INNOVARE CIENCIA Y TECNOLOGÍA VOL. 11, NO. 2, 2022

Disponible en CAMJOL

INNOVARE Ciencia y Tecnología

Sitio web: www.unitec.edu/innovare/

Autor corresponsal: alvaradocariasiving@gmail.com, Asociación de Educación Médica Hondureña, Tegucigalpa, Honduras

Disponible en: http://dx.doi.org/10.5377/innovare.v11i2.14786

Review

Electronic medical portfolio as a tool in formative assessment: a

literature review

Portafolio médico electrónico como una herramienta en la evaluación formativa: revisión de la literatura

Iving E. Alvarado-Carías

a,b,1

, José Gabriel Milla Mejía

a,c

, Nubia Hadanary Molina Baide

a,c

, Elena M. Gonzales

Bardales

, Ginalizia Murillo Castro

a,d

, Wendy Carolina Mejía

a,b

, José M. Madrid

a,b

, Cristina M. Thiebaud

Juan Fernando Suazo

a,e

, Jhiamluka Solano

a,f

Asociación de Educación Médica Hondureña, AEMH, Tegucigalpa, Honduras

Hospital Zafiro, Tegucigalpa, Honduras

Facultad de Ciencias de la Salud, Universidad Tecnológica Centroamericana, UNITEC, Tegucigalpa, Honduras

Facultad de Ciencias Médicas, Universidad Nacional Autónoma de Honduras, UNAH, Tegucigalpa, Honduras

Departamento de Ortopedia, Chelsea and Westminster NHS Foundation Trust, Londres, Reino Unido

Departamento de Medicina Interna, Salford Royal Hospital, Manchester, Reino Unido

Article history:

Received: 1 August 2022

Revised: 3 August 2022

Accepted: 15 August 2022

Published: 31 August 2022

Keywords

Clinical competencies

Electronic medical portfolio

Feedback

Medical education

Palabras clave

Competencias clínicas

Portafolio médico electrónico

Retroalimentación

Educación médica

ABSTRACT. Introduction. The electronic medical portfolio is part of the formative evaluation that allows the

educator to adapt their didactic process to the needs of their students. It also promotes effective formative feedback

that helps create horizontal relationships between educators and students. The aim of this review was to describe the

use of medical portfolios and their impact on medical training. Methods. A review of the literature in PubMed and

Scielo was carried out, including articles and studies on the topic, published in English and Spanish, ranging from 2012

to 2022. Discussion. Medical Education in Latin America, especially in Honduras, relies heavily on summative

assessment as a prevalent evaluation method. In countries like the United States and some in Europe where the student

portfolio is used, it has thrived and been accepted by both educators and students, generating a positive impact on their

learning. Conclusion. The implementation of the medical portfolio in Honduras is a viable and an appropriate process

that will allow the pre-existing traditional academic culture to be innovated. Its multiple advantages such as

encouraging a complete evaluation through feedback from superiors and peers, in addition to ongoing training and

improvement of the student's practical skills, place it as an essential tool for medical education.

RESUMEN. Introducción. El portafolio médico electrónico forma parte de la evaluación formativa. Permite al

docente adaptar su proceso didáctico a las necesidades de sus estudiantes. También, promueve la retroalimentación

formativa efectiva. Esto ayuda a crear relaciones horizontales entre docentes y estudiantes. El objetivo de la revisión

fue describir el uso de los portafolios médicos y su impacto en la formación médica. Métodos. Se llevó a cabo una

revisión de la literatura en PubMed y Scielo. Se incluyeron artículos y estudios publicados sobre el tema en inglés y

español, desde el año 2012 hasta el 2022. Desarrollo. La Educación Médica en Latinoamérica, especialmente en

Honduras, depende en gran medida de la evaluación sumativa como método de evaluación prevalente. En países como

Estados Unidos y algunos de Europa, donde se utiliza el portafolio estudiantil ha prosperado y ha sido aceptado por

ambos docentes y estudiantes; generando una repercusión positiva en el aprendizaje de los mismos. Conclusión. La

implementación del portafolio médico en Honduras es un proceso viable y apropiado. Permitirá innovar la cultura

académica tradicional preexistente. Sus múltiples ventajas, tales como fomentar una evaluación completa a través de

la retroalimentación por parte de superiores y pares, además de la formación permanente y mejoría de habilidades

prácticas del estudiante, lo colocan como una herramienta esencial para la educación médica.

