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<?xml version="1.0"?>

<!DOCTYPE TEI.2 SYSTEM "base.dtd">




<title>Use of Portfolios in Medical Education</title></titleStmt>

<publicationStmt><distributor>BASE and Oxford Text Archive</distributor>


<availability><p>The British Academic Spoken English (BASE) corpus was developed at the

Universities of Warwick and Reading, under the directorship of Hilary Nesi

(Centre for English Language Teacher Education, Warwick) and Paul Thompson

(Department of Applied Linguistics, Reading), with funding from BALEAP,

EURALEX, the British Academy and the Arts and Humanities Research Board. The

original recordings are held at the Universities of Warwick and Reading, and

at the Oxford Text Archive and may be consulted by bona fide researchers

upon written application to any of the holding bodies.

The BASE corpus is freely available to researchers who agree to the

following conditions:</p>

<p>1. The recordings and transcriptions should not be modified in any


<p>2. The recordings and transcriptions should be used for research purposes

only; they should not be reproduced in teaching materials</p>

<p>3. The recordings and transcriptions should not be reproduced in full for

a wider audience/readership, although researchers are free to quote short

passages of text (up to 200 running words from any given speech event)</p>

<p>4. The corpus developers should be informed of all presentations or

publications arising from analysis of the corpus</p><p>

Researchers should acknowledge their use of the corpus using the following

form of words:

The recordings and transcriptions used in this study come from the British

Academic Spoken English (BASE) corpus, which was developed at the

Universities of Warwick and Reading under the directorship of Hilary Nesi

(Warwick) and Paul Thompson (Reading). Corpus development was assisted by

funding from the Universities of Warwick and Reading, BALEAP, EURALEX, the

British Academy and the Arts and Humanities Research Board. </p></availability>




<recording dur="00:29:56" n="5421">


<respStmt><name>BASE team</name>



<langUsage><language id="en">English</language>

<language id="it">Italian</language>



<person id="nf0362" role="main speaker" n="n" sex="f"><p>nf0362, main speaker, non-student, female</p></person>

<person id="nm0360" role="participant" n="n" sex="m"><p>nm0360, participant, non-student, male</p></person>

<person id="nf0361" role="participant" n="n" sex="f"><p>nf0361, participant, non-student, female</p></person>

<person id="nm0363" role="participant" n="n" sex="m"><p>nm0363, participant, non-student, male</p></person>

<person id="nm0364" role="participant" n="n" sex="m"><p>nm0364, participant, non-student, male</p></person>

<person id="nm0365" role="participant" n="n" sex="m"><p>nm0365, participant, non-student, male</p></person>

<person id="nm0366" role="participant" n="n" sex="m"><p>nm0366, participant, non-student, male</p></person>

<person id="nf0367" role="participant" n="n" sex="f"><p>nf0367, participant, non-student, female</p></person>

<personGrp id="ss" role="audience" size="m"><p>ss, audience, medium group </p></personGrp>

<personGrp id="sl" role="all" size="m"><p>sl, all, medium group</p></personGrp>

<personGrp role="speakers" size="10"><p>number of speakers: 10</p></personGrp>





<item n="speechevent">Lecture</item>

<item n="acaddept">Medicine</item>

<item n="acaddiv">ls</item>

<item n="partlevel">Staff</item>

<item n="module">unknown</item>




<u who="nm0360"><kinesic desc="projector is on showing slide" iterated="n"/> are we all ready to to get started <pause dur="0.5"/> <trunc>cou</trunc> could i just <pause dur="0.3"/> ask <gap reason="name" extent="1 word"/> just to come forward to the front just for a second if that's <pause dur="0.5"/> all right <pause dur="2.5"/> # could i just bring <gap reason="name" extent="1 word"/> to the front </u><u who="nf0361" trans="latching"> <gap reason="inaudible" extent="1 sec"/><event desc="walks to front" iterated="n"/> </u><pause dur="0.2"/> <u who="nm0360" trans="pause"> <gap reason="name" extent="2 words"/> is the secretary of our <pause dur="0.2"/> department and i just wanted to say a big thank you to <gap reason="name" extent="1 word"/> because <pause dur="0.8"/> without today it wouldn't have happened she's organized everything from you to be here <pause dur="0.4"/> the food <pause dur="0.3"/> the lunch <pause dur="0.3"/> the coffee <pause dur="0.3"/> just to say thank you very much we're <pause dur="0.2"/> <kinesic desc="applause" iterated="y" n="ss" dur="5"/> very grateful <pause dur="5.5"/> and thank you to everybody who's come today and <pause dur="0.4"/> # shared in the day <pause dur="0.5"/> particularly for representatives from both <gap reason="name" extent="1 word"/> and # <pause dur="0.5"/> <gap reason="name" extent="1 word"/> Universities <pause dur="0.4"/> we've been grateful for for the interaction and hopefully some <pause dur="0.3"/> collaborative initiatives <pause dur="0.5"/> will will come from today <pause dur="0.8"/> i want to introduce you to our last speaker <gap reason="name" extent="2 words"/> <pause dur="0.7"/> i said that a lot of wonderful work had come out of the academic training

scheme for G-P registrars <pause dur="0.4"/> <gap reason="name" extent="1 word"/> used to be <pause dur="0.3"/> an academic G-P registrar <pause dur="0.3"/> here at <gap reason="name" extent="1 word"/> <pause dur="0.3"/> but she's gone on to great <pause dur="0.2"/> greater things now and is a lecturer <pause dur="0.3"/> here in general practice within our undergraduate Department of General Practice <pause dur="0.6"/> but the project that she's been <pause dur="0.4"/> working on is <pause dur="0.2"/> personal development <pause dur="0.3"/> plans in the postgraduate side of <pause dur="0.5"/> of primary care <pause dur="0.4"/> and <pause dur="0.2"/> she's going to <trunc>sh</trunc> <pause dur="0.2"/> share that with us now <pause dur="0.4"/> thanks very much </u><u who="nf0362" trans="latching"> thanks <gap reason="name" extent="1 word"/> <pause dur="2.1"/> # <pause dur="0.2"/> normally when you give a lecture you usually <pause dur="0.2"/> check that people can hear okay but i think it's probably more important that <pause dur="0.2"/> people can actually see me over the lectern <pause dur="1.5"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> # as <gap reason="name" extent="1 word"/> said i used to be <gap reason="name" extent="1 word"/> <pause dur="0.7"/> but <gap reason="name" extent="1 word"/> employ far better looking registrars <pause dur="0.6"/> than <gap reason="name" extent="1 word"/> <pause dur="0.6"/> and # i came here as an academic G-P registrar <pause dur="0.4"/> # it's probably about a year ago eighteen months ago now <pause dur="0.7"/> and was very interested in

