The goal of this research was to develop a specific application plan for using an e-portfolio to encourage learning in the fifth grade of clinical practice courses and to improve learning management efficiency. For this purpose, we examined the utility of using an e-portfolio in clinical practice courses as well as how satisfaction with the use of an e-portfolio in clinical practice courses is influenced by the appropriateness of content composition and feedback.
With regard to our research findings, first we discovered students' perceptions of e-portfolio learning gains and satisfaction varied depending on the e-portfolio material composition for each clinical practice course. During clinical practice courses, there were differences in the composition of e-portfolio items for pediatrics, obstetrics and gynecology, and neurology. Daily practice records, weekly practice records, attitude assessment, outpatient prognostic records, inpatient medical records, clinical skills rubric assessment, and inpatient proportion presentation were some of the most common e-portfolio content items used in pediatric, gynecological, and neurology clinical practice processes. Clinical skills observation and journal presentation were also used as e-portfolio content components in gynecology and pediatric clinical practice. Throughout the course of obstetrics and gynecology clinical practice, elements such as surgical observation records were employed as e-portfolio content items. These e-portfolio content items are primarily for students to keep track of on a continual basis and it can be seen that the greater the amount of content items, the more time students must dedicate to establishing an e-portfolio. So, because the aim of an e-portfolio in the clinical practice process is unclear at first, many attempts have been made to include a large amount of content in e-portfolio content [18]. According to Driessen [18], tailoring portfolios to the needs of professors and students can be beneficial. The competences and learning goals to be reached should be clearly given, and the contents of the e-portfolio should be correctly organized in order to use the e-portfolio in the clinical practice course to enjoy the benefits and consequences of learning.
Furthermore, the more they identified that the e-portfolio's content structure was suitable, the more favorable their responses to the learning advantages were. Specifically, when utilizing the e-portfolio, this is related to the content composition. The e-portfolio's contents should be organized in line with the clinical practice course's educational aims with no superfluous or overlapping elements. According to Vance et al. [19], information created in an e-portfolio without a clear purpose hinders student engagement, and content development and writing should be concise and flexible to promote student participation. According to the findings of this study, the number of e-portfolio items was determined to be a factor determining the learning benefit. Therefore, it is critical to clearly identify the learning goals and skills for each clinical practice course, as well as to arrange the e-portfolio contents simply according to the aim, in order to improve e-portfolio utilization.
Next, faculty evaluation was rapidly delivered in the clinical practice course, which increased the benefits of e-learning portfolios (reflection, self-directed learning, learning, and performance ability). In the following paragraph, we present a list of the providers of feedback from pediatric adolescents, obstetrics and gynecology, and neurology who participated in this study.
While other clinical practice courses provided little or no feedback, the neurology clinical practice course's responsible professor provided immediate feedback on each student's learning record, such as daily feedback on daily records. Students' perceptions of the e-portfolio's learning benefits appear to have been influenced by this difference in feedback. Providing students with regular and timely feedback, in other words, may help them stay motivated and achieve excellent learning results. According to Bleasel et al. [17], providing exact feedback at the correct time is more important than the volume of feedback supplied. Watling [20] also noted that excellent feedback can only be provided at an appropriate time. As a result, it was verified that providing fast feedback to students in the e-portfolio is an essential aspect for clinical faculty.
First, with regard to the study’s importance and implications, this research looked at student satisfaction with the use of e-portfolios in the first year after they were introduced. In a scenario where there is little research on the use of e-portfolios, it is worthwhile to examine the satisfaction of utilizing e-portfolio content by considering the features of each course in the clinical practice process for medical students. Accordingly, because it was the first year of using an e-portfolio, there was no instruction on how to organize and use the content. A satisfaction survey was conducted with students who used the e-portfolio for the first time, and attempts were made to discover variables for content creation and satisfaction enhancement in order to successfully use the e-portfolio that is used as an advantage for students' learning in the future. Hence, satisfaction with utilizing an e-portfolio was highest in the neurology clinical practice course in this study, which included pediatric, obstetrics, gynecology, and neurology clinical practice courses. When compared to other clinical practice courses, the e-portfolio content items in neurology clinical practice courses were minimized. When it comes to using the e-portfolio, students want to be succinct and obtain what they want. It was verified once again that the appropriateness of information creation is a key component in building a student-friendly e-portfolio and increasing user satisfaction. According to previous research, the number of content items in the e-portfolio should be succinct and adaptable according to the learning goal to promote participation in the e-portfolio and enhance the efficacy of learning [18, 19]. In fact, Vance et al. [19] questioned clinical practice students in the United Kingdom about their use of e-portfolios, concluding that content configurations that reduce the time, repetition, and duplication of the process should be accomplished to encourage e-portfolio participation. As a result, the degree of content composition elements should be adjusted according to the learning objective to maximize the learning effect of using the e-portfolio.
Second, this study discovered that feedback is a key element in increasing an e-portfolio's learning advantage. In competency-based medical education, feedback for learners is a significant topic of study. This study indicates that if the faculty offers timely observations on the feedback utilizing the e-portfolio, it aids learners in self-reflection and academic achievement. Research on the efficacy of learning from feedback recognized by students and teachers at a medical education site discovered that feedback becomes more timely, detailed, and constructive [17, 20]. Consequently, a system for delivering detailed feedback must be prepared to maximize the learning advantages of utilizing the e-portfolio.
Notably, there were some shortcomings in this study. The questionnaires were created based on a review of prior studies on the use of e-portfolios; moreover, the satisfaction with the usage of e-portfolios was evaluated. An e-portfolio user satisfaction survey tool is required to perform an e-portfolio user satisfaction survey on a continual basis. The number of questions on assessment and feedback in this study were from one to two of them concerning the confirmation of the link between evaluation and feedback when using an e-portfolio. So, there is a limit that does not include complete e-portfolio evaluation and feedback, such as the suitability of the content development range and questions about particular feedback techniques. Therefore, we recommend that future studies on learning advantages, such as complete feedback on evaluation items and content design, feedback timing, provider, quality, etc. while utilizing an e-portfolio, will need to be more empirically performed.