Association between clinical learning portfolio recording and medical students' competencies and entrustable professional activities in Taiwan.

Background: The clinical reflection-oriented learning portfolio is widely applied in clinical rotation but it is time-consuming for clinical trainees and the effect on learning is still questionable. This study aims to provide effectiveness evidence of learning portfolio by examining the association between learning portfolio appraisal and clinical performance.

Methods: From 2020 to 2022, data were evaluated to investigate the relationship between excellent portfolio award status, proficiency in entrustable professional activities (EPAs)-based assessments, and clinical competencies based on the core EPAs for entering residency of the American Association of Medical Colleges (AAMC), as well as eight core competencies evaluated every two weeks from each clinical department. In addition, clerks who continued their second-year clerkship at the research hospital (continuous follow-up group) were analyzed to further explore the association between first-year award status and second-year clinical outcomes.

Results: A total of 148 first-year clerks were included in the overall group (award recipients and non-recipients). Among them, 86 continued their clerkship at the research hospital in the second year (continuous follow-up group). In the overall group, compared with excellent learning portfolio non-recipients, award recipients demonstrated higher scores in 11 of the 13 EPAs and in all 8 core competencies. Moreover, higher-frequency award winners obtained significantly higher scores compared to lower-frequency award winners. Stratified analyses based on gender yielded similar results during clerkship. However, this beneficial association was not observed in the continuous follow-up group.

Conclusion: This database study supports that better learning portfolio recording is associated with better clinical performance during early stage of clerkship. Learning portfolio could be an effective tool to facilitate clinical in early clerkship.