Patrece Joseph, Sasha A Fleary
"The Way you Interpret Health": Adolescent Definitions and Perceptions of Health Literacy
The Journal of school health
recent years use portfolios learning assessment tools become widespread across range health professions whilst growing body literature accompanied trends clear collated summary evidence educational effects use portfolios undergraduate education systematic review result work provide summarywe developed protocol based recommendations best evidence medical education beme collaboration citations retrieved electronic searches 10 databases assessed predefined inclusionexclusion criteria two independent reviewers full texts potentially relevant articles obtained studies identified inclusion review examination full text articles two independent reviewers stages discrepancies resolved consensus data relating characteristics student population intervention outcome measures student design outcomes collected using piloted data extraction form study assessed 11 quality indicators designed provide information well designed conducted kirkpatrick hierarchy modified educational settings comparisons different groups carried using kruskalwallis test nonparametric anova mannwhitney u test appropriateelectronic searches yielded 2348 citations 23 citations obtained hand searching reference lists 554 full articles retrieved assessed inclusion criteria 69 studies included review 18 medicine 32 nursing 19 allied health professions including dentistry physiotherapy radiography professional groups portfolios used mainly clinical setting completion compulsory reflection required assessment either formative summative combination norm three studies used electronic portfolios whilst many studies used combination data collection methods half included studies used questionnaires third used focus group interviews another third used direct assessment portfolios studies assessed student tutor perceptions effect use portfolios learning five studies used comparative design one randomized controlled trial studies likely meet quality indicators relating appropriateness study subjects clarity research question completeness data however many studies methods reported sufficient detail allow judgement made 19 69 included studies 27 met seven quality indicators across professions higher quality studies likely published recently median quality score number indicators met rose two studies published 2000 earlier seven studies published 2005 later significant differences observed quality scores studies published 2000 published 2001 2004 p 0027 published 2000 published 2005 later p 0002 studies p 0004 similar trends seen professional groups 59 85 included studies assessed level 1 modified kirkpatrick hierarchy ie participation effects including post hoc evaluations student perceptions effects keeping portfolio learning 9 13 studies reported direct measurement changes student skills attitudes one study reported change student behaviour main effects portfolio use identified included studies improvement student knowledge understanding 28 studies six kirkpatrick level 2 greater selfawareness encouragement reflection 44 studies seven kirkpatrick level 2 ability learn independently 10 studies one kirkpatrick level 2 findings higher quality studies also identified benefits areas reported improved student knowledge understanding particularly ability integrate theory practice although correlation improved scores assessments always apparent greater selfawareness engagement reflection also noted although studies questioned quality reflection undertaken higher quality studies also suggest use portfolios improves feedback students gives tutors greater awareness students needs may help students cope uncertain emotionally demanding situations prepares students postgraduate settings reflective practice required time commitment required collate portfolio major drawback identified two studies found detract clinical learningat present strength extent evidence base educational effects portfolios undergraduate setting limited however evidence improving trend quality reported studies higher quality papers identify improvements knowledge understanding increased selfawareness engagement reflection improved studenttutor relationships main benefits portfolio use however also suggest whilst portfolios encourage students engage reflection quality reflections cannot assumed time commitment required portfolio completion may detract learning deter students engaging process unless required demands assessment work needed strengthen evidence base portfolio use particularly comparative studies observe changes student knowledge abilities directly rather reporting perceptions portfolio completed