education <pause dur="0.8"/> especially for postgraduates <pause dur="0.5"/> and looked very much into personal development plans for G-Ps <pause dur="0.3"/> in the area and that's where my sort of <pause dur="0.5"/> area of research lay <pause dur="1.0"/> # <pause dur="0.2"/> i was very aware when i was asked to talk that A this was an <trunc>u</trunc> undergraduate <pause dur="0.5"/> research symposium <pause dur="0.4"/> # and that not everybody here would be a G-P <pause dur="0.3"/> and i didn't know how interesting my research would be to people <pause dur="0.6"/> so what i thought i'd do <pause dur="2.0"/><kinesic desc="changes slide" iterated="n"/> is this basically <pause dur="0.3"/> discuss the history of portfolios where they've come from <pause dur="0.8"/> # <pause dur="0.2"/> different methods of using portfolios <pause dur="0.3"/> in different <pause dur="0.3"/> # career areas especially medicine really <pause dur="0.3"/> and i apologize to those people that aren't from medical backgrounds <pause dur="1.1"/> obviously when discussing portfolios we do need to bring in an element of reflection <pause dur="0.9"/> # <pause dur="0.2"/> so i'm going to discuss that as well <pause dur="0.4"/> and then finally move on to the problems and the benefits of using portfolios in medicine <pause dur="0.3"/> and then i can touch on my research if <pause dur="0.7"/> anyone's desperate to go home at that point <pause dur="2.1"/><kinesic desc="changes slide" iterated="n"/> right <pause dur="0.6"/> so <pause dur="1.0"/> # i wanted everyone to think of something that

reminds them of <pause dur="0.3"/> Italy <pause dur="1.4"/> # <pause dur="0.3"/> it may seem a bit of a strange question <pause dur="0.9"/> # i thought of a few myself <pause dur="0.7"/> obviously food came first <pause dur="1.2"/> # <pause dur="0.9"/> basically the reason why i put this slide in <pause dur="0.5"/> is the word portfolio actually originates from Italy <pause dur="1.1"/> # it started in the eighteenth century <pause dur="0.7"/> and it can be split into two components and i apologize for pronunciation as i don't speak Italian <pause dur="0.5"/> but the first is <distinct lang="it">portare</distinct> <pause dur="0.6"/> which is to carry <pause dur="0.8"/> and the second is <distinct lang="it">folio</distinct> <pause dur="0.4"/> which i'm <trunc>sh</trunc> # sure there is a proper Italian pronuncation for that <pause dur="0.3"/> meaning leaf or sheet <pause dur="0.9"/> and so really <pause dur="0.2"/> in its basic basic # meaning <pause dur="0.7"/> portfolio means a case for carrying loose sheets of paper <pause dur="0.9"/> and obviously <pause dur="0.4"/> in the artistic world that <pause dur="0.5"/> definition still carries and often you see people going for job interviews with their big portfolios <pause dur="1.0"/> # containing all their <trunc>leash</trunc> <pause dur="0.3"/> loose sheets <pause dur="0.5"/> of artwork they they've done <pause dur="1.6"/> basically since this time the definition and the word portfolio has been picked up by lots of

different # occupations <pause dur="0.5"/> the commonest one's the government <pause dur="0.8"/> # they basically have developed the word portfolio to mean a case containing official documents for certain departments within the government <pause dur="0.6"/> and that's led to job descriptions such as Minister with Portfolio <pause dur="0.3"/> and Ministers without Portfolio for those people that do have the responsibilities for looking after these cases of documents <pause dur="1.7"/> in the N-H-S or in the educational field in general <pause dur="0.9"/> # the definition of portfolio has really taken on two main <pause dur="0.2"/> areas <pause dur="0.9"/> and that's what i'm going to discuss today <pause dur="1.0"/><kinesic desc="changes slide" iterated="n"/> starting with the first one of a scrapbook <pause dur="0.7"/> a very basic definition <pause dur="0.6"/> # <pause dur="0.7"/> it's a collection of written material or evidence of skills <pause dur="0.4"/> # a person possesses <pause dur="1.4"/> basically <trunc>y</trunc> years and years ago what used to happen is you used to finish school <pause dur="0.5"/> used to go and get a job down the road where you'd stay really until you retired you'd get married have two children <pause dur="1.2"/> et cetera et cetera things have changed very much so <pause dur="0.7"/> we're now

expected to do <pause dur="0.2"/> extra qualifications we're expected to actively move round get different jobs different experiences <pause dur="0.5"/> even specialize in different specific areas within the occupation that we've actually chosen <pause dur="1.5"/> obviously we need to demonstrate to people the expertise and experience that we have <pause dur="0.4"/> so what we use <pause dur="0.7"/> are best doing is collecting certificates <pause dur="0.4"/> evidence of work that we've done <pause dur="0.8"/> # <pause dur="0.2"/> in order to prove where we've been <pause dur="2.4"/><kinesic desc="changes slide" iterated="n"/> # couple of people that looked into <pause dur="0.3"/> scrapbook type portfolios was Pendleton and Hasler <pause dur="1.0"/> basically they should said that you should be as imaginative as you can be <pause dur="0.2"/> with your portfolios put in anything you think of <pause dur="0.6"/> so that includes videotapes now <pause dur="0.4"/> audits research as we've been discussing today <pause dur="0.3"/> everything to prove <pause dur="0.2"/> where you've been and what you've been doing <pause dur="0.7"/> since you sat <pause dur="0.2"/> your first basic exams <pause dur="3.9"/> right so if we go back to the previous one <pause dur="1.2"/> portfolios can also be used as educational tools <pause dur="0.5"/> # and that's really what i'm going to concentrate on more now

