Tag Archives: functionality

The perfect ePortfolio

Thanks to @londonlime

Thanks to @londonlime

This weekend I am at NHS Hackday in Oxford. I have written about hackdays before. I am a huge enthusiast. It is amazing to see doctors, other healthcare workers, patients, organisations and software developers coming together in their free time to make stuff that could make the NHS better. A hackday IS agile software development, speeded up, with people motivated not by profit but by intellectual curiosity and a desire to make the world a little bit better.

There are some amazing people coming to NHS Hackday Oxford. Some of them are interested in rethinking a professional ePortfolio. The one we have currently is competent. It does a job. The creators at NES are great, but they are constrained by their history and location. In my opinion an IT project that supports thousands of healthcare professionals’ development should not be run by project managers in a Scottish NHS health board. Their customers are Royal Colleges, not ePortfolio users. However great NES are at their job are they really the best people to make the perfect ePortfolio?

As trainees we want more. In relation to the software we want seamless functionality, we want flexibility, we want personalisation, we want visualisation of data, we want speed, we want interoperability, we want openness and APIs, we want mobile offline data entry, we want intuitive navigation, we want reliability, we want to be encouraged and inspired, we want beauty.

Too much to ask? I hope not. 

I need to form these vague statements into some specifics between now and tomorrow. Wish me luck!

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An ePortfolio wish list – created by an NHS ePortfolio NES developer

There have been lots of great suggestions on this site as to features that would make the NHS ePortfolio better. There has also been some insightful debate on the model that we should propose for the future, from aesthetics to functionality to commissioning. When I find a free hour I will make a summary page, as the debate has extended far beyond my initial expectations, and on arriving to the site it may now be difficult to see a coherent narrative. Some ideas for improvements are summarised in the tech improvement shopping list, others are amongst the comments on various posts.

A new development is that an NHS ePortfolio NES developer @ben555 has started a wish list where you can suggest improvements and vote them up or down the list.

Make a (NHS ePortfolio-related) wish

Whilst debate over longer term issues  continues, this is a great way to gather momentum for change. I have voted for an app – this is urgent!

Make your suggestion and cast your vote now…

An app-ortunity

Quite reasonably I have been asked how an NHS ePortfolio app would benefit doctors, and what it would have to do to be worth any investment. In my opinion the need for an app is driven by the need to make WPBAs more relevant. An app would put control back in the hands of trainees, and make life significantly easier for trainers/assessors. This would reduce resentment towards WBPAs and would save an unimaginably huge amount of time for a stressed, squeezed, overworked profession.

The current situation:

I am doctor in training (this covers everyone who is not yet a Consultant/GP partner). I am required to complete a certain number of WPBAs to progress. One day I am at work and am on call admitting new patients to hospital. I think I’ve made a pretty thorough assessment of a patient with a condition I’ve not encountered before and ask my Consultant if, after presentation of the case on the post-take ward round they can fill in a mini-CEX. They say yes.

I present my case during the round and the Consultant provides some useful immediate feedback on my assessment, including a recommendation to read a recent review on the subject in an academic medical journal. However, the Consultant has another 7 patients to review after this and can’t stop to find a computer, login, wait for it to load up, access the NHS ePortfolio website, login and complete the assessment. “Send me a ticket” they say, with a genuine intent to complete is as soon as possible. My shift gets busier and after 13hours at work I go straight to bed when I get home. The next day i am very busy and forget to send the ticket via email. I remember when I get home but realise I don’t know the Consultant’s email address. It’s a weekend so I’m not in for another 2 days. I set a reminder with an alarm on my phone and on Monday the alarm prompts me to retrieve the email  from the hospital system and I send the ticket from the NHS ePortfolio site.

A week later the assessment has not been completed and I send a reminder. Three days after this I bump into the Consultant in the lunch queue and gently remind them about the mini-CEX. They make excuses, feel bad, and promise to do it ASAP.

