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The unintended consequences of portfolios in graduate medical education.

Publication ,  Journal Article
Nagler, A; Andolsek, K; Padmore, JS
Published in: Acad Med
November 2009

Portfolios have emerged in graduate medical education despite lack of consensus on their definition, purpose, or usefulness. Portfolios can be used as a tool for residents to record their accomplishments, reflect on their experiences, and gain formative feedback. This exercise may help prepare physicians for lifelong learning as well as enhance patient care. The Accreditation Council for Graduate Medical Education has endorsed and may soon require the use of portfolios as an assessment tool to evaluate resident competence. However, using portfolios for summative evaluation purposes such as making high-stakes decisions on resident promotion or matriculation may deter resident candidness. In addition, the use of portfolios in clinical settings raises issues unique to the health care setting such as patient privacy, disclosure of clinical information, and professional liability exposure of physicians. It is not clear that peer-review statutes that sometimes protect educational materials used in teaching and evaluation of residents would also bar disclosure and/or evidentiary use of portfolio contents. Is the teaching institution, resident, or graduate vulnerable to requests and subpoenas for the portfolio contents? If so, then a resident's documentation of insecurities, suboptimal performance, or bad outcomes would be ripe for discovery in a medical malpractice lawsuit. If embraced too quickly and without sufficient reflection on the nuances of implementation, this well-intentioned initiative may present unintended legal consequences.

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Published In

Acad Med

DOI

EISSN

1938-808X

Publication Date

November 2009

Volume

84

Issue

11

Start / End Page

1522 / 1526

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Peer Review
  • Job Application
  • Internship and Residency
  • Illinois
  • Humans
  • General & Internal Medicine
  • Educational Measurement
  • Education, Medical, Graduate
 

Citation

APA
Chicago
ICMJE
MLA
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Nagler, A., Andolsek, K., & Padmore, J. S. (2009). The unintended consequences of portfolios in graduate medical education. Acad Med, 84(11), 1522–1526. https://doi.org/10.1097/ACM.0b013e3181bb2636
Nagler, Alisa, Kathryn Andolsek, and Jamie S. Padmore. “The unintended consequences of portfolios in graduate medical education.Acad Med 84, no. 11 (November 2009): 1522–26. https://doi.org/10.1097/ACM.0b013e3181bb2636.
Nagler A, Andolsek K, Padmore JS. The unintended consequences of portfolios in graduate medical education. Acad Med. 2009 Nov;84(11):1522–6.
Nagler, Alisa, et al. “The unintended consequences of portfolios in graduate medical education.Acad Med, vol. 84, no. 11, Nov. 2009, pp. 1522–26. Pubmed, doi:10.1097/ACM.0b013e3181bb2636.
Nagler A, Andolsek K, Padmore JS. The unintended consequences of portfolios in graduate medical education. Acad Med. 2009 Nov;84(11):1522–1526.

Published In

Acad Med

DOI

EISSN

1938-808X

Publication Date

November 2009

Volume

84

Issue

11

Start / End Page

1522 / 1526

Location

United States

Related Subject Headings

  • United States
  • Societies, Medical
  • Peer Review
  • Job Application
  • Internship and Residency
  • Illinois
  • Humans
  • General & Internal Medicine
  • Educational Measurement
  • Education, Medical, Graduate