The evaluation of an approach to reflective learning in the undergraduate dental curriculum

Experiences of the use of portfolio in dental education - A qualitative meta-ethnographic literature review

INTRODUCTION

Portfolio with a collection of evidence has become popular in higher education, including dental education. It is valuable to study the experiences of the use and implementation processes. Meta-ethnography can be a suitable method to analyse, synthesize and construct interpretations of qualitative research. Our aim was to explore experiences from the use of a portfolio/e-portfolio in dental education, from the students' and teachers' perspectives.

MATERIALS AND METHODS

A systematic search in the databases PubMed, Scopus and ERC was performed, and the established seven steps of a meta-ethnographic review were used. 278 papers were initially identified, and seven were included in the final analysis.

RESULTS

Two themes (Issues to Address and Consequences) and five subthemes (Purpose, Roles, Support and Structure, Challenges and Enablers, and Gains) were constructed.

DISCUSSION

Our synthesis reflects various challenges, yet the learning gains are recognized and expressed to be important once the students and teachers have overcome early thresholds. Beyond the conclusions drawn in each paper, our synthesis provides new perspectives on the complexity of an implementation process and the balance of not seeing the woods for the trees being overwhelmed by technical and other practical aspects, reducing the opportunity for learning.

CONCLUSION

The portfolio implementation in undergraduate dental education should address clarification to all stakeholders of the purpose and role, presenting a purposeful portfolio structure and timely support.

'The dental nurse played a vital role in helping to manage the patient': a thematic analysis of undergraduate dental students' reflective journals from outreach placements

Introduction Community-based dental education, or 'outreach', forms a key part of dental courses in some high-income countries. Its educational benefits are well-established and once graduated, participants feel better prepared for their early career. Yet, it is less clear what students actually learn while on placements.Materials and method Qualitative document and thematic analysis of a convenience sample of anonymised dental student reflective journals (n = 51).Results The reflective journals described varied and broadly positive learning experiences. Analysis identified a number of themes of learning. Most related to the process and outcomes of care, but two key themes - dental anxiety and teamworking - were interrelated with both. Within teamworking, dental nurses appeared important in students' learning. Three process interrelated themes of learning were identified in the data. These were: tailoring your approach; communication and time; and evidence-based dentistry and minimising risk. Two broad interrelated themes relating to outcomes for patients and students were also identified: trust and confidence; and professionalism and personal development.Conclusion This research identified important and potentially transformative learning from outreach placements. This included how dental anxiety impacts patients and the dental team, the importance of teamworking, and the role of dental nurses in students' experiential learning.

Development of a mobile tele-education system to assist remote otolaryngology learning during COVID-19 pandemic

Background

Developing clinical thinking competence (CTC) is crucial for physicians, but effective methods for cultivation and evaluation are a significant challenge. Classroom teaching and paper-and-pencil tests are insufficient, and clinical field learning is difficult to implement, especially during the COVID-19 pandemic. Simulation learning is a useful alternative, but existing methods, e.g., OSCE, 3D AR/VR, and SimMan, have limitations in terms of time, space, and cost.

Objective

This study aims to present the design and development of an Otolaryngology Mobile Tele-education System (OMTS) to facilitate CTC learning, and to evaluate the system's usability with senior otolaryngology experts.

Methods

The OMTS system utilizes the convenience of mobile learning and the touch function of mobile devices to assist users (medical students or post-graduate physicians) in learning CTC remotely. Clinical knowledge and system functions in the OMTS system are defined by senior experts based on required CTC learning cases. Through simulated clinical case scenarios, users can engage in interactive clinical inquiry, practice required physical and laboratory examinations, make treatment decisions based on simulated responses, and understand and correct learning problems through a diagnostic report for effective learning. Usability testing of the OMTS system was evaluated by three senior otolaryngology experts using measurements of content validity, system usability, and mental workload during their available time and location.

Results

Statistical results of experts' evaluation showed that the OMTS system has good content validity, marginal-to-acceptable system usability, and moderate mental workload. Experts agreed that the system was efficient, professional, and usable for learning, although the practicality of the clinical inquiry and hands-on practice functions could be improved further.

Conclusions

Based on the OMTS system, users can efficiently hands-on practice and learn clinical cases in otolaryngology, and understand and correct their problems according to the diagnostic report. Therefore, the OMTS system can be expected to facilitate CTC learning according to experts' evaluation.

