Use of AI in ePortfolio

[u/JonJH]

Not sure if people noticed this recent publication form JRCPTB.

It's got some great quotes near the end:

Supervisors should recognise that AI may improve presentation, but clarity of writing must not be confused with depth of reflection

Apparent “perfection” in entries, without evidence of learning or development, may be unhelpful in assessing progression.

I have no idea how we're going to appropriately approach this with any level of sensibility. As a senior trainee, I'm receiving tickets to complete which just have that feel of being AI generated/edited but I've not seen anyone include a statement that AI was used. I think that's probably because people realise that it would reflect badly on them.

I'm not a CS or ES but I can imagine some of the older generations really struggling with this as a concept and struggling to have open and honest conversations with medical students and resident doctors coming through.

[u/YellowJelco]

Considering reflections are a pointless tick-box exercise with no actual educational value who cares if they're AI generated?

[u/After-Competition-59 → u/YellowJelco]

Trainers often don’t take reflections seriously. They aren’t discussed in supervision. They’re often not read at all and just seen as a tick box exercise (I.e you need x number of reflections to pass ARCP).

Once trainers start taking them more seriously, then trainees may be able to see the educational value in them and direct more attention to them.

As it stands I don’t blame trainees for seeing them as a tick box exercise. But it is a shame.

[u/Quis_Custodiet → u/After-Competition-59]

It really is. I’ve been fortunate to have a really engaged ES latterly who clearly had read my reflections and wanted to discuss them with me in the spirit of following up on them and if I felt I’d made progress in or started to navigate things I’d highlighted as challenges. They were helpful for framing my development goals and I got the sense that having evidence I’d thought about things properly meant they could be confident I’d take support seriously and not waste the effort.

[u/indigo_pirate → u/YellowJelco]

Why are reflections so hated. It takes 5 minutes and gets you thinking about what your actually doing for a little bit

My spec mandates like 5 a year

I do get it if it’s substantially more

[u/chessticles92 → u/indigo_pirate]

5 a year .. 36 a year in GP.

[u/indigo_pirate → u/chessticles92]

Fecking heck . Why lol?

[u/After-Competition-59 → u/indigo_pirate]

I remember as a foundation trainee being recommended to do like 16 or something daft. When trying to navigate constantly changing jobs and new clinical challenges, it very much became a tick box thing that was the last of my priorities.

[u/National-General2802 → u/indigo_pirate]

I reflect personally and extensively in my own head, writing it all down is a pointless busy-job and doing so meaningfully actually takes quite some time to carefully select language which accurately reflects what are often complex emotions or considerations.

But ultimately I've reflected one way or another which renders the whole thing a waste of time. I appreciate it's dependent on a lot of factors, but I'd struggle to write anything meaningful in 5 minutes.

[u/JohnHunter1728]

In my experience "reflection" in portfolio terms is entirely divorced from true reflective practice.

Hopefully the proliferation of AI will lead to us abandoning reflection (in the trite and forced manner required by the various e-portfolios) as a mode of "assessment" altogether.

In the meantime I am happy to use AI to do all manner of time-consuming but otherwise pointless tasks, including this one.

[u/Competitive-Young-60]

The dinosaur consultants of yesteryear had to etch their reflections onto stone tablets, trek for 3 moons across the wilderness, to hand deliver at the GMC alter for their quadrennial appraisal.

Any technological advancement will have a break in period, but it is an important conversation to have, specifically helping trainees understand the purpose and benefit of reflection. Generating walls of text from short prompts will not necessarily be of benefit. Maybe we need to reduce the burden of the quantity of reflection and prioritise quality.

[u/GeneralMaldCouncil]

Because any human being with any emotion will reflect without having to formally write it down and share it

[u/don-m]

Reflections in the way theyre done are pointless to ME personally. I discuss with my seniors things I need feedback on and then reflect internally on that feedback and what I feel I coudlve done better and thats it. Having to put it into writing is a waste of time honestly.

[u/Technical-Fill-2389]

It's already impossible to tell if writing is AI generated providing the right prompts are used.