1. Introduction

Medical education has evolved rapidly during the last

two decades, due to new scientific evidence supporting

innovative teaching and evaluation methodologies. This

leaves behind traditional teaching that has been losing

effectiveness or has become obsolete because of

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globalization (Talanquer, 2015). There are multiple

definitions for the term electronic medical portfolio. The

most outstanding elements include an instrument that

stores evidence of skills that students develop and shows

how they acquire skills throughout their training

(Agostini, 2015; Celis-Aguilar & Ruiz-Xicoténcatl,

2018). Medical portfolios play an important role for

formative assessment. Their purpose is for students to

obtain feedback on their learning process and to be able to

recognize aspects to improve through self-regulated

learning (Wood, 2018).

With the feedback obtained, the interaction between

students and academic tutors improves, being a constant

and more accessible monitoring process. This encourages

horizontal communication, nurturing a favorable

environment for the student's academic development and

the educator´s pedagogical development (Yoo et al.,

2020). The portfolio allows the monitoring and recording

of the clinical and non-clinical skills developed, serving

as evidence to verify them. It enables the development of

ethical competencies at different stages, as well as the

construction of professionalism of future doctors (Joshi et

al., 2015; Heeneman & Driessen, 2017).

In Honduras, the Faculty of Medical Sciences (FCM)

of Universidad Nacional Autónoma de Honduras

(UNAH) was founded on February 14, 1882, by lawyer

Marco Aurelio Soto. Since February 26, 1882, up until

now, the FCM is the only public institution that offers

education and certification of Doctor in Medicine and

Surgery and Bachelor of Nursing to the population

(Aguilar Paz, 2004). In 1999, Universidad Católica de

Honduras (UNICAH) began offering the Medicine and

Surgery Career and Universidad Tecnológica

Centroamericana (UNITEC) in 2012, both private

institutions (Bermúdez-Madriz et al., 2011).

The medical education in the different university

faculties has followed a traditional model focused on

summative evaluation. Currently, according to our

research, no university in the country that trains doctors

use fully structured formative assessment methodologies,

much less a medical portfolio in physical or electronic

format. This may be because they are unfamiliar with it or

lack the resources for its implementation (Haldane, 2014).

A review of the literature was done to analyze aspects

that may be included in the construction of an electronic

medical portfolio and the impact this methodology may

have on the medical training process in Honduras. This

review will provide elements that can be used by the

different universities as part of a national effort to improve

medical training, directly impacting the quality of care

received by the Honduran population and, in turn,

enriching the academic and professional profile of the

Honduran population that graduates from the Medicine

and Surgery educational program.

2. Methods

The literature review was carried out in PubMed and

Scielo, including articles and studies published in English

and Spanish on the use of medical portfolios and their

impact on medical training from 2012 to 2022. Except for

the publications by Snadden Mary Thomas (1998), Miller

(1990), Aguilar Paz (2004), Atkin et al. (2005) and

Bermúdez-Madriz et al. (2011), for their historical

relevance. Articles were also consulted that serve as a

practical guide for implementing the electronic medical

portfolio in Honduras. Opinion articles and letters to the

editor were excluded. Key terms such as ''medical

portfolio'', ''formative assessment'', ''feedback'', ''medical

education'' and ''clinical competencies'' were used.

3. Discussion

In 1990, Miller described in his book “The Assessment

of Clinical Skills/Competence/Performance" means to

assess the skills, competencies, and knowledge during

undergraduate and postgraduate training in medical

education. However, he concluded that these are not

legitimate predictors of how well medical doctors would

perform when faced with real-life situations (Miller,

1990). Portfolios commonly used in arts and architecture

offer a space to collect non-standardized information that

helps assess students' performance in an individualised

manner, when it cannot be reached by summative

assessment (Agostini, 2015; Alcaraz Salarirche, 2016). To

fill this gap, higher education started adapting and

transforming portfolios as assessment tools (Driessen &

Tartwijk, 2014), later joining medical education.

Despite these efforts, the traditional approach prevails

in Latin America, where summative models take

precedence (Acosta Silva & Cruz Galvis, 2015). The

principal methodology consists of measuring the

achievements of a course's previously established learning

objectives. However, the student’s feedback is null,

avoiding guidance for the enrichment of their current and

future performance (Cilliers et al., 2012). Formative

assessment refers to a cyclical process in which educators

analyze their students and collect information to

implement changes that meet their needs. This process

promotes creating horizontal relationships between

students and educators, overcoming the traditional

teacher-centered model, and moving to a more student-

centered one. The above supports the use of

methodologies such as problem-based or team-based

learning (Dole et al., 2016).