Through the looking glass: a review of the literature surrounding reflective practice in dentistry

Reflection is an essential component of the learning process that helps to elicit deeper learning. In healthcare, this uses experiential activities to produce knowledge that compels the clinician to change their practice. Deep reflection allows one to explore emotions associated with challenging learning experiences, empowering reinterpretation of these experiences and removing barriers to further learning. Reflection is a key requirement of dental education at all stages. This paper aims to explore the existing literature on reflective practice in dentistry and identify areas for further research to improve reflective practice within dentistry.

Traditional methods of reflecting through written means are not facilitating the deep reflection which is desired. A systematic overhaul of reflective practice is suggested, involving a shift away from structured written reflections. There is little evidence to inform the most appropriate format for reflective practice in dental education. There is a need for further research to determine the effectiveness of reflective practice in dental education, particularly as a move away from structured written reflection to more creative reflective opportunities are encouraged. Greater exploration of barriers to reflection in dentistry is indicated, with consideration to how these may be overcome and a need to engage regulatory bodies in system-wide changes.

Reflection is an essential aspect of the learning process, with deep reflection eliciting deeper learning.

Deep reflection is desirable for learners at all stages, from undergraduate students to experienced clinicians, as it allows exploration of the emotions associated with the learning experience, removing barriers to learning and supporting wellbeing.

Further research to explore the barriers and facilitators to deep reflection in dentistry is indicated in order to support the planning and implementation of a systematic overhaul of current and often ineffective methods of reflection.

Using theory-informed data science methods to trace the quality of dental student reflections over time

This study describes a theory-informed application of data science methods to analyze the quality of reflections made in a health professions education program over time. One thousand five hundred reflections written by a cohort of 369 dental students over 4 years of academic study were evaluated for an overall measure of reflection depth (No, Shallow, Deep) and the presence of six theoretically-indicated elements of reflection quality (Description, Analysis, Feeling, Perspective, Evaluation, Outcome). Machine learning models were then built to automatically detect these qualities based on linguistic features in the reflections. Results showed a dramatic increase from No to Shallow reflections from the start to end of year one (20%  →  66%), but only a limited gradual rise in Deep reflections across all four years (2%  →  26%). The presence of all six reflection elements increased over time, but inclusion of Feelings and Analysis remained relatively low even at the end of year four (found in 44% and 60% of reflections respectively). Models were able to reliably detect the presence of Description (κ_TEST = 0.70) and Evaluation (κ_TEST = 0.65) in reflections; models to detect the presence of Analysis (κ_TEST = 0.50), Feelings (κ_TEST = 0.54), and Perspectives (κ_TEST = 0.53) showed moderate performance; the model to detect Outcomes suffered from overfitting (κ_TRAIN = 0.90, κ_TEST = 0.53). A classifier for overall depth built on the reflection elements showed moderate performance across all time periods (κ_TEST > 0.60) but relied almost exclusively on the presence of Description. Implications for the conceptualization of reflection quality and providing personalized learning support to help students develop reflective skills are discussed.

Reflections of psychomotor skill development in preclinical simulation: A qualitative analysis

INTRODUCTION

Reflection on competency helps students become more proficient in performing skills, with the ultimate goal of better retention of knowledge and skill. Competency progression involves a complex interplay of factors, and not having the insight of such multiple perspectives of the same experience, we will not be able to understand students as learners fully and consequently may rely on assumption and may not be able to provide the necessary interventions for growth and progress towards competency. This study aims to investigate students' insight of their own progression during psychomotor skill development.

MATERIALS AND METHODS

Data were obtained from scanned reflective dialogue log document portfolios from the preclinical fixed dental prosthodontics section, which is part of a comprehensive dental care course during the second year. Data were coded using NVivo software version 12 plus (QSR International Pty Ltd, Vic, Australia), and subsequent thematic analyses identified emerging themes.

RESULTS

Three themes emerged and these were (a) challenges to overcome, (b) feed-back and self-appraisal, and (c) progress and growth. The qualitative data generated did not reveal considerable variation in the students' reflections, and the three themes seem to interrelate.

CONCLUSIONS

The main challenge was the concept of the single path of insertion and the perception that it was a source of frustration during this course. Self-appraisal identified time management issues and the transformation from preconceived or learned concepts. As the semester progressed, students reflected progress and growth.

Effect of self-assessment in a removable prosthodontics preclinical course on skills and competence

PURPOSE

Self-assessment is increasingly implemented in medical professions' curricula. In this research, the authors measure the effects of self-assessment within a preclinical removable prosthodontics course among dental students in a private dental school according to the European qualifications framework descriptors.

MATERIALS AND METHODS

Thirty subjects, all fourth-year dental students, were included in this experiment. Fifteen subjects were included in each of the experimental and control groups during one semester. The experimental group subjects used the study roadmap tool in their preclinical tasks. The control group subjects executed the same preclinical tasks under instructor supervision only. All subjects were filmed, and an autonomy score was given to every subject per session. At the end of the semester, cognitive skills development was compared using the Kember et al. questionnaire while practical skills development was compared using a comparison of grades. Two focus groups were undertaken with experimental group subjects. Qualitative and quantitative data were collected and statistically analyzed (p < 0.005).

RESULTS

Subjects from the experimental group showed development in critical thinking, practical skills, autonomy, and taking responsibility, thus development in the competence level.

CONCLUSION

Implementation of self-assessment within preclinical courses may develop skills and competence among dental students, yet more studies are needed.

Reflective writing in dental education to improve critical thinking and learning: A systematic review

The Commission on Dental Accreditations states that "graduates must be competent in the use of critical thinking and problem-solving." With this in mind, dental education programs continually strive to enhance and deepen these skills by incorporating effective instructional strategies into the curriculum. To do this, predoctoral dental education has used a variety of techniques including problem-based learning, OSCEs, and standardized patient activities. Another technique, while less popular but potentially more effective if done well, is reflective writing. This study aimed to assess the effect of reflective writing on students' critical thinking skills and learning in dental education programs. Two database searches conducted between 2000 and 2019 resulted in 317 articles after the initial screening. Ultimately, 13 articles met inclusion criteria. The following recurring factors were identified for inclusion in dental education reflective writing initiative: reflective writing interventions, reflective writing instructions, writing prompts, evaluation frameworks, and negative perceptions of reflective writing. In answering the key aim of this review, 12 of the 13 studies determined that reflective writing had a positive impact on students' critical thinking, judgment, and/or learning. Key findings included positive effects on student growth in reflection, learning through reflective writing, reflection skills, self-assessment, critical thinking, clinical reasoning, problem solving, and motivation to change after evaluated experiences. The review indicated that dental education programs, which implemented reflective writing as an assessment tool within the curriculum as a means of developing and deepening critical thinking skills and learning were by and large successful in this effort.

Preparing dental students for independent practice: a scoping review of methods and trends in undergraduate clinical skills teaching in the UK and Ireland

Introduction The governing bodies for dentistry in the UK and Ireland require dentists, at graduation, to possess the knowledge, skills and attributes which enable them to practise safely, without supervision. The means by which dental schools achieve this may differ and may undergo modification in response to changes in the expectations of governing bodies and challenges within the teaching environment. It is therefore important to identify which of these approaches works well and to disseminate good practice described in the literature.Objectives To use a scoping review to identify from the published literature the methods used to teach clinical dental skills, including innovations, motivations for changes, and factors affecting the delivery and quality of teaching.Method Scoping review methodology was used to select and analyse 57 articles published between 2008 and 2018.Results Innovations in didactic teaching were facilitated by advances in IT and development of virtual learning environments, which promoted independent, self-directed learning. Pre-clinical practical teaching took place in clinical techniques laboratories utilising mannequin heads, with a minority of dental schools using virtual reality simulators in addition. Clinical experience was gained mainly in multi-disciplinary clinics and offsite outreach teaching centres. Insufficient numbers of suitable patients, increasing student numbers and a fall in teaching staff contributed to a reported reduction in clinical experience of certain treatments.Conclusions Contemporary clinical dental skills teaching produces new graduates who possess excellent theoretical knowledge, are prepared and confident in basic clinical skills, but are lacking in experience of complex treatments which may result in a reduced preparedness for independent practice.