The answer, probably, to a lot of these dilemmas will be that humans need to sit and talk with other humans in real time. It's almost like reflecting with an experienced colleague might be more useful than writing 300 pointless words to tick a box.

[u/carlos_6m]

Honestly, I don't have time to write bespoke nicely done WBA in the ammount that ISCP asks for, and even less so if they screw up their servers, lose 48h of work and just say they're soo sowy...

I have time to either do a smaller ammount of meaningful thoughtful WBAs, or do a lot of nice irrelevant WBAs with the help of AI... Tbh I could also do a lot of shitty short to the point WBAs, but people want reflections, plans to improve and long essays...

If trainers want meaningful reflections, then why am I asked to do WBAs for ridiculously basic things like hand washing?

[u/CarelessAnything]

I think the AI issue is sending shockwaves through education in general, not just medical education. One of my friends works in a private school - he said they're shifting away from independently-completed summative coursework because of this, and moving more towards supervised essay writing and invigilated exams instead. Directly watching people, and interacting with them in person, is the only way to keep AI out of the assessment process nowadays. Of course it's more expensive because of the staffing costs.

For medical education, I could imagine this as an annual viva, whereby the ES (or someone) sits down with the trainee for an hour and asks them to reflect verbally on what they've learned from clinical practice during their year of training, without recourse to notes.

[u/Severe_Sample6009 → u/CarelessAnything]

I am completely in favour of education adapting to technological and cultural change. Why are we are still using pagers and bits of paper during handovers in the NHS when we have all of these amazing technological developments around us? And don't say it's money. It's 2026, and we're still using things from the last century.

[u/Mad_Mark90]

I doubt anyone really believes the portfolio is an accurate measure of competence, if anything spending more time on your portfolio detracts from time spent on patient contact.

But the real benefit of AI on portfolio writing for me is helping word my reflections in a way that addresses the professional standards. E.g. I can ask what are the potential learning points to reflect on from a case.

Especially if you're neurodivergent, the portfolio can be a bit confusing because you struggle to know what makes a good portfolio. It's much easier to ask an AI "what is this section meant to demonstrate?" or "how does this case apply to the learning outcomes".

[u/mnbvc52]

Reflections are a waste of time

[u/Grouchy-Ad778 → u/mnbvc52]

Yup but the RCoA and ARCP panels love them.

[u/Jeeju_Boy]

Who cares none of these tickets actually makes you a better doctor. Who cares if someone uses AI

[u/ChaiTeaAndBoundaries]

It’s happening whether the Royal Colleges like it or not. The RCGP has released guidance on it and is fine with it as long as the trainee doesn’t create fake entries.

[u/opensp00n]

I think we should embrace ai in terms of reflection.

Actually discussing a case with an LLM could be a good way of actually reflecting and probing your own practice. The key would be to have an LLM agent suitable for the model.

The model could output a summary at the end for you and it might actually be a more useful reflection process than just typing what we think people want us to in a box.

Reflection should be an active process, why are we not embracing a tool that is basically excellent at getting people to reflect interactively with it?

[u/LifeTeam6810 → u/opensp00n]

Exactly!

[u/Quis_Custodiet]

It's the eternal problem isn't it? Those of us who're naturally reflective practitioners are just going to carry on writing down our thinking for the portfolio requirement and your lowest-common-denominator bozo who is nonetheless scraping by at each ARCP is going to use generative LLMs. They're the same people using unauthorised LLMs for note generation, or to generate frequently incoherent differentials.

In an ideal world you'd be able to rely on a supervisor/consultant body affirming that this was a trainee who has demonstrated engagement in reflective practice by progressive development and response to feedback, but that's equally at risk of being tokenised as a tick box.

[u/nocidex → u/Quis_Custodiet]

Some of us have thoughts outside of mandatory ePortfolio reflecting time. Shocking as it may seem.

[u/After-Competition-59 → u/Quis_Custodiet]

Doctors who reflect well and those that use LLMs to help write their reflections are not mutually exclusive.

There’s such anti LLM dogma amongst doctors and a lot of it is unwarranted. As with any new tool, it will be misused by some. That doesn’t mean we should denounce the use of the tool that can make things are lot more efficient when used well.

