A HYBRID TEACHING MODEL FOR MEDICAL EDUCATION: REFLECTIVE E-PORTFOLIOS, FACE TO FACE CONTACT AND STUDENT CENTERED INTERACTIVE GROUP LEARNING

Background: The portfolio purpose was defined as 1) personal development; 2) evidence of learning and 3) assessment of learning. We tested attitude and perception of students and faculty in an Arab medical school towards the portfolio and a hybrid model combining face to face teaching and workplace based experience with an on-line reflective portfolio emerging as framework. Method: An action research study was conducted between 2009 and 2012 with final implementation in 2013. Three plan, do check, act (PDCA) cycles were completed. Cycle I comprised of a situational analysis, which resulted in questionnaires and a moderator's guide used in cycles 2 and 3. Ten (10) focus group interviews (FGIs) qualitative-and quantitative data (questionnaires for triangulation) was collected. This informed the framework of the e-portfolio implemented in cycle 4 as part of the hybrid teaching model with focus on clinical reasoning, teaching and evaluating professionalism, ethics and the hidden curriculum. Results: 3 cycles were reported. Cycle 1: Tutor themes: 1) Mentoring 2) on-line interaction and support 3) preference of paper format and face to face interaction 4) complexity of assessment criteria 5) interpretation of terminology and 6) labour intensity. Students Themes: 1) Tutor support 2) computer technology support 3) repetition and duplication 4) lack of literature search skills 5) time commitment 6) peer interaction. Cycle 2: Tutor themes included 1) time commitment and workload 2) training on on-line technology 3) uncertainty about portfolio grading 4) supervision and feedback 5) commitment 6) confidentiality and access to portfolio entries. Student themes included 1) willingness to conduct and develop learning plans, 2) reluctance to share self-assessment results 3) uncertainty about self-assessment criteria 4) attitudes, expectations and response to feedback 5) inexperience, excitement and caution about documented and shared reflection 6) frustration with technology 7) willingness to interact and share knowledge and resources with peers 8) acceptance of summative assessment of portfolio Cycle 3 explored the impact of culture and religion on reflection and interactive learning. Reluctance to criticize authority and governmental institutions with hesitance to explore sensitive issues related to reproduction was identified. Conclusions: E-portfolios fostering independent and team learning was identified to be acceptable to both faculty and students as a teaching tool and could be a solution to changing demands in medical education simultaneously also addressing the hidden curriculum.