Electronic portfolio

Initial situation

Switzerland has introduced a new competency framework for pre-graduate studies in human medicine, called «PROFILES» (or “Principal Relevant Objectives and Framework for Integrated Learning and Education in Switzerland”). PROFILES describes the competencies that a graduating student should master in order to begin the first year of medical residency.

Since the introduction of this new framework, faculties have had to ensure that students master competencies in a much more longitudinal way. These skills are acquired in an integrative way throughout the medical curriculum, and in particular through clinical internships. Throughout their studies, students must document their progress and the degree of autonomy they have acquired in the various activities carried out during these internships. The “GPS” portfolio (for Geneva Portfolio Support) was created to facilitate this process. (ou “Principal Relevant Objectives and Framework for Integrated Learning and Education in Switzerland”). PROFILES décrit les compétences qu’un-e étudiant-e en fin d’études devrait maîtriser pour débuter sa première année d’internat en médecine.

Project implementation

The skills framework lists 9 main professional activities: history-taking, clinical examination, differential diagnosis, complementary examinations, technical procedures, emergency situations, prescribing, documentation and quality, care safety. Through various clinical internships, medical students must acquire autonomy in each of these activities.

The GPS portfolio enables students to document the activities they carry out during their clinical placements. In this way, they can keep track of their experiences and draw parallels between the skills they are expected to acquire and the skills they have or have not acquired, by carrying out a self-assessment of these skills. GPS supports the learning process by allowing them to note their progress, achievements and weaknesses in relation to the clinical skills expected at the end of medical studies.

GPS is a personal space for students, but it is also an assessment tool for teachers. In fact, some of the documented activities are evaluated by the clinicians in charge of internships. When students arrive in a department for an internship, they can consult the list of activities to be carried out on their GPS. Many of these have to be documented, and some are marked as “to be evaluated”. When the student is ready, he or she accesses the documented activity and submits it to the supervising clinician for validation. The clinician assesses the student’s autonomy in the activities of a given clinical situation. The clinician also has the opportunity to specify the student’s strengths and areas for improvement, in order to encourage reflexivity and provide formative feedback.

The GPS remains a confidential tool. Students themselves give access to certain parts of the system to those responsible for their training, in order to validate activities, receive feedback or certify attendance. As access is granted on a restricted basis, an internship supervisor will not have access to data concerning other internships carried out by the student, for example. There is also an area which belongs to the student alone, for personal notes or exam results, and which is not accessible to any third party.

The electronic portfolio also plays an essential role in the validation of internships in the fourth and fifth years of medical school. The portfolio defines a series of activities to be documented during the master’s program. These activities must be documented a certain number of times and/or evaluated by the internship supervisors. The internship supervisor sees a summary of everything that has been documented and evaluated, and decides whether or not to validate the internship on the basis of a table summarizing the student’s autonomy.

Validation of the internship enables the student to sit the exam in each discipline. At the end of their studies, students retain access to the GPS, but cannot add new data. When applying for a job at the HUG, for example, students are often asked to submit an evaluation of their internships.

Thoughts and advice

The use of GPS reinforces the integrative aspect of the curriculum and makes students more active players in their training. Usage statistics for the 2020-2021 academic year show that students documented over 39,000 activities on GPS. Of these, 11,800 were validated by a teacher.

The introduction of GPS did not require any special training for teachers, as it is intuitive enough to be used on its own or with minimal documentation. However, it is necessary to encourage teachers to use it and get them into the habit of using it. It’s a time-consuming tool for them, especially for clinicians who struggle to find the time to fill in the assessments. Sometimes students get stuck and have to insist on getting their assessments. An automatic reminder from the platform is provided after a few days. To motivate teachers to use GPS, all assessments are extracted twice a year. When 5 assessments have been validated by the teacher, this enables him/her to obtain a teaching credit to justify his/her teaching activity.

Before embarking on the creation of such an application, it is important to have a very clear idea of what you want to find in it. It is advisable to work with a pedagogue on the skills and activities you want to follow, in order to define your needs and draw up a model. Care must be taken to ensure that the application covers the entire study framework, but it must undeniably be accompanied by a fully-fledged reference document; GPS only represents the student’s experience of progress through this framework.

It is necessary to identify a person dedicated to managing the platform in both technical and pedagogical terms, in order to handle account creation, deletion, connection problems, rights management (access to the right forms), and so on. You’ll also need to manage all the settings required to create the forms, and help teachers to design them, as they’re not necessarily aware of what the tool can do. Regular updating (every summer) is highly recommended. This means contacting teachers to ask them about the evolution of their courses, so that the application is up to date.

Another facet of the Portfolio is the ability to extract data for student tracking. A student and learning monitoring group has been set up. It is made up of course leaders and student advisors. Its mission is to identify and monitor students who are encountering difficulties in their studies. Once the difficulty has been identified, the group offers students remedial tools adapted to each situation.