Medical training in the context of primary health care: reflexive portfolios as an innovative didactic proposal

Abstract

Medical education in Brazil is shifting towards student-centered teaching and personalized care. The National Curriculum Guidelines emphasize the development of competence in health care, health management, and health education through real or simulated professional practices. Undergraduate institutions use active teaching and learning methods, such as the constructivist spiral and reflective portfolios, to promote student reflection and improve patient care. This study focuses on the importance of involving medical students in practical training through reflective portfolios during their first two years of education. This research is a qualitative and exploratory study that uses the 18 reflective portfolios written by one of the authors while they were a medical student. The data was collected from a Family Health Strategy (FHS) integrated with a Medical School in São Paulo, Brazil, between May 2017 and September 2018. The analysis of the data took place between September 2021 and June 2022 and was conducted through Content Analysis. Four themes emerged, stating the portfolio is a A) Reflexive instrument on Health Care; B) Reflexive tool on Health Management; C) Reflexive instrument on health education; and D) Self-reflexive and self-assessment instrument. Reflective portfolios allow students to reflect on various aspects of medical training, bring knowledge closer to reality, and contribute to the development of a professional identity that considers the biopsychosocial needs of patients. We conclude that the portfolios provide learning beyond the classroom and help students become competent health professionals who understand patients as individuals in a social context. However, the small sample size of one student is a weakness of the study, and further research with a larger sample is needed to better understand the impact of reflective portfolios on professional identity formation.