For formative assessment to be successful, educators

must implement efficient strategies that allow them to get

to know and motivate their students and provide them

with all necessary tools to regulate their learning

autonomously (Mendes dos Santos & Fischer da Silveira

Kroeff, 2018). This evaluation is not intended to give

students a passing or failing grade or to measure their

knowledge or memory, even though a score may be

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awarded. Formative evaluation provides elements to

determine whether the students have developed new skills

or competencies that will allow them to become better

professionals. These elements are mainly developed

through feedback, the central axis of formative assessment

(Kornegay et al., 2017). Effective feedback offers an ideal

space for critical thinking that leads to clinical reflection,

which is necessary to develop and strengthen their self-

directed learning processes (Agostini, 2015). Self-

directed learning is vital for professional development. It

offers students a starting point to know their limitations

and errors and enables them to plan how to improve their

performance with the support of their educator (Yoo et al.,

2020).

Some studies suggest that educator exposed to

portfolios as tools for self-assessment and reflection

consider that they represent a fundamental role in

generating awareness of educators' impact and promoting

personal growth. Additionally, portfolios allow educators

to identify their deficiencies and generate methods that

help improve pedagogical strategies (Arbesú García &

Gutiérrez Martínez, 2014; Patel & Shah, 2021). Regarding

the challenges that educators encounter when using

formative evaluation, the following can be stated: 1) the

demand for solid knowledge in the discipline that they

teach, 2) the constant attention to the perceptions of their

students, 3) the recognition of common learning

challenges faced by students and 4) knowing different

teaching and evaluation methodologies that respond to

different student needs (Atkin et al. 2005). To understand

and identify these needs, educators must be able to ask the

right questions that will assess the student's understanding

and limitations and, in turn, make decisions to promote

effective learning.

Student's perception and acceptance to introduction of

new assessment processes through portfolios have been

documented, demonstrating that there is a considerable

commitment, and the success of its application is

following the importance given to their perspectives and

expectations (Chertoff et al., 2016; Oudkerk Pool et al.,

2020). In the medical field, the portfolio assesses clinical

and academic skills in real-time, therefore providing

stimulus for personal growth (Snadden Mary Thomas,

1998; Kanfi et al., 2021). However, it is essential to

emphasise that some types of portfolios may have

disadvantages compared to others, either because they do

not allow development in a linear visualisation or because

their use is too complex for students or educators.

3.1. Types of portfolios

Portfolios may vary in content or purpose; some of

their goals may be reflection, evaluation, and professional

development (Table 1) (Babaee, 2020). Reflective

portfolios allow the user to keep a diary, leading to self-

assessment and the setting of academic and personal

goals, which in turn, leads them to educate themselves as

introspective and self-critical professionals; at the same

time, they offer a space to receive feedback from peers

and record meetings with academic tutors (Pereira Stelet

et al., 2016).

Evaluation portfolios keep a record of learning goals

with essential evidence of the user's practice; they include

forms for medical procedures, clinical case discussions

and performance patient physical examinations

(Rodríguez Cardenas et al., 2020).

Professional development portfolios focus on

recording personal goals and accomplishments, including

academic presentations, publications, facilitated classes,

attended courses, or other similar projects. They all need

an environment that provides learning opportunities

(access to patients or procedure simulations) and, at the

same time, that offers supervision and feedback from

trained personnel (Driessen & Tartwijk, 2014; Chertoff et

al., 2016).

A portfolio can be oriented towards personal growth,

where it is suggested to apply a checking and motivational

system for its users, in which a series of questions are

answered (Figure 1) (Driessen & Tartwijk, 2014). As the

students develop their portfolios, progress can be

observed through evidence that supports the strengths and

achievements obtained in a certain time period and the

resolution of difficulties encountered (Sidhu, 2015).

Depending on the content and structure, portfolios are

classified as open or free and closed or structured (Table

2).

Table 1

Classification of portfolios according to their purpose.

Reflexive

Evaluative

Professional Development

• Diary-style format

• Allows self-assessment and goal

setting

• Allows record-keeping of feedback

from peers and tutors

• Fill-in format

• Stores evidence of clinical practice

using various forms

• Records personal goals and

accomplishment throughout time

• Requires access to patients,

simulations and other learning

opportunities

c, d

*Feedback and supervisión from experienced personnel are essential in every type.

Stelet et al. (2016),

Rodriguez et al. (2020),

Driessen

& Tartwijk (2014),

Chertoff et al. (2016).

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Figure 1. Questions answered in the forms of an electronic medical portfolio. Adapted from Driessen & Tartwijk (2014).

Open portfolios provide the user with freedom in terms of

structure and include open-ended questions, where they

turn the tool into something that identifies them. It can

collect information on the stages of personal and

professional development over time. However, they

require considerably more time and effort than closed

portfolios. Devotion to the tool is essential to obtaining

optimal long-term results.

