ‘roadmaps’ which set out a vision for future directions. This is great, as their aims, objectives and ideas are being carefully constructed. But where is the trainee input to this process?

Where do we go now?

Where do we go now?

So, if the JRCPTB and NES are going to have ‘roadmaps’, I propose we write our own. I have started a Googledoc. You can edit it by clicking this link:

If  you don’t participate when given the chance don’t complain when you have to do 100 WPBAs a week, link every curriculum item to 50 pieces of evidence and there’s still no app in 2020

Go on, contribute. Put your ideas on paper. Make change happen. If you don’t other people will make decisions for you. I doubt you’ll like them.

Ask and you shall receive…

The process of linking evidence to the curriculum is notoriously time consuming and infuriating. It is ridiculous that you cannot link more than one item at a time, either when linking from the curriculum to your evidence, or when linking from an assessment to curriculum items.

It turns out that the developers were not aware of this. And they can fix it (click here):

Things related to usability that don’t involve big changes to the content or structure of the existing site can be easily fixed. We just need to ask.

Make categories of reflection less restrictive

Most doctors are naturally reflective. There is good evidence that more reflective clinicians learn from their experience and progress and develop. In this world of evidence, the powers that be have decided you need to prove that you are reflecting by logging it into your ePortfolio. This is very frustrating for many people. But if we can’t change the rules (yet), then we should make the systems work for us to make this generating-of-evidence-of-reflection less painful.

Reflection is a broad concept, but this is not reflected (ha ha!) in the current ePortfolio.

Today I listened to a podcast on my way into work, read a news article about the assisted dying bill on my laptop, had a chat with a colleague over coffee about a patient with a rare diagnosis, and moaned to my mum on the phone about a rude and unprofessional colleague. All of this is reflection. But where could I log any of this in my ePortfolio?

We need open categories, and the ability to log URLs/web links and comment on them. This needs to be fast and easy.