because it's what <pause dur="0.3"/> the government want us to do and what's being used most in the field of continuing medical education <pause dur="1.2"/> basically using portfolios <pause dur="0.2"/> as an educational tool you start with your basic scrapbook <pause dur="0.6"/> but you add in the additional dimension of reflection <pause dur="0.5"/> and reflective learning <pause dur="2.2"/><kinesic desc="changes slide" iterated="n"/> so what is reflection <pause dur="1.5"/> # here's a definition by <pause dur="0.3"/> Brown <pause dur="1.2"/> basically if we think of reflection <pause dur="0.3"/> it throws up images of mirrors <pause dur="0.4"/> and seeing ourselves how other people see us <pause dur="0.8"/> # in education this extends to visualizing or thinking about experiences that we've had courses we've been on <pause dur="0.4"/> making sense of them and perhaps seeing them in a different way or a constructive way <pause dur="1.2"/> # we've all got the ability to look at things we do and make changes to how we do those things in the future <pause dur="0.6"/> # <pause dur="0.3"/> even from when we're born <pause dur="0.3"/> if you think of a small child who puts their hand on a hot radiator <pause dur="0.4"/> they soon learn that <pause dur="0.2"/> it's best not to do that again <pause dur="0.6"/> # <pause dur="0.4"/> and that's really reflection in its very basic form <pause dur="1.4"/> it's been a

topic of interest really to lots of educational writers <pause dur="0.4"/> # <pause dur="0.6"/><kinesic desc="changes slide" iterated="n"/> probably one of the most famous ones is John Dewey <pause dur="0.7"/> as you can see by the black and white photo <pause dur="0.5"/> he was born in eighteen-fifty-nine <pause dur="0.7"/> he actually became head of Philosophy and Psychology in <trunc>s</trunc> Chicago <pause dur="1.2"/> # and his main interest really lay in educational systems in different countries <pause dur="0.4"/> and he actually did considering the year that he was born did quite a lot of travelling to different countries looking at the educational systems that <pause dur="0.4"/> were growing in each country <pause dur="1.4"/> he also felt that education resulted in people fitting reacting in different ways and fitting into different niches within society and taking on different roles within society <pause dur="0.4"/> and he felt that was all educational based <pause dur="1.4"/> # he basically described two main types of learning <pause dur="1.3"/> the first was trial and error <pause dur="0.6"/> type learning <pause dur="0.8"/> # he felt <pause dur="0.3"/> that skills could be developed <pause dur="0.5"/> after <pause dur="0.5"/> practising a task over and over again <trunc>resert</trunc> <pause dur="0.2"/> resulting in a more of a learned behaviour <pause dur="1.0"/> #

that could be used in just special circumstances only <pause dur="0.5"/> the commonest one is <pause dur="0.2"/> if someone came to you and said <pause dur="0.3"/> how do you ride a bike <pause dur="1.3"/> # we all know how to ride a bike <pause dur="0.4"/> we've all practised it when we were <pause dur="0.2"/> children with stabilizers and <pause dur="0.3"/> we now know how to ride a bike but try and describe that to someone it's very very difficult <trunc>w</trunc> because it's a learned behaviour <pause dur="1.3"/> he also felt there was a second type of learning <pause dur="0.4"/> and that was reflective learning <pause dur="1.0"/> he where information and feedback from previous experiences <pause dur="0.5"/> could then be used to draw conclusions which if ever you came across that experience again <pause dur="0.3"/> could be used <pause dur="0.5"/> # <pause dur="0.3"/> and basically he <pause dur="0.2"/> <trunc>fi</trunc> was the first one to introduce the concept of learning cycles <pause dur="0.7"/> and learning loops <pause dur="0.8"/> where conclusions from previous experiences could be fed back <pause dur="0.5"/> and used to manipulate <pause dur="0.3"/> the experience when you <pause dur="0.3"/> have it again <pause dur="2.6"/><kinesic desc="changes slide" iterated="n"/> he's <pause dur="0.2"/> very well known for something called his pedagogic creed <pause dur="0.6"/> and i just put that in <pause dur="0.3"/> really for the people who are interested in education

the Master's students in education <pause dur="0.4"/> and as he said he felt education began unconsciously at birth <pause dur="0.5"/> and went throughout life and shaped that individual <pause dur="0.4"/> and it's that that fitted them into a certain area and function in society <pause dur="3.4"/> <kinesic desc="changes slide" iterated="n"/> so after <pause dur="0.4"/> Dewey had <pause dur="0.2"/> had developed this learning loop David Kolb and i don't think that's the most flattering photo that i found of him <vocal desc="laughter" iterated="y" n="ss" dur="1"/><pause dur="0.4"/> # <pause dur="0.6"/> he was another educationalist <pause dur="0.6"/> and he was Professor of Organizational Behaviour <pause dur="0.9"/> and he had a special interest not just in the way that people fitted into social society <pause dur="0.4"/> due to their education he felt <pause dur="0.3"/> that due to your education <pause dur="0.4"/> that made you more likely <pause dur="0.2"/> to pick specific careers <pause dur="0.3"/> and fit within certain organizations <pause dur="0.2"/> and often meant <pause dur="0.5"/> # that's where people ended up working <pause dur="1.3"/> in nineteen-seventy-one he joined together with <pause dur="0.2"/> Rubin and McIntyre who were also interested in education <pause dur="0.4"/> and

developed Dewey's <pause dur="0.3"/> learning loop a bit further <pause dur="2.2"/><kinesic desc="changes slide" iterated="n"/> they produced this <pause dur="1.7"/> and it's well known as <pause dur="0.4"/> Kolb's <pause dur="0.3"/> loop <pause dur="1.7"/> he felt that a learner had to be competent in all of these different areas <pause dur="0.5"/> # and stated the cycle in order for to be an effective learner <pause dur="0.3"/> the whole cycle had to keep turning <pause dur="0.9"/> and <pause dur="0.2"/> if a person was inadequate in any of the areas they were just unable to learn at all <pause dur="4.0"/><kinesic desc="changes slide" iterated="n"/> so moving on to <pause dur="0.2"/> from this <pause dur="0.4"/> # the final person that i'm going to talk about today is Donald Schon <pause dur="0.8"/> he's also well known # <pause dur="0.2"/> for his techniques of reflection <pause dur="1.2"/> he like Kolb was very interested in individuals and the way they functioned within their working organizations and their working environment <pause dur="1.2"/> he really wasn't that interested in Kolb's <pause dur="0.2"/> cycle <pause dur="0.7"/> he <trunc>wan</trunc> went back to Dewey's original concept of the fact of <pause dur="0.2"/> # task learning <pause dur="0.5"/> and reflective type learning <pause dur="0.8"/> he felt that # Dewey had got it slightly wrong <pause dur="0.6"/> and instead of being two different ways of learning that <pause dur="0.2"/> it was actually one type of learning <pause dur="0.7"/> and that <pause dur="0.3"/> people

