# Portfolio of learning in clinical training

## TL;DR

This paper discusses the use of e-portfolios in clinical training in South Africa to assess and support the learning of family physicians.

## Contribution

The paper presents the evolution and implementation of a national e-portfolio system for assessing clinical competencies in family medicine training in South Africa.

## Key findings

- E-portfolios support structured evidence collection and self-reflective learning for clinical trainees.
- The e-portfolio system was redesigned in 2023 to gather evidence for 22 entrustable professional activities.
- Operational costs of e-portfolios become affordable when shared across training programs.

## Abstract

Workplace-based assessment is increasingly crucial in the postgraduate training of specialists in South Africa, including for family physicians. A portfolio of learning allows a structured, flexible way to present evidence of learning. Portfolios are increasingly digitally based as e-portfolios. Portfolios are used for encouraging self-reflective learning, for transforming learning, and for gathering evidence of skills necessary for future employment. Portfolios support assessment for learning and assessment of learning. This necessitates registrar reflections, supervisor feedback and interaction, and linkages to entrustable professional activities (EPAs). The e-portfolio facilitates triangulation, aggregation and saturation of data points for the various EPAs to support clinical competency committees to make high-stakes evaluations of registrar portfolios. While the initial design and development costs are significant, operational costs become affordable when shared across all training programmes. The portfolio of learning has been a key priority in family medicine for almost 15 years. Initially, a paper-based portfolio was adopted to collect evidence of learning for the national exit-level outcomes. It was converted into an e-portfolio and implemented nationally through the coordination of the South African Academy of Family Physicians. In 2023, the e-portfolio was redesigned to gather evidence of learning for 22 EPAs, and a further revision took place in 2024. A portfolio of learning offers a valuable alternative to traditional assessment methods, allowing for a comprehensive understanding of registrars’ growth over time.