The use of professional portfolios and profiles for career enhancement Deborah C Casey and Dominic Egan Deborah C Casey, Senior Lecturer, Dominic Egan, Senior Lecturer, Faculty of Health, Leeds Metropolitan University Email: D.E.Casey@leedsmet.ac.uk

Since the introduction of the Post-registration Education and Practice (PREP) standard for regis-tered nurses and midwives in 1995, the relationship between the professional development, education and training of registrants, and their fitness for practice has been made explicit (Nursing and Midwifery Council, 2010a). The PREP continuing professional development standard requires registrants to: w Undertake at least 35 hours of learning activity relevant

to their practice during the 3-year period prior to renewal of registration

w Maintain a personal professional portfolio of learning activity

w Comply with any request from the Nursing and Midwifery Council (NMC) to audit how these require- ments have been met. In addition, to meet certain NMC practice standards,

such as the standards for mentors and practice teach- ers (NMC, 2008a) or non-medical prescribers (NMC, 2008b), focused evidence to meet specific outcomes must be collected as evidence of continuing professional development. Maintaining a robust portfolio of material evidencing professional development activities and how they have informed and influenced practice is therefore a mandatory requirement and failure to do so could jeop- ardise NMC registration. However, this should not be the only reason for evidencing personal and professional development using a professional portfolio. This article will discuss the wider range of potential personal and professional benefits to the individual practitioner from portfolio development activities. Wk8 Discussion3 Essay Paper

The portfolio defined There are a number of descriptions of what constitutes a professional portfolio but a particularly useful definition, provided by McCready (2007 p. 144) is:

‘…a visual representation of the individual, their experience, strengths, abilities and skills.’

Individual portfolios will therefore be unique in terms of content and presentation, reflecting the specific profes- sional biography of that health professional. Although part of the function of maintaining a portfolio may be as a stor- age portal for certificates, transcripts and job descriptions,

it should provide much more than just a career resumé or curriculum vitae summarizing academic and work history. A portfolio should also provide evidence of how an indi- vidual has developed both personally and professionally. It is therefore a showcase for past accomplishments and achievements, but can also be used as a dynamic vehicle to enable future career and development planning.

Portfolio structure Although most portfolios will be traditional paper-based files or a folder containing a range of written or printed material, increasingly electronic software packages for developing electronic or ‘e-portfolios’ are available. These can significantly reduce the volume of paperwork gener- ated and allow for flexibility of access. More importantly, perhaps, they have the potential to enable real-time capture of information, activities and learning.

Anderson et al (2009) propose that portfolios may be structured in different ways (see Box 1).

The structure and presentation of a portfolio will clearly vary according to the individual’s preferences, experiences and career goals, but some common information and doc- umentation to consider for inclusion are outlined below: w Biographical information w Educational background w Employment history with brief description of roles and

responsibilities w Professional qualification certificates

AbsTrAcT Since 1995, registered nurses and midwives have been obliged to develop and maintain a professional portfolio of evidence reflecting the learning activities that they have undertaken and how these have informed and influenced their practice. The aim of this article is to demonstrate that rather then just a retrospective account of continuing professional development activities, a portfolio can be used as a vehicle for engaging in self-assessment and personal development planning. Possible structures and type of evidence are explored and portfolios in the context of gaining accreditation for prior experiential learning, and in particular for those nurses in advanced clinical roles, are discussed. Wk8 Discussion3 Essay Paper

KEY WOrDs Portfolios w Profiles w Continuing professional development w Evidencing competence w Accreditation of prior learning

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w Training and competency records w Records of appraisal and personal development plans w Professional development activities with supporting

notes outlining the learning from each activity and some reflection on how it has informed and influenced practice

w Activities to support learning and assessment of oth- ers – including mentoring, preceptoring and teaching of pre- and post-registration nursing students, allied health professional students and the non-professional workforce

w Practice development activities undertaken to support evidence-based practice such as audits, development of protocols or guidelines, and change management projects

w Publications and conference presentations w Professional body membership and any associated work

Registered nurses should however, feel free to be creative in their selection of material for inclusion. Hillard (2006) advocates that practitioners should undertake regular writ- ten reflections on incidents that have occurred in the prac- tice arena, and using these within a professional portfolio. She suggests this enables the practitioner to demonstrate self-awareness, to identify the knowledge embedded in

daily nursing practice and to consider areas of practice that require development. This may be particularly pertinent for nurses working in primary care. The nature of work in the community is that it is often carried out by lone practition- ers who, although function as part of a wider health-care team, actually deliver care independently on a daily basis. Reflecting on individual episodes of care may support the autonomous nurse in evidencing skills and knowledge in work that other wise may remain ‘hidden’ to others. Schultz (2007) discussed how reflective practice has the potential to help community practitioners ‘unlock the tacit knowledge and understanding that they have of their practice.’ By recording this, there is the potential for the knowledge to be shared, made explicit and accessible to the wider nursing community to enable the development of practice.

