Portfolios for longer-term learning in health professional education

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Assessment practices in higher education for the professions are focused, not unreasonably, on student progress through their various subjects, culminating in testing of discipline entry standards and competencies. This can, however, neglect the considerable need for the new graduate to continue to learn independently following entry to the profession, judging the quality of their own work as they begin to demonstrate professional expertise. Understanding that assessment processes are a key incentive for generating student engagement in learning, this thesis asks how we might use assessment in university courses for the professions to foster longer-term learning into practice. The problem of identifying and facilitating those learning skills at university that best equip students’ ongoing learning and self-assessment as entry level professionals requires a methodology that recognises the contextual nature and complexity of pedagogical interventions. Educational design research was employed for its capacity to allow theoretical questions about learning in context to be addressed as the research unfolded. The vehicle for the investigation was a professional practice portfolio assembled throughout a course. The context of the health sciences and the setting of a two-year program for medical sonographers, allowed the study of three iterative cycles of portfolio design. In each cycle, interventions were implemented to foster self-assessment, independent learning, reflective practice, and the capacity for making judgments and evidencing competence. Analysis of data from participant focus groups, interviews and portfolio entries, drawn from three years of entry cohorts of students, contributed to ongoing design modifications for improvement of the portfolio process. Twelve months following course completion, the continuing learning practices of new graduates in their workplaces were investigated and reconceptualised through a practice theory lens, identifying both resonances with portfolio assessment, and further avenues for improvement in portfolio practices. This thesis provides empirical evidence, through iterative research of pedagogical strategies, that students’ engagement with a course-long portfolio can positively influence longer-term learning. This is particularly so when it is embedded with supported, scaffolded learning skills. Consideration of the socio-material practices of new graduates offers further insights into ways forward.
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