142 | Chapter 7 disrupt the working mechanisms of portfolio use for the support of SRL (Chapter 2). The focus group study of Chapter 4 provided additional insight, as it showed that portfolio assessment interfered with the support for SRL in two different ways. First, faculty often (unintentionally) took portfolio ownership away from trainees, as they instructed trainees to deliver portfolio content that was considered necessary for assessment. Without ownership trainees experienced little leeway to use the portfolio during SRL. Secondly, the combination of purposes in one portfolio resulted in ambiguities among respondents concerning why and how the portfolio should be used. These ambiguities seemed to add to the predominance of the assessment purpose of the portfolio, since respondents reverted to this purpose as it was considered a more familiar and straightforward purpose than the support of SRL. Besides tensions between portfolio purposes, Chapter 4 discussed another factor that limited the value of portfolio use for the support of SRL within the context of this thesis: the close and long lasting relationship between general practitioner (GP) trainees and their supervisors. During GP specialty training, trainees are assigned to a supervisor for an extended period of time (usually one year), with whom they work together. Trainees described that this relationship was sufficient to support SRL, as the exchange of feedback and prompts for reflection emerged naturally during daily activities (e.g. shared consultations and supervision meetings). Consequently, documenting this information in the portfolio was experienced as a superfluous, administrative activity. It has been previously suggested that portfolio use can be less useful when there is frequent interaction between trainee and supervisor.15 The above indicates that trainees had little motivation to use the portfolio, as the interaction with their supervisor already supported SRL sufficiently. In Chapter 2 it was explained, by use of the self-determination theory and goal orientation theory, that also tensions between portfolio purposes can undermine the motivation of learners to use a portfolio. These motivational problems can explain the checking off behaviour of trainees described in Chapter 4, where learners only used the portfolio perfunctorily to document information that they considered required. Also previous publications have described such a perfunctory use of portfolios.8,10,16-18 This type of portfolio use can clarify the results of the content analysis described in Chapter 3. This content analysis focused on four SRL constructs that are expected to be supported by portfolio use (reflection, exchange of feedback, formulation of learning objectives and plans, and monitoring) and assessed whether these SRL constructs were documented in a way that corresponds with research literature on good practice. The analysed portfolio content generally did not fulfil the criteria that were derived from good practices (e.g. reflective reports were superficial and feedback lacked directions for future learning). In sum, tensions between portfolio purposes and a close relationship between trainees and supervisors limited the motivation for portfolio use, which resulted in checking off behaviour of trainees. Since trainees only used the portfolio perfunctorily,
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