Evidence within the portfolio obviously must conform to professional and ethical standards for protecting confi- dentiality. This applies to patient/client information as well as the location and identify of colleagues or other health- care staff.

A vehicle for personal development The evidence presented within the portfolio must be sup- ported by some additional narrative. This is to ensure that the outcome of any learning event, such as attendance at a study day, is captured. In other words, how the learning was used in practice must be considered. McMullan et al (2003) make the point that portfolios must demonstrate ‘…both the product and process of learning’. Records of attendance at a study day or work shadowing a colleague, for example, are not in themselves evidence of learning. Some discussion of what was learnt and how new skills or theory was applied to develop or reinforce practice is crucial to demonstrate the value of the developmental activity undertaken. Wk8 Discussion3 Essay Paper

box 1 Portfolio structures Shopping Trolley – lots of evidence collected, but no real attempt to pull out themes or present in any specific order.

Spinal structure – evidence and reflective pieces aligned to competency standards or course objectives, for the purposes of meeting prescribed competencies, professional development planning and showcasing evi- dence for authorization, academic award or for potential employers.

Cake mix structure – a reflective narrative tying evidence together, which enables a greater focus on the personal learning journeys, reflection and the development of personal qualities.

Source: Anderson et al, 2009

box 2. Example of a sWOT analysis related to personal development Strengths Weaknesses

Good clinical skills

Sound interpersonal skills

Developing leadership skills

No formal qualification in speciality

Not done any academic study for several years

Opportunities Threats

Support in principle from manager

Flexible degree pathway at local university

Lack of funding from employer

High personal anxiety re work/life balance if studying

Action Plan

Contact university for degree prospectus

Contact appropriate lecturer re study skill support available

Arrange appointment with manager to discuss possibility of studying a module

Explore alternative sources of funding – special trustees?

Look at time management and consider where time for studying could be identified. For example, Sunday morning when children at football

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The portfolio therefore has scope for being much more then just a historical record of development. It can also be used as a vehicle for engaging in self-assessment and personal development planning. Evidence used within the portfolio can be used to undertake a personal review of where a prac- titioner currently is in terms of their development and con- sider where they want to be. A SWOT (strengths, weaknesses, opportunities and threats) analysis can be a simple but useful tool to analyse professional strengths (skills, knowledge and ability) and weaknesses (areas for development.) These can then be considered in the context of the opportunities for development and the potential threats or barriers to develop- ment. An action plan can then be developed ensuring that these are addressed. Box 2 provides an example of this. In this way, the portfolio can becomes a dynamic tool that enables and records professional growth.

Adult learning Knowles et al (1984) identified that adult learners share certain characteristics: w Self-concept: They have developed from being depend-

ent on others towards becoming self-directed individuals w Experience: They have accumulated a range of experi-

ences that provide an increasing resource for learning w Readiness to learn: Their readiness to learn within their

social roles is apparent w Motivation to learn: As a person matures the motivation

to learn is internal (Knowles, 1984 p.12). These criteria are obviously desirable characteristics for

community nurses who are taking on increasingly autono- mous and complex roles in response to the demands of political and societal changes. Portfolios would therefore seem to be a very appropriate vehicle for both enabling and demonstrating these characteristics. Indeed, for this reason portfolios are widely utilized on university courses as part of the assessment process in both pre- and post-registration health-care programme.

Professional profiles Timmins (2008 p. 24) suggests that whereas a portfolio may

be private, a profile is a selection of this evidence extracted from the portfolio to fulfil a particular purpose. In this way ‘…private learning may become public, thus making it available for viewing by others’ (Timmins, 2009 p.5) An example of this might be where a practitioner selects a range of evidence from their portfolio to present as evidence of having the skills and underpinning knowledge for a specific job role as part of the selection and interview process. It is important therefore, that while health professionals need to maintain a portfolio evidencing ongoing competence in all aspects of their professional life, they are likely to be required to provide a narrower range of evidence when profiling themselves for specific job roles or for academic or profes- sional accreditation. In these circumstances, individuals may be required to provide evidence of meeting pre-set criteria. The material presented must be mapped against the specific competencies or requirements. Box 3 provides an example of using evidence to map against a specific competency. Wk8 Discussion3 Essay Paper

