10 | Chapter 1 2. Programmatic assessment aims to combine two purposes of assessment: learning and decision making.7,8 These aims are pursued by developing an integrated programme of assessment that is intertwined with the curriculum, rather than assessing knowledge and/or skills (once at the end) of individual courses.6 It is assumed that continuous low-stake assessments (no formal decisions are based on these individual assessments) are an impetus for learning, as they inform learners about their progress. Furthermore, aggregation and triangulation of multiple low-stake assessments is expected to be valuable for high-stake decision making (important pass or fail decisions), as it provides information about a learner’s performance during a variety of contexts and moments.8 Moreover, it is expected that by integrating a multiplicity of assessment methods and sources, biases and problems that are tied to individual methods/sources are cancelled out.8 3. The focus of (western) society on self-actualisation is mirrored within medical education. This shows in the intention of medical curricula to support concepts like lifelong learning (‘actively engag[ing] in one’s own learning in different circumstances and contexts’)11(p35) and agency (‘one’s capacity to act purposefully and autonomously’). 12(p1) The introduction of portfolios In light of these educational practices, portfolios have been introduced within medical education around 1990.1 Portfolios originate from the arts, where it is custom to compile ones work in a folder, in order to present it to teachers and/or potential clients. 13 In medical education portfolios are used to collect, amongst others: feedback, reflections, learning objectives, assessment outcomes and professional work.14 While medical educational portfolios started similar to those in the arts (i.e. paper folders), current portfolios are mostly provided in a digital format. Portfolios in this thesis are therefore defined as a purposeful aggregation of (digital) items (e.g. evidence, reflections, feedback) that demonstrate learning, experience or professional growth.14,15 Portfolios are implemented in medical education for a variety of purposes, e.g. assessment, guidance and/or competency development.1 In most cases portfolios are used to serve multiple purposes at the same time.1 As stated above, this thesis focuses specifically on one purpose of portfolio use: the support of SRL.16,17 Before discussing the potential relationship between portfolio use and SRL, information on what defines SRL is provided.
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