actually performed a task <pause dur="1.0"/> and then while they were performing that task <pause dur="0.4"/> they were able to reflect <pause dur="0.6"/> # think about what they were doing <pause dur="0.2"/> and make alterations to their behaviour during the time that they were doing that <pause dur="0.9"/> he also felt that <pause dur="0.7"/> people were also able after they'd <pause dur="0.4"/> finished the task to look back <pause dur="0.6"/> and think about what they'd actually done <pause dur="1.8"/><kinesic desc="changes slide" iterated="n"/> from this he developed these <pause dur="0.3"/> three terms <pause dur="0.8"/> reflection in action <pause dur="0.3"/> is where you're doing a task and you actually think about what you're doing at the time <pause dur="0.3"/> and you can alter and modify your behaviour accordingly <pause dur="0.8"/> reflection on action <pause dur="0.5"/> he felt was the ability to look back at what had happened <pause dur="0.3"/> and again <pause dur="0.2"/> make changes for the future <pause dur="0.5"/> and both of those came together <pause dur="0.2"/> in order to provide individuals that had a knowledge in action <pause dur="0.5"/> so they're able to perform both these tasks <pause dur="0.5"/> in order <pause dur="0.2"/> to perform a function <pause dur="2.0"/> it's quite complicated and i think the easiest way for me to describe it and again i apologize to the <trunc>m</trunc> non-medical ones <pause dur="0.3"/> people here <pause dur="0.7"/> is <pause dur="0.7"/> someone taking

out an appendix <pause dur="1.0"/> if a surgeon goes in and takes out an appendix there is the typical way <pause dur="0.3"/> of an appendicectomy if you read the textbook it's the sheet make the incision here <pause dur="0.3"/> find the appendix here <pause dur="0.3"/> remove it as such <pause dur="1.3"/> if the surgeon goes in and the appendix is in a slightly different position <pause dur="0.5"/> for example behind the secum <pause dur="0.5"/> then the whole process has to be modified the surgeon has to look somewhere else for the appendix <pause dur="0.3"/> take it out in a slightly different way <pause dur="0.3"/> extend the scar slightly <pause dur="0.3"/> and that's reflection in action the surgeon has seen while he's doing a function <pause dur="0.8"/> that modifications need to be made <pause dur="1.4"/> afterwards <pause dur="0.2"/> when the surgeon's stitched up and he's sitting down having his cup of coffee <pause dur="0.3"/> he can actually think <pause dur="0.2"/> about that patient <pause dur="0.4"/> was there any clues <pause dur="0.2"/> when he took the history from the patient <pause dur="0.3"/> on examining the patient <pause dur="0.4"/> that he wasn't going to find a typical appendix when he went in there <pause dur="1.9"/> if he does find evidence that there were some differences <pause dur="0.4"/> he

can actually use that information in the future to be more prepared <pause dur="0.5"/> for the next operation that he comes across and that's more of a reflection <pause dur="0.4"/> on action <pause dur="5.8"/> <kinesic desc="changes slide" iterated="n"/> right so basically reflection's a very complex process <pause dur="0.5"/> there's diferent influences that reflect <pause dur="0.5"/> what we # <pause dur="1.3"/> take home <pause dur="1.2"/> and basically what we choose <pause dur="0.5"/> to take from a situation depends on our personal aspirations <pause dur="0.4"/> our past experiences <pause dur="0.6"/> and where we feel our personal needs or inadequacies lie <pause dur="1.5"/> # <pause dur="0.3"/> and all of these result in modifications hopefully in our behaviour <pause dur="1.7"/> going back to the internal and external influences <pause dur="1.0"/> if you provide <pause dur="0.3"/> a group of delegates with the same lecture <pause dur="0.3"/> and provide them with a sheet <pause dur="0.3"/> where they're able to write home one take-home message <pause dur="0.7"/> the take-home message probably will be very different for everybody in the room <pause dur="0.8"/> # that's because each of us <pause dur="0.7"/> will find part of the talk slightly more interesting than another depending on our experiences <pause dur="0.6"/> # and that's really <pause dur="0.4"/> the element of the

internal and external influences on reflection <pause dur="2.1"/><kinesic desc="changes slide" iterated="n"/> so what we need to do now is put all those <pause dur="0.5"/> all that information about reflection back into the use of portfolios <pause dur="1.0"/> so if we return to our scrapbook <pause dur="0.7"/> what we're doing now is we're using our reflective techniques to look at each learning experience that we've had so <pause dur="0.3"/> as we mentioned before the scrapbooks can be full of certificates and achievements <pause dur="1.0"/> so <pause dur="0.3"/> when you came today <pause dur="0.6"/> # you might have thought oh well i might have a certificate at the end of the day that i can put in my scrapbook and people will see that i've been to this interesting course at <gap reason="name" extent="1 word"/> <pause dur="1.0"/> # however if we're going to use <pause dur="0.2"/> that to reflect <pause dur="0.9"/> hopefully some people after they look at that certificate will think <pause dur="0.7"/> oh i know a bit more about education now <pause dur="0.4"/> or <pause dur="0.7"/> i know perhaps that i'm inadequate in knowledge in this area of education and i'll go and find out more <pause dur="1.1"/> some people <pause dur="0.2"/> might have just come <pause dur="0.6"/> and actually found out where <gap reason="name" extent="1 word"/> is and that it's actually got a medical school

in the first place <pause dur="0.8"/> # that's another learning experience <pause dur="0.8"/> some people <pause dur="0.3"/> might have sat next to someone <pause dur="0.3"/> at lunch <pause dur="0.4"/> who's a P-C-T tutor <pause dur="0.5"/> after they started chatting to them <pause dur="0.6"/> and think gosh i've no idea what that is <pause dur="0.5"/> and then go away <pause dur="0.3"/> and actually look that up <pause dur="0.9"/> so <trunc>a</trunc> got absolutely nothing to do with the course <pause dur="0.4"/> but it's a learning opportunity <pause dur="0.5"/> # <pause dur="0.2"/> that has been picked up on reflecting just on that certificate or the course today so it's not just a scrapbook <pause dur="0.5"/> it's an actual reflection <pause dur="1.5"/> # <pause dur="1.0"/> right <pause dur="0.5"/> so it's not just courses that we can use as learning experiences <pause dur="0.7"/> # lots of different things out there <pause dur="0.4"/> there's feedback from colleagues <pause dur="0.3"/> or patients <pause dur="0.7"/> for the students here today trying to get all this back to an undergraduate level <pause dur="0.3"/> there's the use of simulated patients which give very useful feedback <pause dur="0.4"/> there's patients that they come across on the wards <pause dur="0.2"/> or in G-P practices <pause dur="1.0"/> there's so many opportunities <trunc>f</trunc> <pause dur="0.3"/> for learning and reflection <pause dur="0.4"/> that often it sort of

goes in one ear and out the other 'cause we're busy doing something else at the same time <pause dur="1.0"/> so what we suggest people do is keep a log diary <pause dur="0.4"/> that's just a to do list <pause dur="0.3"/> for want of a better word <pause dur="0.4"/> # <pause dur="0.9"/> and basically <pause dur="0.3"/> all that you do is you write down the topic or areas <pause dur="0.4"/> # that you thought ooh hang on a minute i should really go and look that up <pause dur="0.7"/> # <pause dur="1.0"/> and you know it's there it's somewhere safe that you can come back to it and look at it <pause dur="0.3"/> at a time that's convenient <pause dur="0.4"/> when you've got the time to look further into it <pause dur="1.2"/> really what <pause dur="0.2"/> that is is the basis of a personal development plan <pause dur="0.3"/> a personal development plan is a log diary <pause dur="0.2"/> I-E a to do list <pause dur="0.4"/> but with the added dimension of actually a list of how you aim to achieve <pause dur="0.7"/> those needs <pause dur="0.7"/> and a final section <pause dur="0.3"/> on <pause dur="0.4"/> reflection again because it's a cycle <pause dur="0.5"/> <trunc>shar</trunc> saying how you have achieved those needs <pause dur="0.6"/> or whether you have achieved those needs <pause dur="1.7"/> basically <pause dur="0.2"/> the whole of this is <pause dur="0.2"/> due to reflection <pause dur="0.5"/> and self-direction <pause dur="1.5"/><kinesic desc="changes slide" iterated="n"/> so if we come back now to portfolios in

the N-H-S and this is where my interest is <pause dur="0.7"/> is basically at the moment <pause dur="1.0"/> G-Ps that <pause dur="0.3"/> to keep up to date it's suggested that they go <pause dur="0.5"/> and attend lectures <pause dur="0.2"/> and collect points <pause dur="0.8"/> # once they've collected thirty points thanks very much pat on the back <pause dur="0.3"/> money from the government right you're keeping up to date <pause dur="0.7"/> # <pause dur="0.4"/> unfortunately it's been proven that this system <pause dur="0.2"/> of continuing medical education is failing <pause dur="0.4"/> G-Ps are going <pause dur="0.3"/> to <trunc>near</trunc> the <trunc>n</trunc> lectures that are nearest by <pause dur="0.4"/> they're going to <pause dur="0.2"/> the lectures that are free to attend <pause dur="0.5"/> they're going to lectures <pause dur="0.2"/> which interest them <pause dur="0.4"/> great <pause dur="0.2"/> but they're probably already exceptionally good at family planning <pause dur="0.3"/> and they're going to more family planning lectures <pause dur="0.3"/> while they know nothing about rheumatology <pause dur="0.6"/> so they're becoming very non-directed <pause dur="0.9"/> more and more evidence is coming out and <trunc>s</trunc> sure everyone knows that didactic lectures <pause dur="0.2"/> really <pause dur="0.4"/> are not perhaps the best way of learning for everybody <pause dur="1.0"/> also the G-Ps aren't providing any evidence of their learning <pause dur="0.6"/> # which

the government aren't happy with <pause dur="0.7"/> # <pause dur="0.6"/> so they are keen <pause dur="0.3"/> for a new system <pause dur="1.2"/><kinesic desc="changes slide" iterated="n"/> # <pause dur="0.7"/> to come about <pause dur="1.7"/> basically Mathers <pause dur="0.5"/> who i think <pause dur="0.2"/> # is based in Sheffield <pause dur="0.4"/> did some research <pause dur="0.4"/> where he looked at portfolio learning and compared it to the old system of G-P learning and this point collecting exercise <pause dur="0.5"/> he did a crossover trial where for six months half the G-Ps <pause dur="0.4"/> did the old-fashioned type of learning <pause dur="0.6"/> and for the next six months the G-Ps did the newer type portfolio self-directed learning <pause dur="0.6"/> and basically the feedback and the outcomes were very good <pause dur="0.9"/> the G-Ps enjoyed greater flexibility <pause dur="0.4"/> # of using portfolios and picking things that were of interest to them <pause dur="0.5"/> they enjoyed the breadth of the topics which far excelled the local lectures that were being provided <pause dur="0.9"/> # but they did admit that more time <pause dur="0.3"/> and commitment was needed <pause dur="0.4"/> so therefore <pause dur="0.3"/> i thought i'd put up this <pause dur="0.2"/> final slide saying that <pause dur="0.5"/> even though i'm very much for it and have researched it <pause dur="0.5"/> there are some negative points to portfolio learning <pause dur="0.9"/> #

the two in brackets <pause dur="0.3"/> really aren't applicable to undergraduates <pause dur="0.5"/> # they're more applicable to my area of interest which is G-Ps <pause dur="0.5"/> basically <pause dur="0.2"/> the old system and the new system <pause dur="0.2"/> of continuing education are running alongside <pause dur="0.5"/> which is <pause dur="0.3"/> where the confusion's arising <pause dur="0.8"/> # <pause dur="0.7"/> but basically <pause dur="0.2"/> most people are still uncertain about portfolios and reflection and the way that you can learn from them <pause dur="0.4"/> # <pause dur="0.4"/> well obviously it's <pause dur="0.3"/> relatively straightforward <pause dur="0.3"/> i think once people have run with it for a little while they'll feel more confident <pause dur="0.4"/> and get more out of it <pause dur="1.6"/> and so i'm more than happy to answer any questions on portfolios or if anybody wants to know any more about my research then i'm happy to discuss that as well </u><pause dur="7.0"/> <u who="nm0360" trans="pause"> any questions at all </u><pause dur="2.0"/> <u who="nm0363" trans="pause"> how do you control the level of reflecting <pause dur="0.2"/> when you do portfolio learning <pause dur="0.4"/> as you illustrated i could be <pause dur="0.2"/> just reflecting i met a a dental colleague <pause dur="0.5"/> and that will be on my portfolio </u><u who="nf0362" trans="latching">

