A tablet PC web-based supporting tool for clinical rotation aimed at reflective learning


Kazunobu Ishikawa
Gen Kobayashi
Akiko Sugawara
Yoko Moroi
Tatsuo Suzutani
Tetsuto Fukushima


Portfolios and ePortfolios




Center for Medical Education and Career Development, Fukushima Medical University, Japan


Understanding overall goal of clinical clerkship, sharing students’ performance among teachers in multiple clinical units and creating feedback mechanism are essential for successful clinical rotation. To fulfill these, we developed and introduced a tablet PC based-learning portfolio system (Fig. 1 in details).


Representative feedback comments to iPad e-portfolio system for clinical rotation. Students pointed out usefulness for prior-confirmation and reflection of learning points in each clinical unit. They enjoyed self-produced contents. Teachers mentioned benefits to support students by visualization of learning processes in other units. Both teachers and students valued Wi-Fi setting, however, requested further improvement. Especially, they found difficulties carrying iPad in hospital (Fig. 10). 


Summary of Work

During clinical rotation in 28 clinical units, 81 medical students self-assessed their performance in 5 levels. Teachers assessed students’ performance using identical scales for feedback. Students’ also self-assessed their competencies during and after rotation using 68 checklists to reflect entire goal. This system also provided self-produced movies, pictures and mini-test for clinical skillsig (step by step explanation of Fig.2 in details).

Fig. 4 (in details). Learning Contents. Although there are some variability among departments, we have 39 movies and over one hundred learning contents 

Fig. 6A-6C (in details).    Opening page of iPad e-portfolio system.    

Fig. 7 (in details).  A screen of assessment after several rotations. Self-assessment by a student is shown in upper dense orange color. Assessment by a teacher is shown in lower bright color. Mean values of students rotated are shown as a vertical line.




Take-home Messages

Our tablet PC-web based system for clinical rotation promoted reflective learning of medical students and alliance among teachers in multiple clinical units. Learning portfolio software using tablet PC-web based system for clinical rotation has placed in service.







The authors are grateful to the students and the teachers who dedicated their time to participating in this project.


This project was funded as a program for promoting university education and student support from the Ministry of Education, Culture, Sports, Science & Technology in Japan.

COI disclosure: 

The authors have no financial conflicts of interest to disclose concerning the presentation.

Summary of Results

Self-assessment of clinical competency during and after rotation

Using 68 checklists in 15 domains, students self-assessed own competency at 12 week, 24 week and 34 week. These self-assessment promoted reflection of learning. In addition, teachers can understand their progress and problems. At the end of the term, faculties for medical education reminded clinical teachers of the items students did not learn (Fig 8A-C).




Data entry

To continue this e-portfolio project, monitoring and promotion of data entry of students and teachers were important (FIg. 9 in details).


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Summary of Work

Fig. 2. The outline of our e-portfolio system.  â‘  We asked teachers to prepare learning goals, e-contents and short exams before clerkship.  â‘¡ We had meetings with students and teachers to explain this project. We provided iPad and instructed how to use this software.  â‘¢ We asked students to check learning goals before rotation, to utilize e-contents and mini-tests during rotation, and to assess their performance after rotation. In addition, students were also asked to assess themselves according to the core curriculum 68 checklist.  â‘£ Meanwhile, teachers also assess students’ performance after rotation through iPad.  ⑤ Thus, students’ performance can be understood and shared among multiple departments. Teachers can advise and respond to students’ questions and comments.  â‘¥ Students are expected to reflect their own problem areas and train them in next rotation. ⑦ Through this system, we expect students to enhance clinical competencies and to become active learner-doctor. We also expect clinical teachers to instruct each student according to their requirements, and, to improve clerkship program.


 Fig. 6A.  Information and learning objectives for students are provided.  




 Fig. 6B. By changing a tab, users can reach lists of learning objectives, SBOs, learning contents, mini-test, and self-assessment menu. 




Fig. 6C.  Students are asked to assess their learning level in 5-point scale. In case a student has no experience, he should enter zero. Before rotation, students and teachers were orientated that the software is not for ‘academic evaluation’ but for ‘reflective learning’ and ‘partnership among teachers in multiple departments’.  




Fig. 7.  A screen of assessment after several rotations. Self-assessment by a student is shown in upper dense orange color. Assessment by a teacher is shown in lower bright color. Mean values of students rotated are shown as a vertical line.



Take-home Messages
Summary of Results
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