Fundamentally what this paper seeks to answer are questions founded on earlier and recent investigation on the quality of educational provision. Namely, inquiry of knowledge and how it is grounded in theory; the adequate provision for critical reflection, and whether clear indications of clinical competency amongst nursing and midwifery students are evident upon qualification. Both nationally and locally, solutions have been met with many responses. In short, portfolios have been seen as a way forward in the support of professional development. Since 1995 it has been compulsory for all nurses, midwives and health visitors to complete a portfolio profile in order to register. Initially portfolios were designed to ensure that the profession would display a range of evidence incorporating knowledge, skills and attitudes (Standard 13 ENB 1997), ensuring the long term prospects of quality of care required to meet the changing health care needs of the public (ENB 1991a). Essentially, however, comprehensive evidence of portfolios is still under scrutiny as to whether they provide a synthesised process of continual professional development that will also serve as an authentic assessment of teaching, learning and clinical competence. Such scrutiny is not surprising when statutory bodies including the ENB are continually involved in the promotion of improved training methods (Gerrish 1997) aiming for the highest quality assurance in educational provision. Hence, a systematic literature review like this is timely in that portfolios remain an issue which is still open to debate in light of recent initiatives in nursing and midwifery education (UKCC 1999; DoH 1999)