Assuring quality A professional portfolio can be defined as robust if it com- prises evidence that provides a true representation of the individual practitioner – in other words, their professional identity. Wilcox and Brown (2002) suggested that the mate- rial presented in portfolios must meet certain benchmarks: w Valid – this means that the skills, knowledge and expertise

being demonstrated by the evidence matches the require- ments of, for example, the employer, professional body or higher education institution

w Sufficient – there must be adequate amount of material for the assessor to make a judgement as to whether the competency or skills or experience is adequate

w Authentic – the assessor must be clear that work within the portfolio or profile is as a result of the professional’s own effort and expertise

w Reliable – different assessors should place a similar value on the evidence provided and make similar judgements when confronted with the same evidence

w Current – this refers to the date of the evidence. Assessors must be sure that the evidence submitted by the candidate is recent enough to be considered a measure of his or her current levels of competence. Records of attending skills training several years previously with no evidence of updating or ongoing development is clearly not evidence of current proficiency. These generic criteria can be used to as part of self-eval-

uation of a portfolio, but are particularly important when using portfolio evidence to gain academic credit for prior learning from a university. Wk8 Discussion3 Essay Paper

Academic accreditation for prior learning Accreditation of prior learning (APL) is a process whereby academic credits can be awarded for previous learning that an individual has undertaken either through formal courses of study (Accreditation of Prior Certificated Learning – APCL) or through unstructured, informal learning

box 3. An example of using portfolio evidence to map against a specific competency Competency

Candidate is able to work innovatively and be highly committed to providing holistic care with a passion to improve the patient experience for service users.

Demonstrated by:

Led and managed a change development project to set up a nurse led tel- ephone follow-up service for post-operative patients.

Evidence from portfolio

Project plan

Minutes of steering group meetings

Audit report of first 3 months of service

Short reflective account of the process of implementing the service.

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British Journal of Community Nursing Vol 15, No 11 551

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at work or home (Accreditation of Prior Experiential Learning – APEL). Essentially this means that universities will review evidence of learning presented in a portfolio and award academic credits if it meets the appropriate academic standards. The academic standard a practitioner is seeking should be demonstrated in the academic level of the writing, as set by the Quality Assurance Agency (2001), such as structure and referencing. Credits gained can be used towards an academic award, for example, a diploma or degree or used to grant exemption from part of a course of study. In addition, evidence of prior learning can be used to provide evidence of the ability to study for a specific level of study and so enable the potential student to gain exemption from the usual academic entry requirements. With the ending of diploma programmes and a move to all graduate pre-registration nurse preparation programmes from 2013, many registered nurses may want to consider returning to academic study on a part-time basis to achieve a degree. Guidance on APL processes can be obtained from individual universities but having a current and intelligently presented portfolio reflecting past experience and learning is an excellent starting point for those wishing to seek APL

Evidence of competence The NMC (2009) uses the term competence to describe the skills and ability to practice safely and effectively with- out the need for supervision – a reasonable expectation of the registered nurse made by both the professional body and the employer. Since the introduction of the Knowledge and Skills Framework (Department of Health, 2004), all NHS staff are expected to demonstrate appropriate skills and knowledge within their role. These are closely linked to pay and progression through the process of annual development reviews and personal development planning. It is therefore helpful for health professionals to be able to easily access evidence of competence as part of the review process. However, there has been debate as to the best way to assess competence and some recent work suggested that as there is no gold standard for assessing competence in nursing ‘…a multi-method approach to assessment is advis- able’ (National Nursing Research Unit, 2009.) Portfolios certainly constitute a multi-faceted way of presenting a range of evidence and as a focus for discussion as part of a performance development review. Local universities increasingly offer modules to support the development of portfolios for health professionals and a range of self-help literature and texts have been also been published on the topic. Local health librarians should be able to support practitioners in accessing these. Wk8 Discussion3 Essay Paper

