Reflection for the undergraduate on writing in the portfolio: where are we now and where are we going?

Introduction: The portfolio can be seen as a tool for assessment of a variety of learning activities that differ in content, usage, and assessment. The portfolio not only meets the learner's educational needs but also the political and public reassurance demand that the health professional has achieved the required competency of the curriculum that allows him or her to practice safely with or without supervision in the health organization.

Methods: An in-depth search on Google Scholar, Medline and PubMed was conducted using the terms "reflection and portfolio" with especial emphasis on undergraduates. All the manuscripts collected were critically reviewed regardless of the date of publication.

Results: Even though the systematic review showed the limited effect of the educational impact of the portfolio on the undergraduate, numerous benefits can be seen, e.g. improvement in the relationship between students and tutors, an increase in general knowledge, awareness and reflection. Reflection for medical undergraduates in portfolio per se was associated with improvement in communications skills, professionalism and better achievement in postgraduate studies and increase in experiential learning. Interestingly, the portfolio was shown to be useful for undergraduate and tutors in filling the gaps of learning in clinical surgery, urology and geriatric medicine. In addition, for dental and nursing students it was associated with an increase in professionalism, clinical competency, and self-confidence. Lack of integration of reflection throughout the curriculum of the medical school was considered one of the main problems.

Conclusion: Further research is needed to address the following questions (i) it will be of interest to assess if there is any difference in reflective portfolio between students from problem-based learning (PBL) curriculum and those from traditional curriculum. (ii) Assess the difference in reflective portfolio between community-oriented and PBL curriculum and PBL and traditional curriculum (iii) if there is any difference in the reflective portfolio in these three curriculums, it will be of interest how this can alter the evidence base of the educational effects of the portfolio. In other words, is there any curriculum that will consistently produce evidence based educational effects of the portfolio?