New eFolio Connector Will Help Physicians, Students Track Training
AAMC Reporter: October 2011
—By Sarah Mann
As soon as students enter medical school, they start to gather data, including educational experience and assessments, test scores, recommendations, and volunteer experiences that will help them transition into residency. By the time residency ends, they will have accumulated even more.
The way this information is stored is not unlike the way patient records are stored—sometimes electronically, sometimes paper based, and typically spread across several offices or institutions.
In an attempt to centralize and streamline how this information is recorded and monitored, the AAMC and the National Board of Medical Examiners (NBME) are developing the eFolio Connector, a shared infrastructure that will enable students and physicians to view their educational and professional data. The tool connects organizations that assess and license physicians. There is currently no timetable for eFolio’s release, but organizers hope it ultimately will become a standard tool for doctors.
“Physicians need a way to document their professional competence and keep track of that information throughout their lifetime,” said AAMC Executive Vice President Carol A. Aschenbrener, M.D. “The dream is that every physician who wants an eFolio will have one to document competencies and professional growth.”
Today, most physicians keep track of this information with pen and paper, or through electronic platforms hosted by individual medical schools or hospital systems, which often means the material is not easily portable.
“Everyone has their own system. Sometimes, it is literally shoe boxes stuffed with papers,” said Robert M. Galbraith, M.D., executive director of NBME’s Center for Innovation. “Everything is so fragmented that when a physician leaves one particular place, they have to change systems. It is very choppy, and people have to start over every time they move into a new system, which is very tedious and has the potential for error.”
This can make it frustrating for physicians to keep track of all the information they need to maintain a hospital credential or when they begin work at a new hospital, for example. Individual institutions often have specific requirements for how physicians should submit such information and have different ways of verifying data.
“It can be quite a daunting task to make sure all of that information is accurate and verified, and that it is presented in the way that a given [organization] wants,” said Kimberly Hoffman, Ph.D., associate dean for learning strategies at the University of Missouri School of Medicine and chair of the eFolio Advisory Group—medical educators who are helping the AAMC and NBME define the optimal eFolio model.
Through the eFolio, a physician simply would make a direct request to relevant organizations such as the NBME, AAMC, and others to transmit data to the relevant organizations. Because the information come from the primary source, it would not require additional authentication. Medical students beginning clerkships or residents transitioning into practice could theoretically submit all transcripts, test scores, and recommendations with the click of a button.
“When I was in medical school, we had to fill out reams of forms every time we went from one level to the next,” said Neil Mehta, M.D., director of educational technology at the Cleveland Clinic Lerner College of Medicine and a member of the eFolio Advisory Group. “Every time I had to fill it out I would wonder why we had to do it again and why it was not digital. Hopefully, the whole process will be much more efficient with the eFolio.”
The AAMC, NBME, and eFolio Advisory Group are discussing the best way to make these scenarios possible.
One challenge is developing common terminology to characterize the different ways medical schools measure student performance. One school might have a straightforward pass/fail system for rotations, while another might note that a student passed a rotation with honors. A third school might include even more detailed information, such as how many diabetic patients the student saw during the rotation. The advisory group is working with MedBiquitous, an organization that develops technology standards for health professions education, to develop standardized terminology to describe courses and experiences that all medical students should have.
“From a learning perspective, there are a lot of potential benefits for students because it allows the learner to think about their learning activities and reflect on their practice across the entire continuum,” Hoffman said.
The ultimate goal for the eFolio is to transform it into a learning tool that will help students and physicians take advantage of having unified data sets by mapping out professional goals, reflecting on their careers, and tracking their improvement for the duration of their professional practice.
Learners could view their data as a jumping-off point for discussions with mentors about the types of programs they should look for and ways they can advance their medical knowledge and improve patient care, both of which would lead to better health care.
“I think this is a good example of what we need to be doing in medicine,” Galbraith said. “We need to be sharing a lot more data that provides useful reports to people that really do drive improvements in health care,which is what we are all trying to achieve right now. This has the potential to be transformative.”