Bespoke video vignettes - an approach to enhancing reflective learning developed by dental undergraduates and their clinical teachers

This study explores the selective use of video as a medium to support reflective processes as related to dental undergraduate learning. With the objective of developing and enhancing high-quality adult dental care, the use of compiled video materials created in an undergraduate clinical setting was investigated. Video cameras were used to capture elements of reflection-in-action and reflection-on-action typically found during everyday clinical practice. 'Gold standard' or 'textbook outcomes' are rarely, if ever, fully achieved in dental practice. Real-life clinical experiences offer challenges and opportunities for both teachers and students to engage with reflective learning processes. The materials generated allowed for an experience of individual reflective learning and the creation of a data bank or archive with potential use for the benefit of a wider student cohort. Various aspects of the students' views and comments on the process of reflection were reported and explored by means of a semi-structured focus group moderated by a linked educational advisor.

The evaluation of reflective learning from the nursing student's point of view: A mixed method approach

BACKGROUND

Adapting university programmes to European Higher Education Area criteria has required substantial changes in curricula and teaching methodologies. Reflective learning (RL) has attracted growing interest and occupies an important place in the scientific literature on theoretical and methodological aspects of university instruction. However, fewer studies have focused on evaluating the RL methodology from the point of view of nursing students.

OBJECTIVES

To assess nursing students' perceptions of the usefulness and challenges of RL methodology.

DESIGN

Mixed method design, using a cross-sectional questionnaire and focus group discussion.

METHODS

The research was conducted via self-reported reflective learning questionnaire complemented by focus group discussion.

RESULTS

Students provided a positive overall evaluation of RL, highlighting the method's capacity to help them better understand themselves, engage in self-reflection about the learning process, optimize their strengths and discover additional training needs, along with searching for continuous improvement. Nonetheless, RL does not help them as much to plan their learning or identify areas of weakness or needed improvement in knowledge, skills and attitudes. Among the difficulties or challenges, students reported low motivation and lack of familiarity with this type of learning, along with concerns about the privacy of their reflective journals and about the grading criteria.

CONCLUSIONS

In general, students evaluated RL positively. The results suggest areas of needed improvement related to unfamiliarity with the methodology, ethical aspects of developing a reflective journal and the need for clear evaluation criteria.

Using discussion groups as a strategy for postgraduate implant dentistry students to reflect

INTRODUCTION

More than undergraduates, postgraduate students have the day-to-day clinical experience to reflect upon. Nevertheless, reflection in postgraduate dental education is less well studied. Hence, the purpose was to investigate the attitude towards reflection and the content of reflections in postgraduate implant dentistry education in the UK and Belgium.

MATERIALS AND METHODS

To investigate the attitude towards reflection, a questionnaire was administered to the 10 postgraduates at UCL Eastman Dental Institute (EDI) and 6 postgraduates at Ghent University (UGent). Additionally, students were invited to attend two reflective sessions (60-90 minutes). The sessions' audio recordings were transcribed and analysed using a thematic approach.

RESULTS

In total, 16 postgraduate implant dentistry students participated. Although the majority reported prior experience with reflection, there was variation in the provided definitions of reflection. EDI students agreed with reflection being beneficial for professional development/clinical reasoning and were positive about discussing clinical experiences in groups, but were divided about individual/group reflections. Their UGent counterparts were more indecisive (=neutral), but were positive about discussing clinical experiences. Thematic analysis identified recurring themes as individual learning process, learning and clinical experiences, attitude towards implant dentistry and course programme. EDI postgraduates' reflections focussed on specific clinical situations, while UGent postgraduates' reflections described general considerations.

CONCLUSION

Although students/professionals often report to reflect, it is not clear whether/how they actually reflect, due to the all-purpose word reflection has become. A strategy, using group discussions along with supervision/guidance in how to reflect, demonstrated to expand clinical reasoning into reflections about postgraduate students' clinical actions and professional growth.

Dental students' reflective habits: is there a relation with their academic achievements?

INTRODUCTION

Reflection is regarded as an important and essential component of healthcare professionals' education and practice. This cross-sectional study aimed to explore the levels of reflection habits of dental students and clinical and PhD postgraduate trainees and to establish the relationship between students' reflection and their academic performance.

MATERIALS AND METHODS

A total of 324 subjects (208 females, 56% ≥23 years of age) from King's College London Dental Institute, consisting of 281 undergraduate and 43 postgraduate trainees, responded to the invitation to participate and completed an online self-reported Reflection Questionnaire; this assesses two levels of non-reflective actions (Habitual Action and Understanding) and two levels of reflective actions (Reflection and Critical Reflection). Reflection results were compared amongst different cohorts and correlated with students' academic performance.

