The Lifelong Learning Value of a Clinical Portfolio for Doctors

Medicine is a profession defined by change. New evidence emerges, guidelines shift, technologies evolve, and patient expectations grow. For doctors, the challenge is not just staying up to date, but making sense of a lifetime of experiences in a way that informs future practice. Without a structured approach, much of this learning risks being lost to memory. A clinical portfolio provides the scaffolding to capture, reflect on, and build from each stage of a doctor’s career.

Osler’s CPD Home is designed to be exactly that: a living, breathing portfolio that accompanies you from your first day as a junior doctor through to senior consultant practice. It is more than a repository for activities and certificates; it is a record of growth, reflection, and achievement that you can rely on throughout your professional life.

Why Portfolios Matter

The educational value of portfolios is well established in both theory and evidence. Kolb’s Experiential Learning Cycle demonstrates that learning deepens when experience is followed by reflection, conceptualisation, and planning. A portfolio makes this process explicit by recording cases and linking them to deliberate learning goals. Donald Schön’s concept of the Reflective Practitioner likewise highlights the importance of pausing to analyse decisions made in the moment, as well as reflecting afterwards on what could be improved. A portfolio captures both of these reflective modes, preserving them for future reference.

There is strong empirical evidence to support these theories. Systematic reviews have shown that portfolios can improve reflective ability, strengthen professional identity, and encourage self-directed learning, particularly when they are supported by coaching and constructive feedback. They have been successfully applied to domains ranging from clinical competence to professionalism, and from reflective practice to lifelong development planning.

Importantly, portfolios are not only for learners; they also assist supervisors. A well-maintained record allows supervisors to see where a learner is up to, tailor their support to match the learner’s needs, and grant greater autonomy where it is safe to do so.

How Portfolios Shape Learning

The impact of portfolios extends across the full spectrum of learning domains. In the cognitive domain, they help connect knowledge across cases — for instance, enabling a doctor to revisit the outcomes of patients with sepsis in light of updated guidelines. In the psychomotor domain, they provide evidence of skill acquisition, such as documenting the progression of central line insertion technique over time. In the affective domain, portfolios capture reflections on professionalism, ethics, resilience, and communication. Vanderbilt University’s portfolio coaching model, for example, demonstrated that regular engagement with portfolio entries can develop both technical and professional capacities simultaneously.

Portfolios also serve as an invaluable “external memory.” Doctors often recall managing unusual or complex cases but struggle to remember the details when they encounter similar situations years later. By documenting those experiences at the time, portfolios provide a retrievable record for the future. They also make planning easier. Reviewing past cases, feedback, and reflections helps doctors to identify strengths and weaknesses, set achievable goals, and plan their ongoing professional development in a deliberate way. When viewed in aggregate, portfolios tell a bigger story. Patterns become visible — for example, Australian GP registrars have used their case logs to reveal underexposure to women’s health, which then informed targeted placement choices.

Portfolios, Assessment, and Entrustment

One of the most powerful roles of a portfolio lies in assessment. Programmatic assessment is built on the idea that many low-stakes assessments, when gathered over time, provide a more robust and fairer picture of competence than one or two high-stakes examinations. This construct is increasingly popular in education programs such as undergraduate medical school, both for formative and summative purposes. Portfolios are the natural home for this evidence. They can collect mini-CEXs, DOPS, case discussions, and feedback snippets, each of which adds to a richer narrative of a doctor’s growth.

But can they be useful for the individual learner too? Portfolios can enable individuals to collect data from “assessments” - be it feedback from patients, in workplace assessments or their own self refections - to build a picture of their strengths and weaknesses.

Entrustable Professional Activities (EPAs) take this a step further. EPAs are discrete professional tasks — such as handing over a patient, prescribing safely, or managing an acute admission — that can be entrusted to a learner once they have demonstrated readiness. Supervisors rely on portfolios to make these decisions, both in discrete episodes of assessment, as well as longitudinal evidence across different contexts and assessors. In Dutch postgraduate training, portfolios are formally tied to EPA sign-offs, while in the United States, paediatrics residencies embed EPAs into their portfolio systems to support progression to unsupervised practice. The real-world impact is profound: if a registrar’s portfolio consistently demonstrates independent performance in acute resuscitation across multiple supervisors, a decision to entrust them with running a code can be made with confidence.

Imagine having a portfolio of EPAs, displaying your level of capacity for each, that you can take with you wherever you go. A data set like this facilitates you receiving the right amount of supervision you need - simultaneously avoiding over-supervision, which suppresses your natural learning, and undersupervision, which may expose you and the patient to risk, and limits the learning opportunity.

Responsibility and Ownership of Learning

Perhaps one of the most important contributions of a portfolio is the way it encourages doctors to take responsibility for their own learning. A curriculum may define what needs to be mastered, but it is up to the learner to provide evidence of that mastery. Portfolios shift the balance of accountability, placing ownership of learning in the hands of the doctor. The UK Foundation Programme illustrates this well: progression depends on trainees evidencing competence through their e-portfolios. Far from being a burden, this process fosters accountability, self-direction, and pride in professional growth.

Barriers and Solutions

Despite their benefits, portfolios are not always embraced. For learners, they can feel like extra administrative work, irrelevant to daily practice, or even threatening if they expose weaknesses. Supervisors, too, face barriers: reviewing portfolios adds to heavy workloads, many lack training in formative feedback, and some remain sceptical about the reliability of portfolio data.

The literature points to several solutions. Integration into daily workflow, such as mobile-friendly platforms that allow quick entries, reduces the administrative burden. Coaching and mentorship, as demonstrated in Vanderbilt’s program, make the portfolio central to meaningful feedback discussions and increase engagement. Developing feedback literacy among learners — teaching them to actively seek, interpret, and apply feedback — improves the quality of portfolio entries. Faculty development ensures that supervisors are trained to use portfolios effectively, especially for EPA-based decisions.

Finally, reframing portfolios as tools for growth rather than compliance helps shift the culture, making them instruments of genuine learning rather than bureaucratic chores.

Looking Ahead

The future of portfolios lies in integration and personalisation. Automatic logging of cases and procedures from electronic health records could streamline documentation. Advances in artificial intelligence promise personalised CPD roadmaps, analysing case mix and feedback to suggest areas of focus. Aggregated, anonymised portfolio data could also inform workforce planning, helping institutions and health systems understand emerging trends in training and practice.

Osler: A Portfolio for Life

For doctors in Australia, Osler provides a platform that already embodies many of these principles. Osler is not just a CPD Home for meeting regulatory requirements. It is designed to be a lifelong companion, a single home for logging procedures, reflecting on cases, capturing feedback, and planning professional development. By growing with you throughout your career, Osler turns learning into a living record — one that not only supports compliance but also empowers reflection, assessment, entrustment, and personalised growth.

Conclusion

A clinical portfolio is much more than an administrative requirement. It is a living record of growth, grounded in educational theory and backed by evidence. It strengthens reflection, supports supervisors, enables programmatic assessment, and provides the evidence base for entrustment decisions. It places responsibility for learning where it belongs: with the doctor. And with platforms like Osler, portfolios can become lifelong companions, shaping not only careers but the quality of care doctors deliver to patients.

References

Kolb DA. Experiential Learning: Experience as the Source of Learning and Development. Prentice Hall, 1984.
Schön DA. The Reflective Practitioner: How Professionals Think in Action. Basic Books, 1983.
Ten Cate O. Entrustability of professional activities and competency-based training. Med Educ. 2005;39(12):1176–1177.
Ten Cate O, Scheele F. Competency-based postgraduate training: Can we bridge the gap between theory and clinical practice? Acad Med. 2007;82(6):542–547.
Van der Vleuten CP, Schuwirth LW, Driessen EW, Dijkstra J, Tigelaar D, Baartman LK, van Tartwijk J. A model for programmatic assessment fit for purpose. Med Teach. 2012;34(3):205–214.
Driessen EW, van Tartwijk J, van der Vleuten CP, Wass V. Portfolios in medical education: why do they meet with mixed success? Med Educ. 2007;41(12):1224–1233.
Buckley S, Coleman J, Davison I, et al. The educational effects of portfolios on undergraduate student learning: a BEME systematic review. Med Teach. 2009;31(4):282–298.
Tochel C, Haig A, Hesketh A, et al. The effectiveness of portfolios for postgraduate assessment and education: BEME Guide No 12. Med Teach. 2009;31(4):299–318.
Ajjawi R, Bearman M, Tai J, et al. The role of ePortfolios in supporting learning in eight healthcare disciplines: a scoping review. Clin Teach. 2022;19(2):107–117.
Gruss CL, Walsh KJ, Cutrer WB, Fleming A, Parekh K. Fostering lifelong learning: Integrating a portfolio coaching program into an undergraduate medical education competency-based curriculum. Med Sci Educ. 2025;35:141–148.
Warm EJ, Englander R, Pereira AG, et al. Entrustment and mapping competence in residency training. Acad Med. 2019;94(3):313–319.
Frontiers in Medicine. Use of an electronic portfolio for longitudinal assessment of personal and professional development. Front Med. 2024;11:1505378.
MedIllustrator Project. Retrospective learning via multimodal diagnostic data alignment. arXiv preprint. 2024.