Use of an electronic portfolio for longitudinal assessment of personal and professional development in undergraduate medical education

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IntroductionAssessing the Professionalism Competency in Undergraduate Medical EducationContemporary medical education is increasingly competency-based and requires a curricular framework to support individual students' professional identity formation concurrently with defined and benchmarked competencies (Irby and Hamstra 2016;Hall et al. 2012). The transition to a competency-based curriculum requires both longitudinal and integrated assessments, 1 which are challenging to deliver on an individual level (Kalet et al. 2007;Bleasel et al. 2016;Hall et al. 2012). Much has been written regarding the evaluation of professionalism, especially among medical students and residents (Wilkinson, Wade, and Knock 2009). Expert consensus about professionalism assessment is that "Professionalism should be assessed longitudinally. It requires combinations of different approaches, assessing professionalism at individual, interpersonal, and societal/institutional levels" (Goldie 2013). The challenge to medical educators in the longitudinal assessment of professionalism involves integrating a large and dispersed amount of data into an organized and easily accessible format (Wolpaw 2022). (Belcher et al. 2014;David et al. 2001;Carraccio and Englander 2004). Our work focuses on promoting adult learners' professional identity formation through a longitudinal Personal and Professional Development curriculum in undergraduate medical education. ePortfolios in Higher Education and Medical Education ePortfolios have been identified as a high-impact practice for education and are widely used by colleges and universities in the United States (Chen and Light 2010;Skinner et al. 2024).Developing an ePortfolio allows adult learners to cultivate their skills as master learners and participate actively in their education, a key tenet of adult learning theory (Schumacher, Englander, and Carraccio 2013). The Association of American Colleges and Universities has worked to promote the value of portfolios in assessing student learning through their Valid Assessment of Learning in Undergraduate Education (VALUE) project (https://www.aacu.org/initiatives/value). Scholars who study student assessments have evaluated ePortfolios to promote and assess student learning (Chen and Light 2010;Skinner et al. 2024).These researchers similarly conclude that professionalism is not a solitary pursuit; student selfreflection and self-assessment without external guidance are suboptimal (Driessen et al. 2005).Faculty increasingly realize the value of implementing ePortfolios for students to demonstrate competence, while students appreciate the value of reflecting on what they learn throughout their medical education (Chen and Light 2010). Researchers have reported that ePortfolios promote students' reflection and learning: one group reported that "ePortfolios are currently celebrated as a way to facilitate and document more authentic forms of assessment" (Zaldivar, Summers, and Watson 2013;Michels et al. 2016). Subsequent studies have reported positive student perceptions of using portfolios, particularly the utility of reflective learning (Ross, Maclachlan, and Cleland 2009;Buckley et al. 2009;Morris and O'Connor 2023).Although ePortfolio use in medical education continues to grow, documented use within a medical school curriculum is still developing (Chen and Light 2010;Chertoff et al. 2016) Early descriptions of ePortfolio use included how portfolios could be utilized in medical education (Belcher et al. 2014;David et al. 2001;Carraccio and Englander 2004), yet few medical schools have used ePortfolios to assess professionalism.Our Goals for Incorporating an ePortfolioAt Geisinger Commonwealth School of Medicine (GCSOM), we defined the ePortfolio as a student-assembled electronic portfolio that displays academic accomplishments, essays, videos, samples of work, and volunteer and extracurricular activities in required and optional, student-driven artifacts. This tool can monitor and promote each student's curricular progress through course assignments tied to these ePortfolio artifacts related to competency development (McDonald, Hu, and Heeneman 2024;Schumacher, Englander, and Carraccio 2013).Comprehensive ePortfolio assessment data for Doctor of Medicine (MD) program evaluation can highlight opportunities for continuous quality improvement. Therefore, developing and implementing an ePortfolio may be applied to any competency-based educational setting, such as health professions and medical education (Buckley et al. 2009).We felt that using an ePortfolio to assess professionalism could have several benefits, including (1) enabling multidimensional assessment by facilitating longitudinal integration of students' assignments, termed artifacts, (2) highlighting opportunities for continuous quality improvement within our curriculum and (3) serving as an example for educators using an ePortfolio in any competency-based educational setting. Therefore, we aim to share our experience with developing and implementing an ePortfolio for longitudinal assessment of professionalism within undergraduate medical education.MethodsThe GCSOM Total Health Curriculum includes personal and professional development as one of the six programmatic objectives woven throughout the MD curriculum (Appendix A). The personal and professional development curriculum, one of six longitudinal curricular themes, is used to demonstrate achievement in meeting the learning objectives of the MD curriculum. 1 The development and implementation of the ePortfolio assessment at GCSOM was based on Design Thinking, which incorporates organizational and systems theory with social psychology and practical research through inspiration, ideation, and implementation (Brown 2008). By reflecting on their learning, students practiced collective generation of ideas, rapid prototyping, and continuous testing to align technologically based tools with users' needs (Brown 2008). In this manner, we engaged student leaders and faculty champions to review the implementation and provide timely feedback for improving the ePortfolio (Compton-Phillips and Mohta 2018).Partnering with a faculty member, students engaged in ePortfolio development while strengthening their professional identity formation (Brown 2008;Billett 2011;Cruess and Cruess 2017).To begin the implementation of the ePortfolio, we evaluated the curriculum to identify assessments that would be appropriate to use as evidence of individual student growth and achievement in the curriculum's personal and professional development programmatic learning objectives (Fleer et al. 2024;Skinner et al. 2024). The step-by-step inventory process included:1. Assemble faculty members responsible for assessment within the MD curriculum.3. Identify gaps in MD curricular assessments related to the programmatic learning objectives that the ePortfolio could address.4. Propose assessments to address the gaps to meet programmatic learning objectives.5. Link and map identified assessments to the programmatic learning objectives.6. Create labels for ePortfolio evidence to track students' growth in reflection and professionalism.Three GCSOM medical students developed several ePortfolio prototypes. One was selected based on its ability to track students' progress toward achieving programmatic learning objectives (Fortner-Buczala et al. 2023).Current Processes and Continuous Quality Improvement for the ePortfolio All first-year students attend a session that explains the programmatic requirements, introduces the personal and professional development curriculum, and provides an overview of the ePortfolio. Students are also given an ePortfolio manual so they have the necessary educational guidance to construct their ePortfolio correctly. In addition, an active learning workshop is conducted so students can build confidence in using the ePortfolio within the Portfolium platform and upload evidence in real time while receiving feed

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