31 Realist review | 2 Sensitive or otherwise neglected topics were discussed more easily as they were part of the portfolio and needed to be discussed. This broadened the focus of discussions between learners and supervisors and/or stimulated the relationship between them (M) Honest and constructive feedback between learner and supervisor was facilitated.44, 45 Supervisors were able to provide valuable feedback when learners documented complete portfolio reports (M). Feedback was considered valuable by learners in case it concerned specific clinical cases, as this feedback promoted further thought and actions (AP). Moreover, learners enjoyed it when supervisors paid enough attention to provide them with individualized feedback, which promoted a positive self-image of learners (F) Learners actively sought and kept feedback. Provided feedback was used retrospectively (i.e., reading documented feedback to seek solutions after a problem is encountered) and prospectively (i.e., changing practice after reading feedback).36 Supervisors were able to provide valuable feedback when learners documented complete portfolio reports (M) Feedback promoted further research and thought into a topic.46 Context Mechanism Outcome Feedback (-) The number of interesting cases available in the clinical setting varied (WPL). When there was a lack of interesting cases, learners wrote brief reports in their portfolio. These brief reports were followed by brief feedback from supervisors (M) Learners perceived portfolio feedback to have little utility for personal development and, as a result, their feedback-seeking motivation declined.36 Unsatisfying technological infrastructure at the hospital (WPL) Learners were forced to complete portfolio entries at home after work. Due to the time delay learners experienced difficulties in writing optimal submissions. These submissions received suboptimal feedback in return (M) Learners perceived portfolio feedback to have little utility for personal development and, as a result, their feedback-seeking motivation declined.36 The heavy clinical workload of supervisors (WPL) Supervisors often did not react (in due time), as there was no reminder function in the portfolio. As a consequence, trainees (repeatedly) checked their portfolio without finding any feedback, which resulted in frustration (PC/F) Learners perceived portfolio feedback to have little utility for personal development and, as a result, their feedback-seeking motivation declined.36
RkJQdWJsaXNoZXIy MjY0ODMw