30 | Chapter 2 Table 1 Continued. Contexta Mechanismb Outcomec Distilling clinical experiences into portfolio reports helped to analyse these experiences (DC) Learners engaged in reflection.35,42 The portfolio helped to capture what was happening during education (DC) Learners engaged in reflection.45 The portfolio mimicked authentic professional situations since real medical cases were used to fill the portfolio. This reduced the gap between theory and practice (DR/PC). Learners engaged in reflection.31 The portfolio facilitated that all information was stored in one place (DR) Learners engaged in reflection.32 Supervisors emphasized the importance of reflection (M) Learners engaged in reflection.33 Context Mechanism Outcome Reflection (-) - Low resource country with scarce human resources (GC) - Learners and supervisors were not aware of nor experienced with reflective thinking and writing. (ES) Learners thought that they should not reveal any weaknesses, deficiencies, or mistakes in their portfolio and should only include evidence of competency (AP) Although reflection was happening, it was almost unconscious, and very seldom documented.40 Context Mechanism Outcome Feedback (+) Eastern face-saving culture (GC) Learners feared that (negative) feedback would result in uncomfortable situations with teachers (I/F). However, the digital portfolio format provided learners the opportunity to read feedback when alone, which diminished fear (PC/F) Learners were able to learn from the feedback that was provided.36
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