117 Polarity map | 5 The description of this polarity in box 1 focuses on problems that can arise when accountability overshadows learner agency, as we had encountered this situation in our previous studies. In such a situation the different portfolio requirements installed to ensure the portfolio’s value for accountability, restrict the (experienced) possibilities of learners to use the portfolio in accordance with their personal learning objectives. However, also the opposite situation might arise: portfolios that have no value for accountability, as the personal choices of learners have resulted in a disparity of portfolio content. Given the importance of both poles of this polarity in medical training, we considered it important to explore possibilities to balance the polarity. Step 2: Mapping We easily agreed on the values of both poles, as there was a high degree of similarity between the values that were proposed, e.g. (intrinsic) motivation was by most team members mentioned as a value of learner agency. Our proposals for the GPS were also similar, as everyone considered lifelong learning to be an important aspiration of balanced portfolio use. In contrast, the components on the bottom halve of the polarity map® required more extensive discussion, as the initial suggestions of the deeper fear and fears for both polarities were more varied. However, through discussion we realised that also these suggestions shared commonalities. For example, the following suggested fears of accountability, • Deliberate choice for performance assessment of what is already mastered (cherry-picking), • Selective documentation, • Adding socially desirable portfolio content in order to meet external standards, • Avoidance of portfolio entries that are personal (and potentially meaningful), were combined into the fear: learners only add portfolio content in order to meet external standards (tick-box exercise). Our final version of the GPS, deeper fear, values and fears are visible in figure 2. Step 3: Tapping/leveraging During the stakeholder session, it became clear that the participants recognised the selected polarity and the proposed values and fears from their own experiences with the multipurpose portfolio of the GP specialty training. Faculty member 1: “I totally recognised what you just told.” Team leader: “As you mentioned during your presentation, in education, there will always be tensions between on the one hand learning, feeling secure, developing and on the other hand: being observed, being assessed and the presence of an external standard.”
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