A Web-based geriatrics portfolio to document medical students' learning outcomes.

OBJECTIVE: The University of Michigan Medical School is integrating into its curriculum the attitudes, knowledge, and skills that pertain to the care of older individuals using a defined set of core learning outcomes encompassing all four years. Students will demonstrate proficiency in these outcomes as a graduation requirement. We have developed an individualized, interactive, Web-based geriatrics portfolio to track the acquisition and mastery of these outcomes for students.

DESCRIPTION: The required learning outcomes in geriatrics are presented to first-year students in their geriatrics portfolio Web page. The outcomes have been adapted from the recommendations published by the American Geriatrics Society's Education Committee.(1) The portfolio cross-references learning outcomes to specific activities in the curriculum. The activities include content given in lectures, multidisciplinary case discussions, standardized patient instructor (SPI) experiences involving older patients, and specific types of patient encounters during the clinical years. The portfolio allows documentation of completion dates of specific activities and the evaluations the student received. Certain activities such as the SPI experiences will include hyperlinks to their descriptions and the information that should be reviewed prior to each activity. The portfolio is integrated with existing administrative databases. Data entry occurs through links (e.g., exam scores), uploading comment forms from the SPI, and direct student input. One novel example of student input is the ability to upload information concerning encounters with older patients that students are recording in personal data assistant templates such that this information maps directly to the appropriate learning outcomes in their portfolios. The portfolio is designed to encourage students to take responsibility for their geriatrics education. Several types of evaluation data are provided, some that are specific to an activity (e.g., SPI feedback) and others that provide global assessments of learning outcomes (e.g., attitude surveys). The Web page can be displayed by the list of outcomes (categorized by attitudes, knowledge, and skills), by medical school year, and by date of completion. In this way, students can see at a glance how they are performing and whether they are up-to-date with completing the required outcomes.

DISCUSSION: The geriatrics portfolio serves to identify and highlight geriatrics-related content across the four years. Its interactive features make it much more dynamic than a written transcript. Requiring proficiency in learning outcomes related to geriatrics for graduation will clearly convey to students that this information is critically important in their training to become physicians. The individualized evaluation summaries will prove useful to the student because self-directed learning opportunities can be targeted to address weak areas. Evaluation of performances will also aid program directors to appropriately modify the curriculum to address any deficiencies. This innovative Web-based approach to capture learning outcomes that are dispersed throughout a four-year curriculum may also find application in similar curricula (e.g., women's health and end-of-life care).