108 | Chapter 5 Abstract Phenomenon Portfolios are often implemented to target multiple purposes, e.g. assessment, accountability and/or self-regulated learning. However, in educational practice it appears to be difficult to combine different purposes in one portfolio, as interdependencies between the purposes can cause tensions. Often mentioned are tensions that can arise when summative assessment and reflection are combined in one portfolio, but also other tensions seem to be in play during multipurpose portfolio use. Previous suggestions to deal with these tensions did not acknowledge the complexity of the problem at hand. We argue that complexity theory and systems thinking methodologies are vital to provide sustainable solutions. This paper used a systems thinking methodology to explore directions to manage tensions that are inextricably linked to multipurpose portfolio use. Approach We selected a systems thinking methodology, that was based on the polarity thinkingTM framework. This framework provides a step-by-step approach to chart a polarity map® that can help to balance the tensions present in specific settings. The different components of the polarity map® help to clarify the polarity responsible for the tensions in play and offer concrete advice on how to deal with this polarity. We followed the steps of the framework to chart a polarity map® for multipurpose portfolio use, together with a group of stakeholders who work with the portfolio of the Dutch general practitioner specialty training. Findings Based on literature and our prior research, we selected one overarching polarity: accountability and learner agency. This polarity seems responsible for multiple tensions related to multi- purpose portfolio use. By use of the polarity map®, we formulated values (potential benefits) and fears (tensions that can arise) of the two poles of this polarity. Then, we organised a stakeholder session to create action steps and early warnings that can help to balance accountability and learner agency during multipurpose portfolio use. Insights Multipurpose portfolios are implemented in medical education to support the qualification of competent, lifelong learning professionals. However, the different tensions related to multipurpose portfolio use often undermine this aim. In addition to previous recommendations concerning portfolio use, we advocate that it is important to create a shared frame of reference between all involved with the multipurpose portfolio. During this process the acknowledgment and discussion of tensions related to multipurpose portfolio use are vital. These - and other - action steps and early warnings described in our polarity map®, can be helpful during continuous quality improvement of multipurpose portfolios.
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