RESULTS

Reflection Questionnaire mean scores were 10.7 for Habitual Action, 17.3 for Understanding, 17.0 for Reflection and 14.4 for Critical Reflection, with significant differences between cohorts of undergraduate students, clinical postgraduates and PhD trainees. Reflection and Critical Reflection mean scores were higher as students climbed courses. Further, those ≥24 years of age and those with previous university degrees demonstrated higher reflective habits, whilst there was no gender difference. Additionally, the assessment programme methods correlated differently to the Reflection Questionnaire scores.

DISCUSSION

The Reflection Questionnaire's internal reliability was acceptable. The most common approaches used by both students and trainees were Understanding and Reflection, whilst those with high Understanding scores also tended to have good Reflective scores. Further, multiple choice questions encouraged students to 'understand', whilst ill-defined problems, such as those from essays to clinical reasoning cases, increased this to the reflection scale.

CONCLUSION

To foster reflective thinking, tutoring should primarily be focused on younger students (≤23 years old) and those without a previous university degree. Further, a wide variety of assessment methods is suggested to stimulate different reflective constructs.

Assessing short and long-term educational impact of visits to hospice via a combination of qualitative methods

While qualitative methods have gained considerable recognition in medical education research, employing multiple qualitative data sources in assessing long-term educational impact is rare. Utilising in-depth data analysis method to six cross-sectional cohorts (2004-2009) of students' reflection papers (n = 213), this article demonstrates how students experienced subtle but important shifts in their attitudes (including personal, professional and spiritual domains) after making field visits to a hospice centre as part of the Special Needs Dentistry module. For retrospective assessment of learning retention, a pilot focus group was conducted with three junior faculty members who participated in the field visits to a hospice during their own undergraduate training. A subsequent focus group was conducted with graduates of the 2008 (n = 8) cohort using a refined discussion guide arising from the analysis of pilot group results. Graduates were unanimous in stating that the visits had sown 'seeds' in their minds and hearts, seeds which started to grow after they completed dental school and began to practice. This is demonstrative of the long-term positive educational impact of the pedagogical design that entailed a special site visit coupled with post-visit debrief and written reflection.

Exploring motivational interviewing and its philosophical alignment to an undergraduate behavioural science programme in dentistry

Motivational interviewing (MI) is a client-centred, directive, therapeutic approach that enhances clients' readiness to change by exploring their ambivalence about doing so, thus increasing their motivation to change, and by helping them to commit to the process of change. MI is now being applied to dentistry in the area of oral health e.g. smoking cessation and the prevention of early childhood caries. This aligns dentistry with other healthcare professions in their focus on utilising MI to bring about behavioural change. This paper focuses on how the profession of dentistry would benefit from examining how to integrate MI both in undergraduate teaching and practice. Currently the teaching focus in relation to MI has centred on the theoretical content and less on underlying philosophy. This paper explores how a teaching philosophy, as delivered in the behavioural science programme in the School of Dentistry, University College Cork, Ireland, can provide a framework for teaching MI. Key components within this teaching philosophy are: teaching for understanding, developing reflective practice and student-centred teaching.

First reflections: third-year dentistry students' introduction to reflective practice

INTRODUCTION

To develop both professionally and personally, health professionals need to build essential skills in reflective practice. Educators generally agree that these skills should be developed as part of curricula for health professional students. The aims were to introduce reflective practice to third-year dentistry students and to evaluate the students' self-perceived reflective skills before and after their reflective activities.

MATERIALS AND METHODS

Using a written questionnaire, third-year dentistry students' perceptions of reflective practice were gathered before and after their first clinic placement. Students also completed two reflective writing pieces about their clinical placements.

RESULTS

The students' reflective writing pieces were allocated into one of the three categories: non-reflector, reflector and critical reflector. Content analysis of students' perceptions of reflective practice revealed nine themes. Eight main themes emerged from students' suggestions for improving their reflective abilities.

DISCUSSION AND CONCLUSION

Issues around the assessment of reflective writing are discussed, and students' suggestions for improving their reflective abilities are presented.

