Portfolios and practices for lifelong learning in ultrasound education

Abstract

Introduction The focus of most ultrasound programs is to produce clinically competent sonographers who attain the requisite psychomotor skills, recognition of sonographic anatomy and pathology, and clinical reasoning for accurate diagnosis. University education directed towards these ends however, can leave the ‘learning to learn’ skills, and longer-term learning, under-appreciated. Education should provide students with opportunities to ‘sustain effective learning now and in the future’. One strategy used extensively in health and medical education to equip students with lifelong learning skills is Portfolio assessment. Portfolios have long been suggested as a logical bridge between university study and continuing professional education. Methods Thirty-three sonography students at a metropolitan Australian university volunteered over three consecutive years, to participate in educational design research targeting a Portfolio tool. The tool was re-designed to foster longer-term learning by adding specific learning skills to existing professional competencies. Five interventions were included: independent learning, judgement, reflection, self-assessment and self-demonstration of competence. Data was gathered from focus groups, individual in-depth interviews and thematic analysis of participant portfolios. An iterative approach to participant feedback was employed, such that improvements were implemented as each data collection was analysed. Data was also gathered from four sonographers in repeat interviews after one year of qualified practice. Results The major themes identified from the learning skills added to the Portfolio were the benefits of continuous engagement, gains in confidence from demonstrating success, and the value of portfolios as an evidential base of achievement. The evidence base took various forms including interesting case collections or film libraries, used as both aide-memoires for ultrasound appearances of pathology and for teaching peers. Academics came to understand the criticality of portfolio induction, the necessity of scaffolding support for each of the learning skills, and strategies to make the assessment sustainable. Additionally, important workplace ‘doings’ were identified from the data, which adhered to the notion of a learning ‘practice’, suggesting valuable learning takes place in everyday working social interactions, which could receive greater recognition in student assessment tasks. Conclusion This research clearly identified that Portfolio assessment which encouraged skills of longer term learning proved valuable to both students and faculty. The Portfolio increased participants’ confidence, clinical judgement and independent learning, extending into qualified practice. Academics gained useful insights into scaffolding, Portfolio learning and practice theory. Importantly, this research showed that the design and development of portfolios benefit from iterative approaches using participant feedback for ongoing improvement.