Portfolios and advanced nursing practice roles There are particular reasons why those nurses who undertake advanced clinical nursing roles, such as nurse practitioners, consultant nurses and community matrons, should maintain up-to-date professional portfolios. The autonomous nature of the work of nurses in advanced roles

means that they are less subject to the scrutiny of others. In addition, the sometimes fairly wide scope of their nursing practice, and potential overlap with medical practice, makes them vulnerable to questions regarding their competence and qualifications for their practice. It is important there- fore, that nurses in advanced roles should consider carefully how they currently evidence that their practice is safe and effective. Some suggestions for evidencing competence in advanced practice within a portfolio are: w Records of education and training in advanced skills such

as diagnostics to include some corroborative evidence of advanced skill competency such as OSCE or witness testimony

w Reports of audits of practice include documentation reviews

w Patient perspective through/patient stories w Peer review of practice w Feedback from colleagues and line managers w Notes from clinical supervision undertaken w Case studies w Reflection on practice events and incidents includ-

ing commentary on development and refinement of advanced skills over time. The likelihood of regulating advanced practice in the

near future is another reason for portfolio maintenance. For several years discussions have been underway to con- sider the regulation of nurses in advanced clinical practice roles, following concern about their competence and the lack of standardized educational preparation for such posts (NMC, 2004.) Earlier this year, the NMC agreed to establish a project group to take this work further, and build on existing work on the competencies and processes for regulating training and practice at an advanced level (NMC, 2010b). It is likely that the process will involve opening a new part of the register for advanced nurse practitioners with eligibility requiring the practitioner to demonstrate that the approved competencies have been achieved, either through successful completion of an a NMC validated course at a higher education institute, or through an APEL route. This would mean the assessment of competence via a range of methods, including a portfo- lio of evidence that is mapped against the specific compe- tencies. Those practitioners who already have commenced the process of evidencing their skills and knowledge, will obviously be at an advantage. Wk8 Discussion3 Essay Paper

conclusion Portfolio development is a professional requirement, enabling staff to provide documentary evidence of skills, knowledge and experience from a range of sources. A well constructed portfolio should show how learning has occurred as well as its application in practice. The acquisi- tion and development of skills and knowledge over time should also be evident. In this way, portfolios have the potential to be a tool that is an accessible resource that can assist in supporting career changes, meet professional body requirements, attest to academic ability and ulti-

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mately help to individual practitioners to implement and promote best practice. BJCN

Anderson D, Gardner G, Ramsbotham J, Tones M (2009). E-portfolios: developing nurse practitioner competence and capability. Australian Journal of Advanced Nursing 26(4): 70-6

Bogossian F. Kellet S. (2010) Barriers to electronic portfolio access in the clinical setting Nurse Education Today [internet] April 28th

Department of Health (2004) The NHS knowledge and skills framework and the development review process. Department of Health, London

Hillard C (2006) Using structured reflection on a critical incident to develop a professional portfolio. Nursing Standards 21(2): 35–40

Knowles MS et al (1984) Andragogy in Action. Applying modern principles of adult education. Jossey Bass, San Francisco

McCready T (2007) Portfolios and the assessment of competence in nurs- ing: a literature review. International Journal of Nursing Studies 44: 143-51

Mc Mullen M et al (2003) Portfolios and assessment of competence: a review of the literature. Journal of Advanced Nursing 41(3): 283–94

National Nursing Research Unit (2009) Nursing competence: what are we assessing and how should it be measured? Policy Issue 18 June

Nursing and Midwifery Council (2004) Consultation on a framework for the standard for post-registration nursing. NMC, London

Nursing and Midwifery Council, (2008a) Standards to support learning and assessment in practice. NMC, London

Nursing and Midwifery Council (2008b) Guidance for continuing professional development for nurse and midwife prescribers. NMC, London

Nursing and Midwifery Council (2009) Review of pre-registration nursing education-Phase 2. NMC, London

Nursing and Midwifery Council (2010a) The PREP handbook. NMC, London

Nursing and Midwifery Council (2010b) Regulation of advanced practice. http://tinyurl.com/2uyopcr (Accessed 25 October 2010)

Quality Assuarance Agency (2001) The framework for higher education qualifica-

tions in England, Wales and Northern Ireland- January 2001. http://tinyurl. com/37w7bdg (Accessed 25 October 2010)

Schultz S (2007) Reflection and reflective practice. Community Practitioner 80(9): 26-9

Timmins F (2008) Making sense of portfolios: a guide for nursing students Open University Press, Maidenhead

Wilcox J, Brown R (2002) Accreditation of Prior and Experiential Learning – A Student Guide. http://tinyurl.com/26huokm (Accessed 25 October 2010)

KEY POinTs w Maintenance of a portfolio is a professional body requirement for

registered nurses and midwives. w Portfolios offer a wide range of potential benefits for registered nurses

and midwives in terms of their personal and professional development. w These include career enhancement, academic credit for prior learning,

personal development planning and for evidencing advanced skills and knowledge. Wk8 Discussion3 Essay Paper

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