The authors of the award-winning paper are Drs. Susan O’Leary, Andrew Major and Christopher Jenkins of the residency program in the Discipline of Anesthesia and Diana Deacon of the Medical Education Scholarship Centre. The paper is titled Using the portfolio to foster reflective practice through formative assessment of the CanMEDS Professional role: Preparing residents for the competent-to-expert milestone.

Dr. O’Leary explained that the transition from competent to expert practitioner is a key milestone in the first years after completing residency. “Successful consultants practice life-long reflection of their practice in all CanMEDS domains.  Residency programs should guide and motivate residents to develop into reflective practitioners.”

To accomplish this, a portfolio was developed and implemented in the Anesthesia Residency Program at Memorial. “A key component of that portfolio is a reflective narrative,” said Dr. O’Leary. “This year the PGY1-4 (fourth-year) residents undertook the first portfolio in the CanMEDS Professional Role. Prior to implementation, an education specialist held a workshop to introduce residents to the concept and practice of narrative reflection.”

The reflective piece follows several steps. First, the residents complete the assigned background reading, then they write a narrative summary of a clinical or non-clinical (e.g. teaching, research) experience which impacted their thinking about professionalism.  Residents are guided by a designated faculty member to reflect on their experience, demonstrate aspects they handled well and what they would do differently in the future.

Dr. O’Leary explained that the faculty member provides formative feedback on the resident’s portfolio and completes a qualitative assessment form. The program director reviews resident portfolios once a year.  A resident interested in reflective practice acts as a resource for residents with questions or who need help to initiate portfolio writing and facilitates discussion of the portfolio project among the resident group.

Dr. O’Leary said review and feedback are used to reflect on and improve the portfolio process.  The plan is to add a new CanMEDS role each year for the development of resident portfolios as they move to their final year of residency.
This year, 82 abstracts were peer-reviewed as part of ICRE’s What Works track. The reviewers then selected the ten highest-ranking What Works abstracts, and asked postgraduate deans and program directors across Canada to vote on their favourite abstracts. Along with the other Top 5 nominees, the paper from Memorial will be presented at ICRE in Ottawa on Oct. 20.