Development of a portfolio of learning for postgraduate family medicine training in South Africa: a Delphi study

A workshop held at the WONCA Africa Regional Conference in 2009 explored the purpose and broad contents of the portfolio. The 85 training outcomes, ideas from the WONCA workshop, the literature, and existing portfolios in the various universities were used to develop a questionnaire that was tested for content validity by a panel of 31 experts in family medicine in South Africa, via the Delphi technique in four rounds. Eighty five content items (national learning outcomes) and 27 principles were tested. Consensus was defined as 70% agreement. For those items that the panel thought should be included, they were also asked how to provide evidence for the specific item in the portfolio, and how to assess that evidence.Consensus was reached on 61 of the 85 national learning outcomes. The panel recommended that 50 be assessed by the portfolio and 11 should not be. No consensus could be reached on the remaining 24 outcomes and these were also omitted from the portfolio. The panel recommended that various types of evidence be included in the portfolio. The panel supported 26 of the 27 principles, but could not reach consensus on whether the portfolio should reflect on the relationship between the supervisor and registrar.A portfolio was developed and distributed to the eight departments of Family Medicine in South Africa, and the CMSA, to be further tested in implementation.The National Health Act of South Africa (Act 61 of 2003) identifies the District Health System as the context for 90% of all state health delivery [1]. Within each of the 52 health districts in the country, the family physician is recognized as the person who is primarily responsible for clinical governance. The family physician is seen as the clinical leader of a multi-professional district health team (including nurses, doctors, allied health professions, pharmacists, radiographers, home based carers, and managers). It is expected that family physicians will be competent to meet 90% of the health need