Educational institutions are embracing the concept of Portfolios for their students. The hope is that creating a portfolio will help the student become more reflective and introspective and help him/her become a life long learner. Thus for these institutions, the process of creating the Portfolio is probably more important that the actual content (evidence) in the portfolio.
But when this same student graduates and goes into a residency program or into practice, the hard evidence is what seems to be the most critical piece that is used in the selection/appointment process.
Thus medical schools need to develop a model for allowing the students to create their reflective portfolios but these models should also allow for export of hard evidence in a portable format that the students can take with them when they go for residency interviews. The same process then would get repeated during residency when the ACGME gets to the point of using portfolios in a more universal manner.
Thus as we think about ways for data from medical schools to be passed on to residency programs and then to other bodies like state licensing boards, we need to look at pieces of evidence from each stage of training and practice that would be relevant at the subsequent stage.
The schematic diagram above shows some of the evidence generated at each stage of education/practice. The evidence below the horizontal line is likely the evidence that should be relevant to later stages. We should keep this in mind as we develop models for data sharing for medical education and practice.