Development of a portfolio approach for Clinical Observation and FeedForward (CO-FF) through a participatory process

We identified a need for a transparent and coherent approach to support frequent multisource feedforward and track student progress across clinical placements. Our aim was to develop and implement an evidence-informed portfolio approach through a participatory process. The development process comprised four steps: Exploration, Preparation, Initial Implementation, and Full Implementation. Evidence and stakeholder experiences were gathered through document analysis, literature review, and interviews with students and teachers. Student interview data were analysed thematically, and infrastructure feasibility was assessed using descriptive usage statistics. A portfolio approach CO-FF (Clinical Observation FeedForward) was developed and implemented. Recorded criteria increased substantially over time, and the autonomy scale showed progression patterns consistent with teacher expectations. The structured, iterative participatory process enhanced the feasibility and educational utility of the approach. Our findings offer a practical example of how portfolio-based feedback systems can be designed and implemented in health professions education and other practice-based disciplines.