A week after this the Consultant finally has some time for admin and discovers my reminder email in their inbox. They login and struggle to remember anything about the patient or the feedback they gave me. They have an overall impression of whether I’m any good or not and complete the assessment mainly based on this overall view, rather than the specifics of the case we discussed. I get an email to say that the assessment has been completed. At a later date I login and read the comments, which are brief, and get no educational benefit from the recording of the episode. I do however feel less stressed as that’s one less assessment to get ticked off. I can’t remember the author of the review recommended by the Consultant and never quite get round to searching for it.

A possible future situation:

One day I am at work and am on call admitting new patients to hospital. I think I’ve made a pretty thorough assessment of a patient with a condition I’ve not encountered before and ask my Consultant if, after presentation of the case on the post-take ward round they can fill in a mini-CEX. They say yes.

I present my case during the round and the Consultant provides some useful immediate feedback on my assessment. I get out my smartphone and login to the NHS ePortfolio app. I bring up the mini-CEX form and we complete it together adding comments based on the feedback the Consultant has just given, including the recommendation to read a recent review by author X in journal Y. There is a prompt to enter the Consultant’s email address so that they can validate the mini-CEX as an accurate representation of the assessment, and I input this as the Consultant dictates it. I save the form. The Consultant continues with the post-take ward round. I continue to admit new patients.

When I get home my phone picks up my wifi signal, and the ePortfolio app automatically synchs with my account so that the mini-CEX is uploaded. An email is sent to my Consultant and me to inform us of this new entry on my ePortfolio. I don’t have to waste time chasing up multiple assessments like this, so actually get round to looking up the review recommended by the Consultant, and learn something that will benefit my future patients.

It is essential that an NHS ePortfolio app:

  • is cross platform (iPhone, android etc)
  • can perform most functions offline with synching later with the main site. Most NHS hospitals have no wifi and poor phone sinal coverage. If an app required wifi it would be of no use to many, many, users

Another possible function would be to record reflection-in-action – essentially quick notes about things that happen that are particularly challenging, satisfying etc. There would then be scope to comment on this in the portfolio later (reflection-on-action).  Professionals must be reflective to learn and develop, but there is debate around the value of writing down these reflections. An app would at least make the process easier for those that wished to do this.

Oh, and of course ideally it would be free. But I’d pay £0.69 to make my life easier, wouldn’t you?

The NHS ePortfolio fan club

A recent twitter post directed me to the blog of Dr Fiona Pathiraja, which I encourage you to read. She asks:

Am I the only member of the ePortfolio fan club? If the recent vitriol on Twitter is anything to go by, one would be forgiven for thinking that the fan club comprises n=1.

She suggests that much of the negative press is unfair, and that medics don’t know how lucky we are, especially when compared to the private sector.

However, looking more closely her comments are a mix of praise for the concept of an ePortfolio itself, the structured nature of medical training programmes, and the job security that so many others rightly envy. She is honest about the shortcomings of the NHS ePortfolio in its current form and the need for change.

Of course, the ePortfolio is far from perfect. The end user is typically generation Y and expects technology to have the beautiful aesthetics and seamless functionality of their i-products. Improving functionality e.g. linking curriculum items to assessments, and aesthetics is essential for an improved ePortfolio.

This is exactly the point. We expect more. We deserve more. It is time for investment in the NHS ePortfolio to bring its functionality and aesthetics into the era of generation Y.

She also goes beyond the technical aspects of the current ePortfolio and makes requests for: a better and more transparent evidence-base for assessment tools including WPBAs; more training for supervisors on use of assessments; and the need to treat medics as adult learners:

As a cohort of intelligent, motivated young people, we are able to take responsibility for adult learning, but need to be treated like adults in order to do so.  If the ePortfolio gods are listening—engage with us, take constructive feedback, and try to improve the portfolio to inspire the medical generation Y.

I couldn’t have said it better myself. This site is a first step in connecting users, developers, and Royal Colleges.  If we can all work together to effect these changes, I might just join the fan club myself!