DIVING FOR PERLS: USING PORTFOLIOS FOR EVALUATION AND REFLECTION ON LEARNING. K. Edwards 1 , L.E. Pinsky 1 ; 1 University of Washington School of Medicine, Seattle, WA STATEMENT OF PROBLEM OR QUESTION: Lifelong learning is an important goal of medical training. However, objective tools for teaching skills of self-assessment and for giving feedback on professional development are lacking. Medical training is an experiential process and reflection is necessary to develop expertise and professionalism from the practical experiences. OBJECTIVES OF PROGRAM/INTERVENTION: Residents participating in the portfolio program will: 1) learn how to set achievable learning goals; 2) identify learning experiences that will facilitate achieving learning goals; 3) develop skills of self-assessment, identifying strengths and weaknesses 4) receive structured peer and supervisor feedback in a range of skill areas 5) develop important professional skills that support life-long learning, physician-patient communication, and excellence in patient care. DESCRIPTION OF PROGRAM/INTERVENTION: Portfolios constitute an integrated system of learner-directed evaluation. The primary outcome of the evaluation project is for each resident to create a portfolio that includes a comprehensive collection of different types of feedback and self-assessment. The components of the portfolio may vary, but are based on specific activities to assure broad coverage of skill areas. They include: worksheets on goal setting, tracking and self summary of learning, teaching self-evaluation, colleague feedback; critical incident type narratives; mini-CEX observations; CD-ROM compilation of the resident's videotaped encounters with patients, directed self-evaluation, a summary of resident/attending meeting, and overall department evaluation. There is a Working Portfolio for the resident's use and work-in-progress, and a Performance Portfolio for highlighting core competencies and strengths at the end of the year. FINDINGS TO DATE: After a pilot program with the internal medicine residents, a surprising number of the portfolio skills and objectives needed significant attention by the mentor faculty. Simple goal setting exercises presented challenges for some residents. This finding highlighted the need for the portfolio exercise within the residency program. KEY LESSONS LEARNED: We identify 5 elements critical to the success of a meaningful and effective portfolio intervention: 1) distinguishing the goals of the Working and Performance portfolios; 2) establishing a collegial educational climate; 3) teaching and refining selfassessment acumen; 4) promoting reflection on goals and progress over time; and 5) supporting structured autonomy via iterative discussions with mentors. Without these elements, trainees may view a portfolio simply as another tedious exercise and we risk trivializing an innovative tool. STATEMENT OF PROBLEM OR QUESTION: Community based ambulatory educational experiences have been increasingly emphasized in medical education due to the need to prepare medical students and residents to become more knowledgeable about primary care medicine in the era of managed care. At our institution, students start working in community based practices in the first year of medical school. Effectiveness of the students' educational experience in the community has frequently varied depending on the skills and interests in teaching of the physicians participating in the program. All physicians in our network are required to teach medical students at least 1/2 a day a week but little faculty development in teaching has been provided. How to effectively address the needs of these faculty is addressed in this innovative peer teaching program. OBJECTIVES OF PROGRAM/INTERVENTION: In order to improve the overall experience for both students and faculty, our institution has developed a``Teach the Teachers'' program. The primary objective of the program is having community based faculty associated with our institution's primary care network teach their peers skills in effective teaching and mentoring of medical students. It is also an objective to develop a core of community based faculty who will be able to provide leadership in the faculty development arena for our community based teachers of medical students. DESCRIPTION OF PROGRAM/INTERVENTION: Over the course of a year, the university staff collaborated with four affiliated community based primary care faculty to guide them in selecting the curriculum modules they felt would be most useful to office based teachers. The team also participated in the nationally organized General Internal Medicine Faculty Development Project (GIMGEL) where additional skills and training techniques were acquired. In order to develop a quality program, the community faculty selected four curriculum areas as well as a kick-off session for their program activities. They also worked with the Sr. Associate Dean for Medical education to make sure that the chairman of the Department of Medicine supported the program and would strongly encourage all of the university's primary care network of physicians (total of 91) to participate in at least 20 hours of faculty development over a two year time period. CME was also offered for all faculty development. The program selected includes the following modules: