Guidance for writing portfolio cases in Geriatric Medicine
Students should choose a case for their portfolio essay as early as possible
because the timescale for submission is quite short – it needs to be uploaded by
12 noon on the Friday of week 3 (of your 4 week posting).
Your tutor will let you know if a hard copy is also required.
Most units will allow the student to choose his / her own case but can provide
suggestions if necessary. You are encouraged to select a case with
multidisciplinary issues. You should choose a case which will allow you to focus
on vertical themes which are of interest to you and which you have not covered
previously.
Ideally, students should select newly or recently admitted patients, so as to allow
a week or two to follow them up, and to allow you to see what the initial /
evolving outcomes are.
The format for the portfolio case is in common with other specialties, with marks
being awarded for History, Examination, Diagnostic Summary, Management
Plan, Discussion (including ‘Vertical Themes’ or ’Programme Themes’)*, and
Presentation (of the Essay).
History - Most patients in Medicine for the Elderly units will have multiple
pathology and pre-existing functional impairments. Your history should reflect
this, and should give a picture of the patient’s functional state, and also explore
his / her ideas, concerns and expectations where appropriate.
When writing up the case, it is quite acceptable and indeed desirable to obtain
information from many sources – including relatives and carers, nursing and
AHP staff treating the patient, and the case notes. Do acknowledge these sources
of information in your essay if appropriate.
When making reference to a patient’s medication history, do place emphasis on
ensuring correct spellings, correct doses and indications, and also on the
inclusion of allergies.
Examination - Students are encouraged to perform and report on their own
clinical examination findings (rather than merely reporting on the findings of
others as reflected in the medical notes). However, if you do make reference to
the examination performed by others then this should be acknowledged.
Diagnostic Summary - We would particularly draw your attention to this
section. As noted, most elderly patients have multiple pathology and it is usually
most helpful to formulate your diagnostic summary with the aid of a “Problem
List”, which may refer to psychological and social as well as physical issues. It is
not always necessary to write a “Differential Diagnosis”, for example if the
patient has already been in for a period of time and if the ‘Diagnosis’ is well
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established, although this might be appropriate if you are writing up a patient
who has only just been admitted with an acute problem.
Management Plan – This section can refer back to the problems noted in your
Problem List. You should tailor your plan to the individual patient, and ensure
that you reflect the multi-disciplinary and multifaceted nature of the patient’s
needs. In some cases, it might be appropriate to indicate how you might support
or address the needs of the patient’s carers as well.
Discussion – This section should make direct reference to, and be relevant to the
clinical case (i.e. rather than making merely broad generalisations around the
chosen topic or ‘portfolio vertical theme’ / ‘programme theme’) *.
The discussion section also gives you the opportunity to conclude your essay
with a personalised statement, or with your concluding thoughts on how this
specific case would influence your future practice and personal development.
I hope this is helpful to you. Good luck!
David J. Grant
Consultant Geriatrician
Liberton Hospital
Edinburgh
March 2013
*NB
– In 2013/14, the portfolio vertical themes are due to be replaced by
programme themes.
Updated May 2013. Dr Yinka Ogundipe
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