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Medical registrar learning and assessment portfolio

Peter - medical registrar (New Personae)

Peter is a family medicine registrar working a District/Provincially Aided Hospital. He is required to keep a portfolio to document his learning journey. He is told that the learning should cover 60 hours of learning per semester. It is also a way to supervise his clinical work from a distance.
He attends an interesting meeting on ADHD in adults. He makes notes of the content of the meeting and his mixed feelings about the use of mind-enhancing drugs. However the next patient he sees who meets the criteria, he prescribes a trial of Ritalin. She reports back that she has benefitted and that her relationships have improved. He writes this up on the shared Family Medicine Forum page on Vula (the UCT instance of Sakai). A heated tho collegial discussion ensues online. As the discussion tapers he uses some of the points raised and adds them to his initial notes. He adds this to his learning portfolio.

Peter is on call late one night. He has been on call 3 times that week and is exhausted. The nurse phones him and asks him to come and see a 16 year old girl who is in labour but not progressing. He asks the sister to give Pitocin and he falls asleep as he puts the phone down. The nurse phones an hour later to say that the mother is in extreme pain. He had not realised that the young patient had had a previous caesarian section (at age 14) and she has now ruptured her uterus. His quick actions now save the mother and child, but he feels devastated at the near-miss tragedy. He phones his mentor in Cape Town to discuss the strong emotions he is experiencing. Later it is discussed at a mortality and morbidity meeting at the hospital. Peter and his colleagues look at ways of preventing similar problems in the future and a protocol for Pitocin is put up in labour ward. Peter writes of this experience and adds it to his portfolio, under the heading "Mistakes and Near Misses".

Peter's portfolio includes the number and type of surgical procedures he has done. It includes 6 patient scenarios, where he identifies his learning needs that act as triggers to learning. He does a reflection on his own lifestyle and how he analysed it against what he tells patients and how he has worked to change it and what he has learned from the experience. He includes a number of articles he has read and summarised.

At the end of the module, one of his lecturers and an external examiner read the portfolio, allocate marks based on his meeting his learning needs and then have an oral exam where they ask questions based on what was learned by doing the portfolio. He is well prepared as he has consulted books, journals and colleagues on the topics that he has presented. His patient studies have been marked by topic experts already.

Peter graduates and the habit of reflecting remains tho he is delighted that he no longer needs to write it all down. When he goes for a job interview he takes his portfolio to show (re-purpose) his experience and learning.

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