Commentaries

The daily grind use of log books and portfolios for documenting undergraduate activities

How many of you have used logbooks in one form or another for documenting the activities of your undergraduate students? The two articles in this issue may give you ideas of how logs can be used in traditional, and not so traditional ways.1,2 As we move towards community teaching and decentralized clerkships, logbooks can be used to track the activities of students as they learn in different environments, providing feedback for programme planning.

Logbooks are also extremely useful in focusing students on important objectives that must be achieved within specic time frames
Logbooks are also extremely useful in focusing students on important objectives that must be achieved within specic time frames. Murray et al.s paper1 highlights that students perceived supervised interaction with patients and teaching by doctors as the most educational activity in both community and hospital environments, but they found it even more educational and enjoyable in the former.

takes time and effort to sit down with them to teach and to provide ongoing feedback during their experience. There is often more onetoone interaction with a single preceptor and even if a number of teachers are involved, there are more links among the group to discuss the students' learning. In the teaching hospital setting there are many more teachers, often sicker patients, and many other conicting needs so that students lose the personal mentorship. This is particularly the case in tertiary centres as supported by the amount of unsupervised time recorded by students in this study.

However appealing the technology, the interaction with the patient is one of the most valuable experiences for any student and entering or looking up information should not diminish this. Hand held computer logs are in their early days and are not without problems. The effort to put information on these devices is signicant and although the Liaison Committee on Medical Education (LCME) requires that students document patient encounters during their clerkship, paper documentation remains more convenient.3

The interaction with the patient is one of the most valuable experiences for any student
Murray also points out that the heterogeneity of the data they obtained suggests that individual students have very different experiences even with apparently similar timetables. It is important for both students and faculty to recognize that although their learning experiences may be very different, core objectives can still be attained. Logbooks can be used to `check off' these objectives, and to inform the students whether they need to nd experiences or opportunities that have not been achieved in a particular rotation. The students' logs can then be reviewed by the rotation coordinators to see if the objectives they have set have been attained, so completing the education cycle. With computer technology taking over, the paper held logbook will evolve into one stored on a hand held device such as the Palm V. These are appearing in every student's hand in North America and if you do not wish to fall behind the times I would suggest that you put a request for one in your upcoming Chanukah or Christmas list.

One of the realities of the teacher's life is that we must enlist the students to help in collecting material to document their experiences
I like the idea, from La Palio, of multiple strategies to document a student's learning process.4 Ideally, to really understand students' experience, we would need to follow them more closely, minute by minute, or even participate in part of the clerkship as a student. If we had the time this would be most enlightening. However, one of the realities of the teacher's life is that we must enlist the students to help in collecting material to document their experiences.

Individual students have very different experiences even with apparently similar timetables
What are the strengths of learning in the community? Murray's results conrm what students tell us: they say that, on the whole, it is that the preceptor
Correspondence: Kim Blake, Department of Paediatrics, IWK Grace Health Centre, 5850/5980 University Avenue, PO Box 3070, Halifax, Nova Scotia B3J 3G9, Canada. Tel.: 00 902 420 8226; Fax: 00 902 428 3216; E-mail: kblake@is.dal.ca

Many of us would have benetted from the experience of keeping a learning portfolio in our undergraduate and postgraduate years
Lonka et al.2 describe a portfoliobased system to support the personal and professional development of the medical student, which may help in this regard. There are several reports of

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Use of logbooks and portfolios

K Blake

portfolio use that support them as a learning tool. For instance, the Internet-based, multiuser, multicentre learning portfolio has been shown to have a signicant effect on residents' perception of their self-directed learning abilities;5 this study also involved obstetrics and gynaecology residents. Where CME is concerned, a portfoliobased learning scheme can meet the needs of GPs relevant to their professional practice; it can give learners control over how, what and when they learn and encourage active and peersupported learning.6,7 In Finlay's study students recorded triggers to learning and key items in a personal learning portfolio. Students' performances in the clinical examination correlated positively with the contents of their portfolio; the more information in the portfolio the better they did in the nal examination.8 However, the usefulness of the portfolios in summative assessments have been more controversial.

faculty to document teaching scholarship, accomplishments, skills, and strategies. Teaching portfolios provide a means for teachers to demonstrate their teaching achievements and display their best work. I believe that many of us would have beneted from the experience of keeping a learning portfolio in our undergraduate and postgraduate years, both as a means of developing the habit of maintaining one and also as a means of examining our experiences and using the information as a basis for ongoing learning and improvement. Perhaps we should all undertake logging or portfolio keeping ourselves. Kim Blake Halifax, Canada

Acknowledgement
I would like to thank Dr Karen Mann for her helpful comments. References

Perhaps we should all undertake logging or portfolio keeping ourselves

In recent years, teaching portfolios have been developed as a way for

1. Murray E, Alderman P, Coppola W, Grol R, Bouhuijs P, van der Vleuten C. What do students actually do on an internal medicine clerkship: A log diary study. Med Educ 2001; 35:11017. 2 Lonka K, Slotte V, Halttunen M, Kurki T, Tiitinen A, Vaara L, Paavo-

nen J. Portfolios as a learning tool in obstetrics and gynaecology undergraduate training. Med Educ 2001;35: 11251130. 3 Marshall M, Sumner W. Family practice clerkship encounters documented with structured phrases on paper and hand-held computer logs. Med Educ 2002;36: in press. 4 La Palio L, Filling C, Engel J, Ways P. Multiple Strategies for Studying Medical Clerkship Experiences: a Case Study. J Med Education 1983;58:328 34. 5 Fung M, Walker M, Fung K, Temple L, Lajoie F, Bellemare G, Bryson S. An internet-based learning portfolio in resident education: the KOALA multicentre programme. Med Educ 2000;34:4749. 6 Mathers N, Challis M, Howe A, Field N. Portfolios in continuing medical education. effective and efcient? Med Educ 1999;33:52130. 7. Lim J, Chan N, Cheong P. Experience with portfolio-based learning in family medicine for master of medicine degree. Singapore Medical Journal 1998; 39:543546. 8 Finlay I, Maughan T, Webster D. A randomized controlled study of portfolio learning in undergraduate cancer education. Med Educ 1998;32:1726.

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