28 | Chapter 2 Table 1 The context–mechanism–outcome configurations identified during the extraction process of the sixteen included papers focusing on portfolio use in clinical workplace learning (WPL), ordered according to SRL outcomes. Contexta Mechanismb Outcomec It was difficult to ensure protected time within the clinical hospital setting (WPL) Learners thought that time spent on the portfolio reduced the time available to spend on patients (AP) Learners doubted the educational benefit of the portfolio.42 - Learners did not have a personal work and/or storage space within the hospital (WPL) - The busy, frenetic pace of the clinical setting (WPL) - Summative assessment; more specifically, requirements regarding the (number of ) portfolio reports (SA) Learners struggled to collect the required portfolio forms, because they usually did not have access to their portfolio at the workplace. And because they were reluctant to add to the workload of colleagues by asking them to observe and provide feedback on routine procedures (M). Consequently, the portfolio requirements induced stress, anxiety, and other negative feelings (F) Learners doubted the educational benefit of the portfolio.39 Context Mechanism Outcome Self-assessment (+) The busy, frenetic pace of the clinical setting, which can result in the training year passing by without any concrete developments (WPL) The portfolio provided a structure to document information during busy workdays (DC). Subsequently, this documentation reminded learners of what happened before and thus provided an opportunity to look back (DR) Learners reviewed their weak and strong points.44 Learners documented frank and open portfolio reports about their deficiencies and how they had tried to remedy them (DC) Learners were aware of their feelings, attitudes and concerns.37 Distilling clinical experiences into portfolio reports helped to analyse these experiences (DC) Learners engaged in constructive self-criticism, thereby clarifying thoughts and feelings and identifying proficiencies and deficiencies in performance.35 The portfolio facilitated that all information was stored in one place (DR) Learners identified gaps in learning.32
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