Closed portfolios are highly structured; they use a pre-

established format where users follow clear and concise

instructions to fill out the forms (Muñoz Palacios, 2017).

These are easier to teach to first-time users. However, they

do not provide room for creativity in deciding what and

how to capture content; therefore, their use has shown

negative results in some of its users (Chertoff et al., 2016).

A combination of both modalities is a semi-structured

portfolio, being the most used in universities due to its

good qualities, i.e., flexibility and ease of use.

Often the medical portfolio tends to be similar to the

Curriculum Vitae (CV). However, a CV doesn’t show its

user's continuous growth or the skills they have obtained

and improved throughout their career. Each activity is

recorded in the portfolio to observe the changes and

efforts that students make to acquire new skills and

develop over time, while learning and improving

techniques through feedback obtained from their educator

(Chamblee et al., 2015). The main aspect to consider

which type of portfolio to use should be the desired scope.

3.2. Tools for designing an electronical medical

portfolio

The tools available for constructing an electronic

medical portfolio are based on the educator and students'

needs, usefulness, and apprehension; multiple digital

platforms offer different strategies, costs, and academic

benefits, among others. For a correct tool choice, it is

necessary to have a common objective between the

platform, tutors, and students (Ramírez-López &

Sánchez-Meza, 2013).

Prior to deciding on the portfolio database in which it

will be created, the orientation type must be determined to

define the methodological bases considering the

following (Trejo González, 2019): (1) if the platform will

be used to provide resources that support the student's

training (including videos, books or study guides) (2) if

bilateral feedback between educator and student will be

allowed; and (3) if peer review would be allowed to

improve peer communication and teamwork.

Among the tools for the medical portfolio construction,

we can list Microsoft Office editing programs and others

that allow the creation of an original tool from scratch; the

most generic are: Google Drive, Google Sites, Wikis,

blogs, websites (Weebly, Yola and Webnode) in which

the activities carried out by the student will be recorded

online and include educational files to obtain different

types of evidence (Murillo Sancho, 2012; Ramírez-López

& Sánchez-Meza, 2013; Trejo González, 2019). In the

case of Wikis, there is more of a group approach, unlike

blogs with a more interactive platform. However, their

contents are created individually, and their formality is

less than a personalised document.

For the creation of electronic portfolios, web editors

are also required, with a purpose to create interactive

spaces for the placement of relevant evidence for the

protagonist, who is the student (Quesada, 2013).

Predesigned platforms provide the portfolio experience,

such as Edu-portfolio, Mahara and MyStuff. The first two

work together and are integrated into a learning platform

called Moodle (Murillo, 2012; Ramírez-López &

Sanchez-Meza, 2013). In recent years, the Moodle

platform has had a greater scope and use due to its

facilities and advantages both in the university

environment and in the distance learning modality (Reis

de Góes Monteiro Antonio et al., 2020).

In the context of a portfolio, Moodle allows to build a

learning framework in which the tutor and learner are in

constant communication, with the possibility to

implement other characteristics of a medical portfolio

(Oproiu, 2015; Gamage et al., 2022).

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Table 2

Classification of portfolios according to their structure.

Open or free

Closed or structured

Semi-structured

• The user has the freedom of deciding

what to record and in what way they

should do it

• Includes open ended questions

• Requires a significant amount of

commitment and time on behalf of the

user

• It utilizes a preestablished format with

closed questions

• Provides no room for creativity

• It is easier to teach to first time users

• Constitutes a combination of open and

closed portofolios

• It is the most popular type due to its

flexibility and user-friendliness

Chertoff et al. (2016),

Muñoz (2017),

Ramírez-López & Sánchez-Meza (2013).

3.3. Promotion strategies

Implementing an electronic medical portfolio must

entail important planning that includes strategies to

promote its use by educators and students, as well as the

evaluation of its impact and constant improvement (Díaz

Plasencia, 2016). The Kotter model aims to manage and

provide strategies for the changes that are developed

within an entity, allowing this process to be faster and

more effective over time, including new teaching

evaluation methods (Torres Herrera, 2019). This model

has 8 stages, which can be grouped into 3 main ones: the

creation of the climate of change, commitment, and

training for the organization and third, implementation

and maintenance of the change (Keyser Wentworth et al.,

2020). In the first stage, spaces must be provided to

facilitate an introduction to the tool for educators and

students. All those involved must become familiar with

the portfolio format. It is recommended to carry out

training with practical examples, such as simulations of

the goals expected to be met daily using the tool, so that

its use is fully demonstrated.

