The e-portfolio is at the centre of GP training - it is 'the glue which holds the curriculum, learning and assessment together'.1 Use it efficiently and you should fly through the year. Leave it to the last minute and you will struggle. The same applies to GP appraisal.
The first tip is the most important: make sure you fill in your e-portfolio as you go along. If you are in general practice, have the e-portfolio open as you consult. You can enter the basics of a learning log between patients and add the details later.
Fill in all of the sections - entries can dry up by the time you get to your learning needs, but the Annual Review of Competence Progression (ARCP) will want to see that you are thinking critically about this. If you make this a habit, you can avoid any nasty surprises at ARCP time.
The dates of these entries are logged, and the panel will be suspicious if a year's worth of entries have been made in two weeks.
There are minimum numbers for your learning logs and personal development plans.
You need to share entries for your trainer to comment, but do not expect them to comment on multiple entries in the week before your final review.
The e-portfolio has only been around since 2007, so be prepared to explain if necessary. Send tickets in plenty of time, being aware of the minimum requirements for each area and trying to exceed this where possible. The same goes for patient feedback, which always takes longer than you think.
You will submit your e-portfolio eight weeks before your ARCP, having had your final educational supervisor review. Allow a couple of weeks to arrange the review.
Similarly, you need to have all 18 out-of-hours sessions arranged by submission, although two can be booked for future dates.
- Fill in your e-portfolio as you go along
- Ensure that you fill in all of the sections
- Share your entries with your trainer
- Submit your e-portfolio eight weeks before your ARCP
Reflection may not come easily to everyone and plenty of GPs dislike it. It might perhaps be defined as thoughtful analysis of your work.
Use it to show insight into how you managed a case, what you learnt, how you learnt it and how this will influence your practice. You are supposed to develop throughout your training, so it is normal to address simpler cases at first and more complicated ones at the end.
Do not be afraid to share cases that went badly or where you learnt from another member of the practice team - this will show that you are developing as a doctor.
At an electronic ARCP, you will not be there to explain the situation, so reading your entry has to make the panel members feel as though they were there.
A good reflection might touch on how the patient made you feel - no matter whether this is competent, frustrated, angry or satisfied. These are all valid reactions and the ability to recognise these emotions will help you to avoid burnout in future.
Show your learning logs to your educational supervisor early in your first job - if you are on the wrong track, that is the time to find out, not at your first ARCP.
The curriculum coverage section is also worth looking at early on. A learning log can cover three areas, although your trainer can remove any that are not justified, so make sure you keep it focused.
For example, if a patient consults you about her family history of breast cancer, you would tick genetics and women's health. If you are not sure what to do next, you can discuss it with your trainer, who may suggest that you look at the NICE guidelines and referral criteria for the genetics clinic - that is enhancing professional knowledge too.
You need at least one log for each area, so be strategic and try to fill in the rarer areas. Your trainer and the practice should support you in this, directing certain types of patient your way if necessary.
The more common areas will have more entries, so do not worry about it looking asymmetrical. The same goes for linking to competencies (which is done by your trainer) - for example, that patient will require communication and consultation skills, and the family history aspect will involve practising holistically.
The e-portfolio can be a valuable tool to organise your training and see what gaps you need to fill, as well as good practice for appraisals and revalidation to come.
- Dr Hazell is a GP in north London and e-learning development fellow for the RCGP. Thanks to Dr Nick Antonakopoulos, Dr Jamie Coady and Dr Claire Stewart for their help in the preparation of this article
1. RCGP. The Trainee ePortfolio. www.rcgp.org.uk/training-exams/ mrcgp-trainee-eportfolio.aspx