mm </u><pause dur="0.5"/> <u who="nm0363" trans="pause"> having a chat <pause dur="0.4"/> or how deep do i reflect <pause dur="0.2"/> how do you </u><pause dur="1.1"/> <u who="nf0362" trans="pause"> mm </u><u who="nm0363" trans="latching"> it's the same as point isn't it </u><u who="nf0362" trans="overlap"> <gap reason="inaudible due to overlap" extent="1 sec"/> </u><u who="nm0363" trans="overlap"> yeah i just come and sit down here <pause dur="0.3"/> and i will write a few point </u><pause dur="0.2"/> <u who="nf0362" trans="pause"> absolutely </u><u who="nm0363" trans="overlap"> but <pause dur="0.5"/> so <pause dur="0.3"/> if you you you think portfolio learning is the way forward <pause dur="0.2"/> how do you know that person just because they reflected </u><pause dur="0.3"/> <u who="nf0362" trans="pause"> yeah </u><u who="nm0363" trans="latching"> actually learned </u><pause dur="0.3"/> <u who="nf0362" trans="pause"> i think the important thing is every single system <pause dur="0.6"/> there's an ability <pause dur="0.3"/> to cheat and not get involved <pause dur="0.5"/> as you need <pause dur="0.7"/> the points based system <pause dur="0.3"/> great you get a certificate you gain a point but that's not to say that you didn't turn up at the back of the lecture pick your certificate up <pause dur="0.2"/> walk straight back out the door <pause dur="0.7"/> # <pause dur="0.3"/> and very much i think with portfolios is the same you get out of it

what you put into it <pause dur="0.8"/> # they've tried to minimalize that <pause dur="0.2"/> by proving evidence of learning <pause dur="0.6"/> that you've achieved what you set out to achieve now <pause dur="0.9"/> that could be just a certificate of attendance and <unclear>the</unclear> again <pause dur="1.2"/> in one door out the other <pause dur="0.3"/> it's meant to be <pause dur="0.3"/> more documentation of your reflection <pause dur="0.3"/> or changes in practice <pause dur="0.6"/> # attendance at clinics et cetera et cetera <pause dur="0.3"/> but i think there's <pause dur="0.3"/> you're completely right there's an <trunc>abe</trunc> <pause dur="0.3"/> you know # a possibility of cheating every system <pause dur="0.7"/> # </u><u who="nm0363" trans="latching"> i just wonder what are you need to define what is that evidence of learning because earlier on you </u><u who="nf0362" trans="overlap"> mm </u><u who="nm0363" trans="overlap"> say i might come to this conference </u><pause dur="0.2"/> <u who="nf0362" trans="pause"> mm </u><u who="nm0363" trans="latching"> and i learn about P-C-T tutor </u><u who="nf0362" trans="latching"> mm </u><pause dur="1.0"/> <u who="nm0363" trans="pause"> might be accurate that <pause dur="0.3"/> is not <trunc>s</trunc> <pause dur="0.4"/> adequate </u><pause dur="0.2"/> <u who="nf0362" trans="pause"> mm </u><pause dur="0.4"/> <u who="nm0363" trans="pause">

in term of # <pause dur="0.3"/> acceptable that public money </u><u who="nf0362" trans="overlap"> mm </u><u who="nm0363" trans="overlap"> spent on learning about P-C-T tutor <pause dur="0.5"/> might well be need to be something <pause dur="0.3"/> change to <trunc>quali</trunc> </u><pause dur="0.3"/> <u who="nf0362" trans="pause"> mm </u><u who="nm0363" trans="overlap"> patient care </u><pause dur="0.5"/> <u who="nf0362" trans="pause"> i mean they are trying to push that the problem is it's in its very early stage # <pause dur="0.2"/> speaking as G-Ps <pause dur="0.3"/> it's in its very early stages <pause dur="0.3"/> and they're trying to get as many people <pause dur="0.3"/> to run with these P-D-Ps because of the uncertainty putting people off at the moment <pause dur="0.4"/> # so they're not being that specific or critical <pause dur="0.3"/> about what is done <pause dur="0.4"/> # even they're saying that perhaps <pause dur="0.7"/> they're still suggesting that you spend thirty hours <pause dur="0.3"/> a year <pause dur="0.9"/> on continuing medical education whether it be in the form of portfolios <pause dur="0.5"/> or point collecting <pause dur="0.6"/> # i mean some people have said oh well it's <pause dur="0.2"/> it's taken me ten hours to write my P-D-P <pause dur="1.4"/> # and again it's hard to justify that because <pause dur="0.5"/> you may have an A-four sheet in front of you that looks like it's taken thirty minutes to throw together but <pause dur="0.4"/> i

think you have to try and get people on board <pause dur="0.3"/> and once it's been running for a few years perhaps they're going to be a bit more critical </u><pause dur="2.1"/> <u who="nm0364" trans="pause"> # <gap reason="name" extent="1 word"/> i found it really helpful this # <pause dur="0.3"/> whole idea i didn't know the <pause dur="0.7"/> # the word portfolio how it had originated <pause dur="0.3"/> thank you very much <pause dur="0.6"/> the way i # my students the ones from <gap reason="name" extent="1 word"/> attach <pause dur="0.6"/> i use a method where <pause dur="0.9"/> they select a patient <pause dur="0.5"/> they talk to the patient <pause dur="1.1"/> then they present it to me </u><pause dur="0.4"/> <u who="nf0362" trans="pause"> mm </u><u who="nm0364" trans="latching"> then they provide their portfolio <pause dur="0.2"/> and they got a section that they have to do the research <pause dur="0.7"/> and then later i mark it <pause dur="0.8"/> <trunc>s</trunc> # so it has given them a chance one to present it to me then they write it <pause dur="0.9"/> and then they have to do some reading and research and then write it back again </u><u who="nf0362" trans="latching"> mm </u><pause dur="0.3"/> <u who="nm0364" trans="pause"> so the same portfolio can be used in a very reflective way </u><u who="nf0362" trans="latching"> mm </u><pause dur="0.2"/> <u who="nm0364" trans="pause"> to learn to see whether they <pause dur="0.2"/> when they present it and when they finally write it

