Professional competence – adding reflective elements to case reports
To the Editor: Logbooks of procedures are helpful in determining the professional competence of trainees. There has been correspondence in the SAMJ on aspects of their use in South Africa – for example, the value of specifying the number of surgical operations in the logbook.1 , 2
However, experience does not automatically translate into learning. Reflection is needed to turn experience into learning. Logbooks of procedures may be complemented by case reports that are structured so as to contain a reflective element.
The College of Radiation Oncologists of South Africa has used structured case reports for the past 4 years, based on a model developed by the Royal Australian and New Zealand College of Radiology. These structured case reports include technical aspects of cases from both the clinical and treatment points of view, as well as the potential benefits and toxicity of treatment. In addition, candidates describe both the lessons they have learnt and the candidate’s role in treating the case, to add a reflective element. A minimum of 20 structured case reports are produced during training, which are individually signed off and included in a larger learning portfolio.
The correspondence in the SAMJ does not make it clear whether it is practice to have the logbooks scrutinised by the examiners. It is appreciated that this can be logistically difficult. The College of Radiation Oncologists has dealt with this by having the candidates present their learning portfolios with structured case reports to their examiners one or more days before their oral examinations. The case reports are scrutinised, usually overnight, and the candidates then undergo an oral examination on the structured case reports. This is helpful in assessing the authenticity of the candidates’ practical and learning experience.
The experience with structured case reports has been helpful in both training and examining candidates, and the system could be extended and expanded.
President, College of Radiation Oncologists of South Africa
1. Benatar SR. Professional competence and professional misconduct in South Africa. S Afr Med J 2014;104(7):480-482. [http://dx.doi.org/10.7196/SAMJ.8492]
2. Fagan J, Lindeque G, Benatar S. Professional competence in South Africa. S Afr Med J 2014;104(8):524. [http://dx.doi.org/10.7196/SAMJ.8703]
S Afr Med J 2014;104(10):651. DOI:10.7196/SAMJ.8808
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