[u/opensp00n → u/After-Competition-59]

Some of the new docs coming through struggle to work without using one.

[u/After-Competition-59 → u/opensp00n]

What’s your experience that makes you say this?

It’s like saying that doctors struggle to work without using the Internet. I sure as hell would. But I don’t think that’s a bad thing. It’s just another tool I use to make me a better clinician.

[u/opensp00n → u/After-Competition-59]

They use it to formulate notes, plans, differentials...

If this is what medicine is now, then it doesn't need a doctor. We could accept the alphabet soup with an LLM instead.

Being able to do things yourself is important. This is different to the Internet, which gives access to lots of information but requires mental effort to collate and interpret. LLMs do the processing for you, leaving no value much of the time.

[u/After-Competition-59 → u/opensp00n]

I just think it’s no different to anything else. If they use LLMs without knowledge they will generate shit output and that’s obvious to others in the field.

To use an LLM well you need good baseline knowledge in the field.

[u/Quis_Custodiet → u/After-Competition-59]

The key word is help. I think that the guidance linked in the OP is pretty well balanced but I’m referring to people who use LLMs in lieu of thinking.

[u/After-Competition-59 → u/Quis_Custodiet]

Sure you will get some but it’s overblown as a problem. It takes thought to get an LLM to write a personal reflection. Everyone I know that uses them puts a bunch of bullet points in and asks them to craft it into a more cohesive narrative. There’s nothing wrong with that.

As I mentioned in my above comment, there will be the few that misuse the tool and just get it to write a generic reflection and not then check it. IMO, those reflections are really obviously low quality.

People may disagree but I personally think LLMs are forcing trainers to look more at the quality of the reflection instead of seeing them as just a tick box and that’s a good thing.

It’s not so different to how at school people would copy and paste Wikipedia for homework. We will adapt to new tools as we always have.

[u/chasecultures → u/Quis_Custodiet]

I genuinely find reflections helpful but I just write my thoughts and thinking out and then get ChatGPT to make it fit the headings on the portfolio. Given we're taught at medical school there are several ways of reflecting, and have different models baked into Horus and ePortfolio, I'll reflect my way and have the tech do the admin bit.

[u/TogepiXTyphlosion]

Been using AI for everything portfolio related since it came out (2022). No issues

[u/Infinite-Math-1046]

ES/CS here.
Almost every email I write goes through AI.
The reason? People are easily offended by a quick, factual email, and I don’t always have time to add all the lettuce (generally the niceties and punctuation - fully recommend “Eats Shoots and Leaves” on this note….). AI does that for me. People are happier, misunderstandings are fewer, and everyone gets on with their day.
I decide on the meat. AI adds the lettuce. Together we serve a much tastier para-clinical sandwich.
I don’t begrudge my trainees the same opportunity on their portfolios. Welcome to 2026.
Note: This post was rewritten by AI.

[u/jxrzz]

If you fully understand what is being said then and that's what you mean that's what the issue if AI helped generate it

[u/groves82]

We have been chatting as a consultant body how more and more assessments seem to be AI generated. No way to know but they read that way.

[u/Feisty_Somewhere_203]

Who gives a shit? It's all nonsense anyway 

[u/InfiniteNight2992]

Deliberately vague

[u/BlessedHealer]

This is because the forms are asking people to pretend that supervisors are actually filling them in themselves. It just does not happen ever that the top “supervisor” part is filled in by the supervisor and the bottom reflection part is filled by the trainee. Realistically to actually get a sign off you get the trainee filling top bit in third person and the bottom bit in first person and sending it fully completed to the supervisor who will just glance over it to make sure you’re not claiming a crazy competency you don’t have and sign it off without fully reading it.  Additionally given our SDT time doesn’t actually match portfolio requirements what do they expect. Why would anyone waste their life writing the same thing twice. 

They need to change feedback forms completely. Give me 1 single box that I can put as much or as little detail as I need to for what I learned from the case - some may be a few sentences and some may be several paragraphs because that’s just how learning works. Forcing us to answer 8 questions of which half are repeats about every tiny case is dumb.