Second, the integration of the portfolio into the

curriculum must be planned, based on the regulations of

each one provided by the universities, considering a

flexible format that allows its incorporation into teaching

(López López et al., 2020). An electronic portfolio is a

tool that can be used even in environments that do not

have access to high financial resources, since it has free

electronic platforms with a high-quality margin (García-

Carpintero, 2017).

In the tool implementation phase, form overload and

high levels of ambition may occur especially in

undergraduate students, these are commonly known as

classic errors (Gómez-Urrutia & Arellano Faúndez,

2019). To avoid them, efforts should be made to create a

system that specializes in educator-student interactions or

mentoring, providing didactic benefits (Canga Alonso,

2013). There is an excellent benefit behind creating

training for educators on how to give feedback and

promoting that each activity carried out by students is

done under the supervision of someone with more

experience, creating an adaptive process. It is essential to

consider possible challenges and solutions during

implementation, such as technological problems

(Driessen & Tartwijk, 2014).

To measure long-term impact there’s the Kirkpatrick

levels; it is a model applied in medical education created

in 1967, that divides learning into 4 levels: reaction,

learning, transfer, and results (Reyes et al., 2019) (Figure

2). The first level, reaction, is where students subjectively

evaluate the program based on their experience. At the

second level, learning occurs when there is a new

acquisition of knowledge or practical skills. The third

level, transfer, refers to how new knowledge is applied

and how it leads to changing behaviors in a real work

environment. The fourth level, results, are where the real

impact of training and its final effects on the clinical

environment and patients are evaluated (Johnston et al.,

2018).

The medical portfolio has been useful for multiple

countries worldwide such as Spain, the United States,

Canada, Mexico, Cuba, Chile, Norway and the United

Kingdom, the latter being the pioneer. This high-level

teaching tool can generate greater learning and closer

relationships between educators and students. Creating a

database of this level does not require major

complications since multiple electronic tools facilitate its

process (García Fraile & Rojas Aguilera, 2018).

For an effective portfolio implementation, it’s

advisable to take the Kotter model as a strategy guide due

to its positive impact in the field of change management.

With three main stages, the first one aims to create the

necessary climate for change by developing an induction

program and explaining concretely the portfolio as an

educational tool.

The second stage introduces the portfolio and generates

results in a short term. Finally, it consolidates the tool by

modifying settings as needed based on the feedback

provided by educators and students, thus giving way for

constant improvement.

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Figure 2. The 4 levels of Kirkpatrick. Adapted from Reyes et al. (2019).

4. Conclusion

Implementing a medical portfolio in Honduras

represents a critical challenge due to the academic and

cultural characteristics that predominate in traditional

medical training. However, the portfolio could foster

standardized learning and development of clinical skills

for students, through actions and data collection during

their training process. The portfolio's introduction may

help identify training deficiencies in the different training

institutions, helping decision-makers design interventions

that will improve future professionals' performance and

positively impact the quality of care patients receive. The

strengths (identified) can be expanded, and existing

methodologies can be standardised.

There are different types of portfolios that vary

according to their objective and structure. The portfolios

may be reflective, evaluative or for personal development.

The first ones are essentially diaries that encourage the

user to be introspective, set their own goals, and record

feedback from peers or tutors. Evaluative portfolios are

essential to record evidence of practice through pre-

established forms. Personal development portfolios

record both goals and achievements but rely on an

environment that provides opportunities and offers

supervision and feedback from knowledgeable tutors. The

portfolio design may be structured, free or semi-

structured. Structured designs have established tasks and

documentation. The students give results or reports, and,

in the end, it allows a simplification of the academic

evaluation. Free designs allow students to oversee

decisions on what to do and document, for a subsequent

verification of skills and abilities acquired. Finally, semi-

structured designs are most popular among students since

they have characteristics of both free and structured

designs.

5. Author Contributions

JS and EMG conceptualised the study. IEAC

coordinated the literature review with EMG. All authors

carried out the literature review and wrote the manuscript.

All authors have read and approved the final version of

the manuscript.

6. Acknowledgements

We thank Dr. Teshka Chakowa from the United

Kingdom for her support and guidance at the beginning of

this project and to all the members who have helped us in

the different initial stages before the completion of this

manuscript: Dr. Ángela Díaz, Dr. Pedro Fernández, Dr.

Andrea Velásquez and Dr. Dennis Reyes.

7. Conflicts of Interest

The authors declare no conflict of interest.

