26 | Chapter 2 papers fulfilled the three rigour criteria (See Appendix G for a more elaborate description of the included papers). Overview of identified CMOs An overview of the identified CMOs is provided in table 1. The different CMOs are organised according to the SRL outcome they were assigned to. Amodel of how portfolio use works for the support of SRL during WPL The relationship between contextual factors, portfolio (related) mechanisms and SRL outcomes is visualised in Figure 2. Below we explain the components of the model. Contextual factors The contexts of the CMOs were abstracted into four contextual factors. First, we identified a relationship between portfolio use and characteristics of workplace learning.33,36,39,41-44 Multiple papers referred to aspects of WPL that can complicate learning, such as limited access to computers, time constraints resulting from a high workload and the frenetic pace of the clinical setting. Some papers explained that portfolio requirements added to these pressures.36,39 In contrast, other papers described that portfolio use resolved issues related to WPL by creating moments of contemplation, i.e. learners that were able to use their portfolio during busy workdays were provided with an opportunity to pause and think about what had happened.36,39,43,44 The second contextual factor concerns the system of assessment in place.36,39 Two studies showed that formal requirements concerning the amount and/or quality of portfolio reports in the context of summative assessment, were related to stress and anxiety of learners.36,39 These assessment requirements might interfere with the support of portfolio use for SRL, as learners in one of these studies did not experience any educational benefits of the portfolio.39 Two papers mentioned geographical/cultural characteristics in relation to portfolio use.36,40 The face-saving culture present in Taiwan was thought to influence feedback seeking of learners with the portfolio, due to a fear of negative feedback.36 In addition, Jenkins et al. describe how the exceptionally high service demands in South-Africa, limited time available for portfolio use.40 In the same two studies the final contextual factor surfaced: prior experience with SRL constructs.36,40 It was described that limited experience with reflection on the part of learners and supervisors resulted in low awareness and documentation of reflection in the portfolio.40 Furthermore, the learners in the study of Fu et al. found it difficult to individually perform a learning needs assessment, which resulted in inauthentic portfolio reports.36
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