9 Introduction | 1 Medical training programmes across the world have implemented portfolios for a variety of purposes, e.g. assessment, guidance and/or competency development.1 This thesis focuses on the value of portfolio use for one specific purpose: the support of self-regulated learning (SRL). SRL concerns ‘the degree to which students are metacognitively, motivationally, and behavio[u]rally active participants in their own learning process’ and is considered of eminence during and after education.2(p167) Since portfolio research within the field of clinical workplace learning (WPL) has mainly focused on other purposes of portfolio use, much is still unknown regarding the effectiveness of portfolio use for the support of SRL in this educational setting. Therefore, this thesis was conducted to answer the following research question: How does portfolio use affect SRL during clinical WPL? Since the use of portfolios fits within a tradition of educational practices, three of the practices that define current medical curricula will be discussed before the use of portfolios for the support of SRL is further introduced. Furthermore, the context in which the different studies were performed, a reflexivity statement, the aim, research question and outline of this thesis will be presented in this chapter. Educational practices that define current medical curricula The use of portfolios for the support of SRL is not an isolated practice within medical curricula, instead it strongly relates to other current educational practices. Consequently, knowledge of these practices is fundamental to understand the studies that are part of this thesis. Therefore, three common educational practices within medical curricula are described below: 1. Competency based education3-5 2. Programmatic assessment6-8 and 3. Focus on self-actualisation. 1. Competency based education is centred around the competencies that are considered vital to the field being educated.3 In medical education these vital competencies are often derived from the Canadian Medical Education Directions for Specialists (CanMEDS) physician competency framework. This framework describes competencies of physicians by use of seven roles that are considered essential to the profession: Medical Expert, Communicator, Collaborator, Leader, Health Advocate, Scholar and Professional.9 Competency based education is outcome-based, as it only prescribes the competencies that learners ought to possess in order to graduate. It is therefore considered more flexible and learner-centred than traditional education, that also specifies how and when learners (and teachers) should achieve the desired results.3,10
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