8. Bibliographic References

Acosta Silva, I. L., & Cruz Galvis, C. R. (2015). Estado del conocimiento

sobre la evaluación del aprendizaje, en algunos países de

Latinoamérica y España, durante 2003 y el 2013. Universidad Santo

Tomás. https://hdl.handle.net/11634/2604

Agostini, M. C. (2015). Aprendizaje reflexivo en la carrera de medicina :

un estudio acerca del portafolio en la adquisición de competencias

profesionales (1st ed.). Editorial Teseo.

https://uai.edu.ar/media/109532/aprendizaje-reflexivo.pdf

Aguilar Paz, E. (2004). Bosquejo histórico de la enseñanza médica en

Honduras. Revista de la Facultad de Ciencias Médicas, 1(1), 9–16.

http://www.bvs.hn/RFCM/pdf/2004/html/RFCMVol1-1-2004.html

Alcaraz Salarirche, N. (2016) La evaluación a través de portafolios:

¿Una ocasión para el aprendizaje? Revista Iberoamericana de

Evaluación Educativa, 9(1), 31-46.

https://dx.doi.org/10.15366/riee2016.9.1.002

Arbesú García, M. I., & Gutiérrez Martínez, E. (2014). El portafolio

formativo: Un recurso para la reflexión y autoevaluación en la

108

I. E. Alvarado-Carías, et al.

INNOVARE Revista de Ciencia y Tecnología Vol. 11, No. 2, 2022

docencia. Perfiles Educativos, 36(143), 105-123.

https://dx.doi.org/10.22201/iisue.24486167e.2014.143.44025

Atkin, J. M., Coffey, J. E., Moorthy, S., Sato, M., & Thibeault, M. (2005).

Designing everyday assessment in the science classroom. Teachers

College Press.

Babaee, S. (2020). E-portfolio as a higher training professional tool: a

comparative-descriptive study. American Journal of Humanities and

Social Sciences Research (AJHSSR), 4(2), 225-233.

https://www.ajhssr.com/wp-

content/uploads/2020/02/ZE2042225233.pdf

Bermúdez-Madriz, J. L., Sáenz, M. del R., & Muiser, J. (2011). Sistema

de salud de Honduras. Salud Pública de México, 53, S209-S219.

https://saludpublica.mx/index.php/spm/article/view/5042

Canga Alonso, A. (2013). Students’ beliefs on portfolio assessment.

Alicante Journal of English Studies, 26, 225-238.

https://dx.doi.org/10.14198/raei.2013.26.16

Celis-Aguilar, E., & Ruiz-Xicoténcatl, J. (2018). Conventional and

electronic portfolios in medical residencies. Educación Médica,

19(5), 309-315. https://dx.doi.org/10.1016/j.edumed.2017.06.004

Chamblee, T. B., Conkin Dale, J., Drews, B., Spahis, J., & Hardin, T.

(2015). Implementation of a professional portfolio: a tool to

demonstrate professional development for advanced practice.

Journal of Pediatric Health Care, 29(1), 113–117.

https://dx.doi.org/10.1016/j.pedhc.2014.06.003

Chertoff, J., Wright, A., Novak, M., Fantone, J., Fleming, A., Ahmed,

T., Green, M. M., Kalet, A., Linsenmeyer, M., Jacobs, J., Dokter, C.,

& Zaidi, Z. (2016). Status of portfolios in undergraduate medical

education in the LCME accredited US medical school. Medical

Teacher, 38(9), 886–896.

https://dx.doi.org/10.3109/0142159X.2015.1114595

Cilliers, F. J., Schuwirth, L. W. T., Herman, N., Adendorff, H. J., & van

der Vleuten, C. P. M. (2012). A model of the pre-assessment learning

effects of summative assessment in medical education. Advances in

Health Sciences Education: Theory and Practice, 17(1), 39-53.

https://dx.doi.org/10.1007/s10459-011-9292-5

Díaz Plasencia, J. A. (2016). Bases teóricas del portafolio en la

educación médica basada en competencias. Educación Médica

Superior, 30(1).

http://www.ems.sld.cu/index.php/ems/article/view/796

Dole, S., Bloom, L., & Kowalske, K. (2016). Transforming pedagogy:

changing perspectives from teacher-centered to learner-centered.

Interdisciplinary Journal of Problem-Based Learning, 10(1).

https://dx.doi.org/10.7771/1541-5015.1538

Driessen, E., & van Tartwijk, J. (2014). Portfolios in personal and

professional development. In T. Swanwick (Ed.), Understanding

Medical Education: Evidence, Theory, and Practice (1st ed., pp.

193-200). Wiley-Blackwell.