up <pause dur="0.7"/> # and give it back to you and then we see it again <pause dur="0.4"/> so you get a third way of going round the problem is <pause dur="0.6"/> # the students do an eight week <pause dur="0.2"/> thing and they give their portfolios in the sixth week </u><pause dur="0.7"/> <u who="nf0362" trans="pause"> mm </u><pause dur="0.2"/> <u who="nm0364" trans="pause"> it's not enough time you should somehow <pause dur="0.5"/> do you give the students this lecture on portfolio </u><u who="nf0362" trans="latching"> no <pause dur="0.3"/> i don't </u><u who="nm0364" trans="overlap"> i think it would help them to get # this <pause dur="0.5"/> thing right at the beginning <pause dur="0.6"/> they must get their portfolios in at least one or two right at the beginning </u><pause dur="0.2"/> <u who="nf0362" trans="pause"> mm </u><pause dur="0.3"/> <u who="nm0364" trans="pause"> you otherwise eight weeks go very rapidly </u><pause dur="0.5"/> <u who="nf0362" trans="pause"> mm </u><u who="nm0364" trans="latching"> so if we want to get the best out of our students they must do this <pause dur="0.4"/> exercise <pause dur="0.5"/> one or two twice earlier on <pause dur="0.9"/> to answer the question about the reflection method otherwise what happens <pause dur="0.5"/>

at the seventh week they rush in with three portfolios <pause dur="0.5"/> i have to mark them rapidly and sometimes they give it </u><pause dur="0.4"/> <u who="nf0362" trans="pause"> <gap reason="inaudible" extent="1 sec"/> </u><u who="nm0364" trans="overlap"> you know after they have left us </u><u who="nf0362" trans="latching"> mm <pause dur="0.6"/> i think as well the students are seeing it very much <pause dur="0.2"/> as <pause dur="0.4"/> a tick box part of the course thank you very much that's another essay handed in <pause dur="0.4"/> i think they've lost <pause dur="0.6"/> the track of yes it is that but it's something they can carry with them for life <pause dur="0.7"/> and i think perhaps if early on they realize it's not just <pause dur="0.2"/> for the four years of this course they're going to be doing this they can keep that as evidence of learning <pause dur="0.5"/> that goes on and on and on unfortunately your portfolio starts to get bigger and bigger and bigger and bigger <pause dur="0.6"/> # <pause dur="0.2"/> but <pause dur="0.6"/> i think that's the problem is they're still perhaps seeing it as a <pause dur="0.9"/> a sort of milestone <pause dur="0.7"/> course </u><pause dur="3.0"/> <u who="nm0363" trans="pause"> can i just <pause dur="0.4"/> <gap reason="inaudible" extent="1 sec"/> another problem is <pause dur="0.9"/> if everything we do we need to reflect on it like general i read an article i

read i will be spending a lot of time writing i find it's quite difficult </u><pause dur="0.5"/> <u who="nf0362" trans="pause"> mm </u><u who="nm0363" trans="latching"> every time i read see an article in the B-M-J i need to write another A-four <pause dur="0.2"/> pages <pause dur="0.6"/> <trunc>i</trunc> <pause dur="0.5"/> i just sometimes can be overemphasized </u><u who="nf0362" trans="overlap"> mm </u><u who="nm0363" trans="latching"> and become paper <trunc>collec</trunc> <pause dur="0.2"/> collection </u><pause dur="0.3"/> <u who="nf0362" trans="pause"> yeah <pause dur="0.5"/> # i think <pause dur="0.5"/> mm it's <pause dur="0.3"/> it's considered it doesn't have to be A-four <pause dur="0.2"/> it can even be a couple of lines you can even write <pause dur="0.5"/> i read this article it was completely and utterly useless and not relevant to me <pause dur="0.8"/> it's evidence that you've read that article <pause dur="0.3"/> it's <trunc>elo</trunc> <pause dur="0.2"/> evidence that you've been self-directed enough to recognize that that hasn't addressed your needs <pause dur="0.5"/> and <pause dur="0.2"/> people are not <pause dur="0.2"/> they're still going to count that <pause dur="0.4"/> as a learning opportunity <pause dur="0.4"/> the problem comes as the fact that now <pause dur="0.4"/> they're trying to use G-P portfolios for revalidation and appraisal <pause dur="0.5"/> and the whole thing about

portfolios is <trunc>y</trunc> that you should be as reflective as possible it's a personal development plan <pause dur="0.2"/> so you can write in there <pause dur="0.5"/> # <pause dur="0.6"/> i don't know how to examine eyes i'm a G-P and i don't know how to examine eyes so i'm going to go to clinic and learn how to examine eyes <pause dur="0.6"/> and then you can write <pause dur="0.3"/> in an ideal world <pause dur="0.2"/> i went to clinic and i learned nothing about examining eyes <pause dur="0.7"/> but the problem is people <pause dur="0.5"/> the personal development plan side of it is if someone else is looking in <pause dur="1.0"/> then people are going to stop being as personal and as reflective that's the worry <pause dur="0.5"/> # in educational terms it was always <pause dur="0.4"/> held by the student not looked at by anyone else <pause dur="0.4"/> unless the student was happy and if they wanted to give <pause dur="0.4"/> part of their personal development plan <trunc>f</trunc> for a tutor to look at that was fine <pause dur="0.4"/> but unfortunately in medicine that's been taken out of our hands <pause dur="0.4"/> so even though i say to you you can write one line and say it was useless <pause dur="0.3"/> or one line and say it was very good i think <pause dur="0.5"/> # that people are going to be a bit

more wary about what they write in their personal development plans as time goes on </u><pause dur="0.4"/> <u who="nm0366" trans="pause"> can i kind of echo that as well </u><u who="nf0362" trans="overlap"> mm </u><pause dur="0.2"/> <u who="nm0366" trans="pause"> this this one has a a slight resonance for me 'cause at the moment i'm i'm doing <pause dur="0.2"/> postgrad study in <gap reason="name" extent="1 word"/> teaching higher education <pause dur="0.4"/> and there is a portfolio issue around that what you've just said has an amazing resonance because <pause dur="0.3"/> for me i <pause dur="0.4"/> this is great 'cause it <unclear>dovetails</unclear> today </u><u who="nf0362" trans="pause"> mm </u><pause dur="0.2"/> <u who="nm0366" trans="latching"> # but for me i i want to be able to write down things these are the things i need to be thinking about and and meant to be able to refer back to at a later date </u><u who="nf0362" trans="overlap"> mm </u><u who="nm0366" trans="overlap"> <pause dur="0.4"/> but i have an awareness that part of the process with P-G serves # at <gap reason="name" extent="1 word"/> is <pause dur="0.3"/> that that material then <pause dur="0.2"/> is is able to be looked at or should be looked at by the head of department </u><u who="nf0362" trans="latching"> mm </u><pause dur="0.4"/> <u who="nm0366" trans="pause"> so i'm saying to myself <pause dur="0.5"/> what areas # how much <pause dur="0.3"/> can i declare about my teaching practice </u><u who="nf0362" trans="latching">

