“Reflection” Student Created E-Portfolios in Respiratory Care

A Review of the Literature

By: Jessica Hudnall BS, RRT

EDLD 5315 Lamar University


Establishing a program, where students are capable of creating e-portfolios for authentic learning, as well as, structured learning in and out of the classroom will allow them to take control of the way they learn, but also have the capability to receive information that is needed per the curriculum.  Also, allowing them to reflect on what they have created, learned, and the feedback they have received from their instructors in and out of the classroom. Unlike most public schools, colleges, and universities in health care programs are accredited not only under their college or university accrediting body but their field; respiratory care is placed under Commission on Accreditation of Respiratory Care (COARC).  The COARC requires administration and instructors to abide by their standards to provide adequate clinical and classroom knowledge to students that want to become respiratory therapists (COARC, 2019). Students are either in the classroom setting receiving a face-to-face lecture or in clinical or lab completing required competencies. Little has been found in regards to creating e-portfolios for authentic learning.

Therefore, respiratory care students have been very limited when using their authentic voice, creating projects, presentations, and participating in online learning due to the limited knowledge of how to incorporate into the health careers field. This raises the question does the use of student created e-portfolios, in higher education by respiratory care students provide reflection from semester to semester to help retain course and clinical information, and provide as a study guide for exams, provide a source to prospective employers as a resume?

Implementing eportfolios into Angelina College’s Respiratory Care Program will require research to analyze the effectiveness of the overall outcome. Qualitative data will be collected from past, current students, and faculty after the end of the Spring Semester via face-to-face interviews, google surveys, as well as, course evaluations. Data received will be entered and analyzed via google sheets or microsoft excel.

                E-Portfolios in Education

E-portfolios? They are descendants of the reflective print portfolios, that were established in many higher-education english, teacher programs, and not long after sparked interested in other disciplines between the 1980-90s. They were meant as a metacognition, reflective practice, and self-critique and sometimes to demonstrate achievements for students learning outcomes (Kahn, 2019). Educational programs have been using these for many years before, having the ability to access the internet as a platform to house this information as an on-going record. Today, they are works and reflections on what students are learning and experiencing. Outcomes are critical thinking, integrative learning, and ethical reasoning (Kahn, 2014).  As Fitch et al stated (2008), are becoming more popular due to the fact they proved a “content management system” that can collect, reflect, and share outcomes as well as other digital documents (Berlin, Langlois, Guevara, & Schuurman, 2012).

        Authentic Learning & Feedback for Respiratory Care Students

Attraction to e-portfolios begins with authentic learning in students work.  Buzzetto-More (2010) states, they authentically capture students’ ongoing progress and highlight their involvement and goals. Therefore, Darling-Hammond  & Snyder (2000) argues, Authentic tasks present firsthand materials for students to try out new concepts and skills and even to critique existing knowledge (Lim, Tai, & Yang 2016).  The REFLECT Initiative believes keeping learner portfolios’ separate from the assessment management system will provide ownership and engagement. This way they will feel in control of the process and their learning of the portfolio. It will also, provide them their authentic voice. Allowing students to create their own e-portfolios, reading reflections, and having the access to add multimedia (Barrett, 2007).

What is feedback? According to Nicol, (2010) it is a complex phenomenon that will help improve students through reflection and prepare them for the future past college. Failure to address feedback for healthcare students could not only be life threatening, but could affect the patient a student is treating directly addressed, Hopwood, Pearce, and Price (2000) (Murray, Peacock, & Scott, 2011).   A study conducted with medical interns in Sydney Medical Program were asked questions regarding feedback that was given to them post study from medical professions on their assessing skills on their e-portfolios. One student stated, it is a great idea to get feedback on terms of final assessments. That way we know where we are at, where we are going, and where we need to be in our program. Assessments are such a variable based on where we are located at the time (Bleasel, Burgess, Haq, & Weeks, 2016). Feedback is a key issue when always addressing students clinically or didactically in health careers. According to a study performed by a health studies college in Australia, one physiotherapy student stated one of the best takeaways from establishing my e-portfolio is being able to self reflect on each topic and prepare for my future career (Bidewell & Eta., 2018). Feedback from instructors, peers, and faculty on students’ e-portfolios will help improve their upon their projects such as vlogs, blogs, presentations, and competencies.