Gamage, S. H. P. W., Ayres, J. R., & Behrend, M. B. (2022). A

systematic review on trends in using Moodle for teaching and

learning. International Journal of STEM Education, 9(9).

https://dx.doi.org/10.1186/s40594-021-00323-x

García-Carpintero, E. (2017). El portafolio como metodología de

enseñanza-aprendizaje y evaluación en el practicum: percepciones

de los estudiantes. Revista de Docencia Universitaria, 15(1), 241-

257. https://polipapers.upv.es/index.php/REDU/article/view/6043

García Fraile, J. A., & Rojas Aguilera, M. (2018). El portafolio de

evidencias del alumno: una estrategia didáctica de enseñanza-

aprendizaje favorecedora de la evaluación clínica. Voces De La

Educación, 3(6), 177-190.

https://www.revista.vocesdelaeducacion.com.mx/index.php/voces/a

rticle/view/129

Gómez-Urrutia, V. E., & Arellano Faúndez, O. M. (2019). Portafolio

reflexivo: una propuesta para la enseñanza de la Metodología

Cualitativa. Zona Próxima, 31, 87-106.

https://dx.doi.org/10.14482/zp.31.001.4

Haldane, T. (2014). "Portfolios" as a method of assessment in medical

education. Gastroenterology and Hepatology from Bed to Bench,

7(2), 89–93.

https://journals.sbmu.ac.ir/ghfbb/index.php/ghfbb/article/view/556

Heeneman, S., & Driessen, E. W. (2017). The use of a portfolio in

postgraduate medical education - reflect, assess and account, one for

each or all in one? GMS Journal for Medical Education, 34(5), 1-12.

https://dx.doi.org/10.3205/zma001134

Johnston, S., Coyer, F. M., & Nash, R. (2018). Kirkpatrick’s evaluation

of simulation and debriefing in health care education: a systematic

review. Journal of Nursing Education, 57(7), 393–398.

https://dx.doi.org/10.3928/01484834-20180618-03

Joshi, M. K., Gupta, P., & Singh, T. (2015). Portfolio-based learning and

assessment. Indian Pediatrics, 52, 231–235.

https://dx.doi.org/10.1007/s13312-015-0613-2

Kanfi, A., Faykus, M. W., Tobler, J., Beck Dallaghan, G. L., England,

E., & Jordan S. G. (2021). The early bird gets the work: maintaining

a longitudinal learner portfolio from medical school to physician

practice. Academic Radiology, 29(4), 569-575.

https://dx.doi.org/10.1016/j.acra.2020.12.012

Keyser Wentworth, D., Behson, S. J., & Kelley, C. L. (2020).

Implementing a new student evaluation of teaching system using the

Kotter change model. Studies in Higher Education, 45(3), 511-523.

https://dx.doi.org/10.1080/03075079.2018.1544234

Kornegay, J. G., Kraut, A., Manthey, D., Omron, R., Caretta-Weyer, H.,

Kuhn, G., Martin, S., & Yarris, L. M. (2017). Feedback in medical

education: a critical appraisal. AEM Education and Training, 1(2),

98-109. https://dx.doi.org/10.1002/aet2.10024

López López, V., Briones, M., Inostroza V., Salazar A. & Ruiz Á.,

Gädicke, P., Lagos, N., & Rosales, E. (2020). El portafolio, una

herramienta que promueve competencias de responsabilidad y

reflexión. Un estudio de caso en estudiantes de primer año de

Medicina Veterinaria de la Universidad de Concepción, Chile.

Revista de Investigaciones Veterinarias del Perú, 31(3), e16673.

https://revistasinvestigacion.unmsm.edu.pe/index.php/veterinaria/ar

ticle/view/16673

Mendes dos Santos, C., & Fischer da Silveira Kroeff, R. (2018). A

contribuição do feedback no processo de avaliação formativa.

EDUCA – Revista Multidisciplinar em Educação, 5(11), 20-39.

https://dx.doi.org/10.26568/2359-2087.2018.2776

Miller, G. E. (1990). The assessment of clinical

skills/competence/performance. Academic Medicine, 65(9), S63-S67.

https://journals.lww.com/academicmedicine/Abstract/1990/09000/

The_assessment_of_clinical.45.aspx

Muñoz Palacios, P. (2017). El portafolios electrónico como herramienta

didáctica. Su uso, grado de satisfacción y validación. Universidad

Autónoma de Madrid.

https://repositorio.uam.es/bitstream/handle/10486/681144/munnoz_

palacios_pilar.pdf?sequence

Murillo Sancho, G. (2012). El portafolio como instrumento clave para la

evaluación de educación superior. Revista Electrónica

“Actualidades Investigativas en Educación”, 12(1), 1-23.

https://dx.doi.org/10.15517/AIE.V12I1.10266

Oproiu, G. C. (2015) A study about using E-learning platform (Moodle)

in university teaching process. Procedia - Social and Behavioral

Sciences, 180(5), 426 – 432.

https://dx.doi.org/10.1016/j.sbspro.2015.02.140

Oudkerk Pool, A., Jaarsma, A. D.C., Driessen, E. W., & Govaerts, M. J.

