The use of a portfolio in postgraduate medical education – reflect, assess and account, one for each or all in one?

Competency-based education has become central to the training and assessment of post-graduate medical trainees or residents [1]. In competency-based education, there is a strong focus on outcomes and professional performance. Typically, holistic tasks are used to train, practice and assess the defined outcomes or competencies. In residency training, these tasks are part of the day-to-day clinical practice. The performance of residents in the workplace needs to be captured and stored. A portfolio has been used as an instrument for storage and collection of workplace-based assessment and feedback in various countries, like the Netherlands and the United States. The collection of information in a portfolio can serve or be used for a variety of purposes. These are: The collection of work samples, assessment, feedback and evaluations in a portfolio enables the learner to look back, analyze and reflect. The content is used for assessment or making decisions about progress. And the portfolio is used as an instrument for quality assurance processes. In post-graduate medical education, these purposes can be combined but this is not always reported transparently. In this paper, we will discuss the different perspectives, how a portfolio can serve these three purposes and what are opportunities and challenges of combining multiple purposes.