The impact of portfolios on health professionals' practice: A literature review

Objectives: The purpose of this paper is to review the literature on the use of a portfolio and discuss the evidence for the impact of a portfolio on professional practice, in particular pharmacy practice. Method: A literature review was performed using databases from health care and education, namely AMED, BEI, CINAHL, Embase, ERIC, IPA, MedLine, PHARM-LINE, PsycInfo, TIMELIT and ZETOCs, as well as a manual search of relevant journals and documents between 1991 and 2007. The search terms included portfolio, progress files and assessment, and these were linked with pharmacy. Articles were included in the review if they had a focus on the portfolio as a contribution to professional practice. Key findings: Portfolios have been used in the education field for over decade. A total of 26 out of 1901 papers were identified which examined portfolios in a post-registration setting. The majority of these publications were from medicine (12), with education (six), pharmacy (five) and nursing (three) making up a small proportion. Portfolios were seen as (a) a tool for use in feedback, (b) a useful trigger for reflection and (c) a link between academic learning and practice. A similar set of findings were seen in the educational context. In addition, a portfolio (a) requires motivation to record and (b) can change behaviour towards colleagues. Conclusions: There is still confusion about the meaning of a professional portfolio in health care professions. It is suggested that portfolios should be classified according to a modified system from the teaching profession. The evidence that portfolios can contribute to practice is limited. This review suggests the need for more studies into the impact of portfolios on professional practice, in particular in a pharmacy context.