B. (2020). Student perspectives on competency-based portfolios:

Does a portfolio reflect their competence development? Perspectives

on Medical Education, 9, 166–172.

https://dx.doi.org/10.1007/s40037-020-00571-7

109

I. E. Alvarado-Carías, et al.

INNOVARE Revista de Ciencia y Tecnología Vol. 11, No. 2, 2022

Patel, A. B., & Shah, S. V. (2021). Evaluation of medical student

program with the use of a reflective portfolio: a qualitative study.

Journal of Education and Health Promotion, 10(1), 259.

Pereira Stelet, B., Ferreira Romano, V., Borges Carrijo, A. P., & Teixeira

Junior, J. E. (2016). Portfólio reflexivo: subsídios filosóficos para

uma práxis narrativa no ensino médico. Interface-Comunicação,

Saúde, Educação, 21(60), 165-176. https://dx.doi.org/10.1590/1807-

57622015.0959

Quesada, A. P. (2013) Aprendizaje colaborativo en entornos virtuales:

los recursos de la Web 2.0. Revista de Lenguas Modernas, 18, 337-

350.

https://revistas.ucr.ac.cr/index.php/rlm/article/view/12370/11624

Ramírez-López, N. L., & Sánchez-Meza, C. V. (2013). Portafolio

electrónico en educación médica y las herramientas de la web para

su elaboración. Investigación en Educación Médica, 2(8), 225-228.

https://dx.doi.org/10.1016/S2007-5057(13)72716-9

Reis de Góes Monteiro Antonio, M. Â., Goulart dos Santos, G., & Riceto

Ronchim Passeri, S. M. (2020) Portfólio on-line: estratégia para

melhorar o sistema de avaliação da disciplina de Atenção Integral à

Saúde do curso de Medicina. Interface - Comunicação, Saúde,

Educação, 24, e190069, 1-12.

https://dx.doi.org/10.1590/Interface.190069

Reyes, D., Isbej, L., Uribe, J., Ruz, C., Pizarro, M., Walker, R., Pérez-

Cruz, P., Maldonado, A., Robles, C., Latorre, G., Ivanovic-Zuvic, D.,

Figueroa, C., González, A., Cotoras, P., Núñez, C., Labarca, J., &

Riquelme, A. (2019). Portafolio en pregrado de Medicina: impacto

educacional a 10 años de su implementación. Revista Médica de

Chile, 147(6), 790–798. https://dx.doi.org/10.4067/S0034-

98872019000600790

Rodríguez Cardenas, M., Paz Paz, O., Sánchez Pérez, I. I., & Pérez

Rodríguez, L. A. (2020). Portafolio de evaluación: una experiencia

novedosa en la asignatura Introducción a la Medicina General

Integral. Edumecentro, 12(4), 235-241.

http://revedumecentro.sld.cu/index.php/edumc/article/view/1498

Sidhu, N. S. (2015). The teaching portfolio as a professional

development tool for anaesthetists. Anaesthesia and Intensive Care,

43(3), 328–334. https://dx.doi.org/10.1177/0310057X1504300308

Snadden Mary Thomas, D. (1998). The use of portfolio learning in

medical education. Medical Teacher, 20(3), 192–199.

https://dx.doi.org/10.1080/01421599880904

Talanquer, V. (2015). La importancia de la evaluación formativa.

Educación Química, 26(3), 177-179.

http://dx.doi.org/10.1016/j.eq.2015.05.001

Torres Herrera, L. K. (2019). Impacto del modelo Kotter para la gestión

del cambio, como herramienta de mejora continua en las

organizaciones. Universidad Militar Nueva Granada.

http://hdl.handle.net/10654/34865

Trejo González, H. (2019). Recursos digitales para la elaboración de e-

portafolios educativos. Sincronía, 75, 328-362.

https://dx.doi.org/10.32870/sincronia.axxiii.n75.17a19

Wood, D. (2018). Formative assessment. In T. Swanwick (Ed.),

Understanding Medical Education: Evidence, Theory, and Practice

(2nd ed., pp. 317-328). Wiley-Blackwell.

Yoo, D. M, Cho, A. R., & Kim, S. (2020). Development and validation

of a portfolio assessment system for medical schools in Korea.

Journal of Educational Evaluation for Health Professions, 17, 39.

https://dx.doi.org/10.3352/jeehp.2020.17.39

110