Tag Archives: Excellence

The Bigger Picture

The NHS ePortfolio started as a local pilot project. It’s use was then expanded and expanded. There was no budget for this, and no vision for how trainees might want it to look and feel. It fulfills it’s purpose, is functional and allows trainees to record meetings and assessments. But is “functional” really good enough?

Here are some quotes from the ePortfolio site, and the JRCPTB (who fund the Physician version):

The NES (NHS Education for Scotland) ePortfolio has grown rapidly since its inception in August 2005 and now comprises over 20 versions for over 35,000 healthcare trainees within Scotland (Nursing, Midwifery, Dentistry and Pharmacy), across the United Kingdom (Medicine), and The Republic of Ireland (Medicine).

This ePortfolio is designed to support learning by providing a secure record of appraisal discussions, an ongoing personal development plan, workplace assessments plus reflection on clinical and other learning events. The ePortfolio links to the relevant GMC approved curricula appropriate to your stage of training.

The ePortfolio is designed to help gather and organise evidence in a way that is trainee centred and user friendly. The emphasis for this is on you as the trainee with support from your supervisor.

If the emphasis is on the trainee to gather and organise evidence, then the emphasis should be on the trainee to determine how that is done. There has been a lack of investment in the ePortfolio which has resulted in the current slow, unimaginative, frustrating version. This needs to change. As trainees we need to demand more.

Direct feedback to developers is needed to bring about improvements in day to day usability. Feedback to Royal Colleges etc is needed to communicate the need for investment in the overall structure and function of the system. We need an app and we need an overhaul of how the ePortfolio works in order to encourage trainee  and supervisor engagement. There is no obvious way in which this feedback can be given, hence this site….

Practice what you (aspire to) preach

What I don’t think the Colleges etc realise is that the ePortfolio is the only concrete thing we see as a result of handing over large amounts of money in JRCPTB fees.  Therefore in surveys it is said to be “poor value for money.”

Even more importantly the ePortfolio itself is a reflection of how training is currently viewed. It feels to many that we are aiming for competence – how uninspiring! What happened to striving for excellence? What happened to valuing the diversity and individuality of talent and interest amongst trainees? What happened to mentorship? Many trainees feel like just a number on a rota spreadsheet, getting through the day, jumping through hoops for assessments that often become tick-box exercises of no educational value. Of course competency in the required knowledge and skills is essential, but competency is a MINIMUM requirement. It often feels that this is all that is expected. Many trainees do extraordinary things but their supervisors and deaneries would never know this. One trainee’s portfolio looks just like any others, the only difference being whether they have done 6 mini-cex’s or 7.

If we want to inspire excellence, we need to show this in everything we do, and in every system we create. Trainees need a system that allows them to not only demonstrate that they have reached the minimum standard to progress, but that they are so much more than the sum of a few WPBAs. They need to be proud of their portfolio. Currently the system is failing them, with the danger of producing uninspired, undervalued, underachieving, burnt out doctors. Bad for trainees, bad for Trusts, bad for patients.

Time for a fresh look at what we expect of trainees, and what trainees can expect of the system.

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