Early perceptions of portfolios in an outcome-based curriculum

Background: Despite the widespread use of portfolios in medical education, their outcomes remain variable. This study evaluated students’ perceptions of portfolios at an institution that recently adopted an outcome-based curriculum. Methods: This descriptive cross-sectional study involved 4th, 5th, and 6th -year medical students (n = 94; response rate = 64.8%) at Prince Sattam Bin Abdulaziz University, Saudi Arabia, during the 2023–2024 academic year. A 13-item Likert-type questionnaire assessed students’ portfolio perceptions across five domains: design, feedback and reflection, benefits in assessment, openness to their broader use in the college, and usefulness. Students’ Grade Point Average (GPA) was also recorded as an index of academic performance. Data were analyzed quantitatively; results were expressed as frequencies, means, medians, and percentages. Correlation analyses were conducted to explore the relationships between overall portfolio perception and other measured domains. Results: Ninety four students participated in this study. Only 48.9% of students found portfolios useful, with neutral average score of 3.3 ± 1.4 on the Likert scale and 5.66 ± 2.7 on the visual scale. Fewer than half reported positive perceptions across the five assessed domains. Differences in perceptions across academic levels were analyzed using the Kruskal-Wallis test which revealed statistically significant differences (p < 0.05). Post-hoc pairwise comparisons using the Mann-Whitney U test showed that fourth-year students had significantly higher perception scores than both fifth- and sixth-year students (p < 0.05). Although perceptions improved slightly in the sixth year, these differences were not statistically significant. Strong positive correlations were observed among the survey variables (p < 0.001), but no significant correlations were found between portfolio perceptions and academic performance (p > 0.05). Conclusion: The transition to outcome-based education may be associated with poor portfolio perceptions. Adjusting workload, enhancing feedback, and integrating portfolios into the curriculum may improve portfolio acceptability.