mm </u><u who="nm0366" trans="latching"> in this thing knowing that the person <shift feature="voice" new="laugh"/>who is<shift feature="voice" new="normal"/> paying my wages <pause dur="0.2"/> could look at it and go <pause dur="0.7"/> <shift feature="voice" new="mimicking an other's voice"/>he's a crap teacher <shift feature="voice" new="normal"/></u><u who="nf0362" trans="overlap"> yeah <vocal desc="laughter" iterated="y" n="ss" dur="1"/></u><pause dur="0.7"/> <u who="nm0366" trans="pause"> i mean the whole point about reflective practice i think is is to be able to <trunc>se</trunc> to be able to write down i did this today <pause dur="0.6"/> this didn't work as well as it might have done here is what i <trunc>th</trunc> here is </u><pause dur="0.3"/> <u who="nf0362" trans="pause"> <gap reason="inaudible" extent="1 sec"/> to do </u><u who="nm0366" trans="overlap"> how i think it might be improved </u><u who="nf0362" trans="latching"> mm </u><u who="nm0366" trans="latching"> but the implication is that you did it poorly <pause dur="0.7"/> in terms of an arbiter reading it at some later point so <pause dur="0.2"/> i'm sorry that's not a question </u><u who="nf0362" trans="overlap"> no not at all </u><u who="nm0366" trans="overlap"> it's just a reflection </u><u who="nf0362" trans="overlap"> # it's interesting because </u><u who="nm0365" trans="latching"> <gap reason="inaudible" extent="1 sec"/></u><u who="nf0362" trans="overlap"> <vocal desc="laughter" iterated="y" n="ss" dur="7"/>as i say i think it's going to <shift feature="voice" new="laugh"/>be a real problem <shift feature="voice" new="normal"/><vocal desc="laugh" iterated="n"/></u><u who="nm0366" trans="overlap"> <shift feature="loud" new="ff"/>how do you do that how do you that <shift feature="loud" new="normal"/> </u><pause dur="0.5"/> <u who="nf0367" trans="pause">

you <trunc>w</trunc> so walked right into that though </u><u who="nm0366" trans="latching"> i'm going to write that down now don't use bad jokes <vocal desc="laughter" iterated="y" n="sl" dur="1"/> <pause dur="0.2"/> when </u><u who="nf0367" trans="overlap"> <gap reason="inaudible" extent="1 sec"/> <vocal desc="laughter" iterated="y" dur="1"/> </u><u who="nm0366" trans="overlap"> yeah absolutely my mental one <pause dur="0.6"/> <vocal desc="laughter" iterated="y" n="nf0367" dur="1"/> 'cause i didn't say any of that <pause dur="0.5"/> mm <pause dur="0.9"/> never mind </u><pause dur="1.2"/> <u who="nm0360" trans="pause"> can <pause dur="0.2"/> can i just say a big thank you <trunc>t</trunc> <trunc>t</trunc> # # <pause dur="0.7"/> # something i 'cause this is a personal research area of mine <pause dur="0.4"/> but i've learned an awful lot from it so i'm going to ask <trunc>e</trunc> <gap reason="name" extent="1 word"/> to print a handout of her # <pause dur="0.3"/> Powerpoint slides for me 'cause i found it very helpful <pause dur="0.4"/> and i was thinking particularly of your first slide where you put in relation to Italy <trunc>l</trunc> <pause dur="0.4"/> Italy leaning tower when i first looked at it i wondered if it was a spelling mistake and should actually say learning tower </u><pause dur="0.2"/> <u who="nf0362" trans="pause"> it was # <gap reason="name" extent="1 word"/> said that this morning <pause dur="1.0"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/>

so thank you for a super presentation and very interesting thank you very much <pause dur="6.4"/><kinesic desc="applause" iterated="y" n="ss" dur="4"/> contrary to what <gap reason="name" extent="1 word"/> has just been saying we're not actually i <pause dur="0.4"/> believe i'm correct in saying we're not giving out certificates of attendance <pause dur="0.2"/> <vocal desc="laughter" iterated="y" n="ss" dur="1"/> # because </u><u who="ss" trans="overlap"> aah </u><u who="nm0360" trans="overlap"> it's <pause dur="0.2"/> in a sense it's not that type of <vocal desc="laughter" iterated="y" n="ss" dur="1"/> it's not that type of course of collecting <pause dur="0.3"/> collecting points and so on <pause dur="0.2"/> there's one person that i haven't thanked and has been so quiet and unobtrusive even though there are lots of cameras here <pause dur="0.3"/> has fallen into the background is is <gap reason="name" extent="1 word"/> that <pause dur="0.5"/> <trunc>w</trunc> # i haven't mentioned because in a sense it's made today's meeting <pause dur="0.3"/> # an educational research project <pause dur="0.5"/> in itself <pause dur="0.4"/> so i'm very grateful for <gap reason="name" extent="1 word"/> being here and i'm sure if anybody <pause dur="0.2"/> wants to recall the events of today when <gap reason="name" extent="1 word"/> eventually produces a D-V-D <pause dur="0.3"/> of today it will be possible <pause dur="0.3"/> to reflect <pause dur="2.7"/> <vocal desc="laughter" iterated="y" n="ss" dur="2"/> on today

will you be writing that in your portfolio <vocal desc="laughter" iterated="y" n="ss" dur="1"/></u><u who="nm0360" trans="latching"> i will be certainly <pause dur="0.7"/> thank you very much for everybody to coming and thank you for everybody that has contributed and prepared for today and as i say particularly for <gap reason="name" extent="1 word"/> at the last minute <pause dur="0.5"/> doing her # presentation and again to <gap reason="name" extent="1 word"/> for for everything that she's done today <pause dur="0.6"/> thank you and i <pause dur="0.2"/> the only thing is i gather as a collaborative initiative <pause dur="0.4"/> we've already collaborated in that i'm <pause dur="0.2"/> think my colleagues in <gap reason="name" extent="1 word"/> are going to <pause dur="0.3"/> run the next one of these <pause dur="0.3"/> similar days so we'll be looking <pause dur="0.2"/> very much <trunc>fo</trunc> </u><u who="nm0366" trans="overlap"> all we have to do is persuade the head </u><pause dur="0.2"/> <u who="nm0360" trans="pause"> that's right <vocal desc="laughter" iterated="y" n="ss" dur="2"/> we'll be looking <gap reason="inaudible" extent="1 sec"/> coming to <gap reason="name" extent="1 word"/> <gap reason="inaudible" extent="2 secs"/> thank you