The influence of reflection on portfolio learning in undergraduate dental education

INTRODUCTION

Disparity exists between the growing consensus about the positive effects of reflection on performance and the scarcity of empirical evidence demonstrating this effect. Portfolios are considered a useful instrument to assess and supervise competence-based education and to stimulate reflection. The present study describes the introduction of a portfolio in a social dentistry and oral health promotion course and investigates student reflection as a predictor for the acquisition of the other competences in the course.

METHODS

Fourth year undergraduate dental students (n = 110) in the course 'Society and Health' between 2008 and 2011 collected evidence in their portfolios, demonstrating the acquisition of five competences: the ability to (1) assess the oral health profile of a target group; (2) integrate theoretical models in health promotion; (3) search for and apply scientific evidence; (4) work trans-, multi- and/or trans-disciplinarily; (5) reflect on personal development. Linear regression analysis was used to investigate the predictive value of reflection on the other course related competences.

RESULTS

Reflection scores proved to significantly predict other course-related competences, when analysing all students between 2008 and 2011 and for each year separately, explaining between 10.7% and 25.5% of the variance in the other competences.

CONCLUSION

Undergraduate dental students' competences related to social dentistry and oral health promotion were significantly predicted by the reflection scores obtained in a portfolio-based context. In line with the growing consensus about the benefits of reflection for dental students and professionals, results suggest the value to further develop the integration of reflection in dental education and practice.

Perspectives on being a mentor for undergraduate dental students

As part of the new study programme in Dentistry, an obligatory mentor programme was introduced during autumn 2005 for all student dentists at Karolinska Institutet, Sweden. The aim of the programme is to provide support and guidance for the students in their professional role as dentists. All mentors in the programme are licenced dentists and lecturers at the Department of Dental Medicine. The mentors follow three to five mentees throughout the entire 5 year programme. This study aims to evaluate the programme from the mentors' perspective and to explore the perceived effects of being a mentor. Following an exploratory focus group, questionnaires were distributed to all mentors (n = 66, response rate 83%). The results of the evaluation of the programme show that being a mentor is perceived to be rewarding in many different ways, including an increased understanding of the students' situation and some professional development as a teacher.

Oral health students' perceptions of clinical reflective learning--relevance to their development as evolving professionals

CONTEXT

A clinical professional should be a reflective practitioner, however reflective learning and deliberate clinical reflections have not traditionally featured in dentistry or dental hygiene programs. To the authors' knowledge, there are no studies exploring the perceptions of oral health students to reflective learning and clinical reflective practices.

AIM

This study determined student perceptions of clinical reflective learning and its relevance to their clinical and professional development.

METHODS

Reflective learning was embedded as a topic in the curriculum of the University of Queensland Bachelor of Oral Health program, within the discipline of dental hygiene practice. Reflective practices were integrated with clinical practice, and were linked with assessment requirements. Students' perceptions of clinical reflective learning were obtained via quantitative and qualitative analyses of sequenced questionnaires. Computer-assisted thematic analyses of the students' reflective journals, reflective essays and summary notes from in-class group discussions validated students' perceptions.

RESULTS

Students (n = 17) perceived clinical reflective learning as relevant, and useful for consolidating their clinical learning and accelerating their professional development. In particular, students gained insights about their strengths and weaknesses, thought more deeply about what they were doing in the clinic, and unpacked difficult concepts.

CONCLUSION

Students views of clinical reflective learning in this program were positive. They believed that the deliberate reflective process assisted their clinical learning and professional development.

The development of an ePortfolio for life-long reflective learning and auditable professional certification

Recent legislative changes, that affect all healthcare practitioners in New Zealand, have resulted in mandatory audits of practitioners who are now required to provide evidence of competence and continued professional development in the form of a professional portfolio. These changes were the motivation for our development of an electronic portfolio (ePortfolio) suitable for both undergraduate and life-long learning. Bachelor of Oral Health (BOH) students, studying to qualify as Dental Hygienists and Dental Therapists, and BOH teaching staff (who held registrations in Dental Hygiene, Dental Therapy and Dentistry) trialled the use of a personal ePortfolio for advancing their academic and professional development. The ePortfolio enables BOH students to collect evidence of their achievements and personal reflections throughout their 3 years of undergraduate study, culminating in registration and the award of an Annual Practising Certificate (APC). The ePortfolio was designed to allow users to store information and then select appropriate material to be displayed or published, thus assisting health practitioners to present high-quality evidence of their participation and achievements, and to meet the professional requirements for their APC.