Reflection on E-portfolios for Respiratory Care Students

Reflection is not only mental but effective, involving attitudes such as openness, curiosity, and readiness to reevaluate self and the world around themselves (Eynon, Gambino, Torok, 2014). Reflection is a key-component in student and instructor expectations or outcomes. Competence development is central basis that is closely linked to self- reflection and reflection for universities according to, Schon (1983) (Slepcevic-Zach & Stock, 2018). As stated by, Rees (2005) e-portfolios should become a source for the student to reflect on their performance, work, and or the impact it will have on the progress of their future (O’Sullivan. Eta. 2012). Reflection from semester to semester will help on going review of information to help them continue to perform at their utmost standards. According to Gikandi (2013) and Hawkes (2001), there has been a need to focus exclusively on reflective task and skills to produce appropriate practitioners that will be lifelong learners and teachers who will be able to keep up to date with the ever changing world of education (Roberts, 2018). One of the essays from the high-end scale provided from Alverno College’s mid-program portfolio assessment drew conclusions from her analytic ability in her field of English. She stated how analysis is natural to her, when given the chance to reflect on her learning experience and personalize the information she shines best. Through her work she is building connections and will help develop as a student (Rickards, Et Al. 2008). Therefore, having the access to an ongoing e-portfolio to help reflect on what are their importance in those settings or feedback of their work would improve patient and student outcomes.


Students begin to think of themselves as the teacher as they begin to internalize the role; they observe, analyze, develop and design a plan to improve themselves as a student (Rickards Et Al. 2008). Learning to reflect seems to be one of the hardest most challenging skills for a student to take on.  The study conducted in Australia health careers showed challenges as well. Another student stated how it was “daunting”, it was hard to evaluate and identify one's shortcomings and the causes behind them (Bidewell & Eta., 2018). A study conducted on reflection at Texas A&M University at Commerce secondary education Master Level program, revealed that from semester one to semester two that there was a heightened awareness as an educator. The study was put in place to try to persuade them to transition to e-portfolios. Even though they were aware as an educator that reflection was improved on e-portfolios they were not quite ready for the change to e-portfolios (Chambers, S. & Wickersham, L., 2007). One student at an undergraduate Hong Kong University, where a study was conducted stated since there were no actual requirements on our reflections, we wrote unauthentic reflections. She was not sure if they were actual learning since, they were given a template for their reflections (Lim, Tai, & Yang, 2016.)


In conclusion, e-portfolios provide authentic learning through creativity, voice and ownership. Students are allowed to create their own e-portfolios, establish their learning with creating how they present their materials through vlogs or blogs, presentations, or assignments. With authentic learning students will stay more engaged.

Feedback is one of the most important key sources in health careers. Instructors need to provide students with constructive feedback in order to provide adequate health career students, but also to save someone’s life. Being able to provide instructor, peer feedback on their student created portfolio will allow them a sense of ownership. If the student knows others are viewing their information online they are held more accountable to what is being accessed.

Reflection as a tool to view competencies from semester to semester, view past feedback, or assignments will help students progress each semester. Students tend to find it hard to self-reflect on their own assignments as it is hard to self criticize themselves. It helps students build connections on their learning. The development of e-portfolios should also, help build their skills in preparation for lifelong learning professional development tool (Barrett, 2007). Developing their tools in advance for a reflective piece, making modification based on their feedback provided would allow the students an ongoing professional e-portfolio.

E-portfolios have proven effective for many different disciplines in higher education. Education being the field having the most research resources available from many different aspects and across the world. As seen from, the research recently there has been information found in different fields and directly in the health careers field.

The research has showed no information in regards to respiratory therapy education in e-portfolios for reflection, feedback, or authentic learning. Therefore, the overall research showed little support for my research question.There has been a few articles found on research on implementation on e-portfolios in nursing, medical school or general health careers. The study will be focused on respiratory therapy education and developing e-portfolios for reflection.  

Therefore, now that the research questions have been approached  they will have to take on a whole new look at how the study will be conducted.  The study will still look at does the use of student created e-portfolios, in higher education by respiratory care students provide reflection from semester to semester to help retain course and clinical information, and provide as a study guide for exams, provide a source to prospective employers as a resume?

The study will continue to conduct the design in qualitative because the goal is to observe the problem by way of generating narrative. As well as, collect data from google surveys and interviews will be entered and analyzed via excel spreadsheets based on the information received back from present, past students, and faculty from May semesters.


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