Legal relations - guiding frameworks

Among the numerous justifications and arguments for the relationship between active methodologies and the use of portfolios, we found what is called legal frameworks, that is, what educational legislation preaches about training. Box 1 shows the frequency that legal and guidance documents were cited.

Source: The authors, Atlas.ti (2021).

Box 1 - Citations of legal frameworks related to the health area 

The National Curriculum Guidelines (DCN) for the area of health education were launched in 2001 and updated in 2014. The formation of the graduate profile, the new concept about health, with a focus on its promotion and not on the disease, proposed by SUS, as well as the need for new educational paradigms to meet these precepts favor the use of active methodologies and portfolios. According to the DCN, graduates of courses in the health area must have generalist, humanist, critical, reflective, ethical, and transformative training, committed to improving the population's quality of life and health. The perspective of collective health is adopted, instead of the individual, and it focuses more on the health of the person than on the disease, therefore, a biopsychosocial view of the individual. Health professionals must provide care at different levels, with a special focus on Primary Health Care (^{FERREIRA et al., 2019}). Corroborating this view, other documents from international representative bodies are cited, such as the World Health Organization (WHO), the Pan American Health Organization (PAHO), and the United Nations Educational, Scientific and Cultural Organization (UNESCO), which address the need for comprehensive training, the pillars of education for the 21st century, working in interdisciplinary or interprofessional teams.

Regarding the publication of the Pedagogy course and the internship practice, Art. 34 also addressed the legal bases that have changed in recent years regarding the educational profile and performance of the pedagogue. In basic education, the only mention of normative acts was the concept of evaluation expressed in the Law of Directives and Bases of National Education (LDB), current Law 9394/96.

Legal relations - pillars of the training process

The legal frameworks and guidance documents also outlined the new contours for the health training process, as seen in Box 2.

Source: The authors, Atlas.ti (2021).

Box 2 - Quotes about the contours of professional training 

Training based on competences was one of the most cited aspects as it precisely developed the expected graduate profile in the health area, being present in 18 articles. Competency-based training has become the current educational challenge. One can verify the occurrence of the use of classic concepts, which conceptualize competence as the articulation of knowledge and experiences, attitudes, and values to solve complex daily problems, especially those related to the professional context (Art. 15, Art. 20, Art. 5, Art. 48, Art. 66, Art. 69 and Art. 96). This concept comes from ^{Perrenoud (1999b}) or even from ^{Scallon (2015}), although Perrenoud has been cited in only two productions (Art. 48 and Art. 69) and Scallon, in none of them. Analyzing the references of the studies, authors were identified who discuss competences in a more particular way for training in higher education and especially for the area of health professionals, as in ^{Lima (2005}), Lima et al. (2014), and ^{Blanco (2009}), therefore, applied references.

The classic concept of competences is complemented by the active performance of students in contexts of personal and social life, not just professional, given the formative dimension of the health professional's performance, in which knowledge and practices must be for the benefit of the collective, applying the principles of SUS (Art. 20, Art. 5, Art. 96).

As for the dimensions, some mentions highlighted the emphasis beyond cognitive and technical skills, mentioning social or psychosocial, or even relational skills (Art. 15, Art. 65, Art. 68, Art. 87, Art. 78, and Art. 96). The affective and psychomotor domains were also mentioned (Art. 5), as well as the technological and instrumental ones (Art. 15). These indications demonstrate the commitment to the integral formation of the human being and future professional. In this sense, two articles (Art.15 and Art.20) explicitly cited the four fundamental pillars proposed by Unesco (DELORS, 1996) for professional education in the 21st century: learning to be, learning to do, learning to know, and learning to live and work together.

From these findings, it appears that training by competences goes beyond the technicality that was initially understood in the history of Brazilian education and, now, with a view of complexity, it seeks the integral formation of the human being and the professional future in solving problems.

As for the other aspects of training, the DCN is resumed, as previously pointed out, which raised the need to rethink and design new training models, which, in the case of health education, stand out: breaking with decontextualized, fragmented curricula focused on technique, advancing towards interdisciplinary curricula, guided by the transversality of the practice guided by the social determination of the health-disease process. With this, we seek a strong relationship between theory and practice, the integration between teaching-service-community, as well as the expansion of the training context, beyond the academic walls, seeking intersectoriality for humanized, assertive, and proactive training in health. These are the elements that outline the new training of health professionals (^{FERREIRA et al., 2019}). The relationship between theory and practice is also the most cited element in the case of experience in Pedagogy.

Educational relations - conception of education

As a result of legal relationships, we identified characteristics of the conception of education, highlighting specificities of the pedagogical practice that meets the expected training.

Source: The authors, Atlas.ti (2021).

Box 3 - Quotations on the conceptions of education 

Certainly, the “construction of knowledge” by the student is one of the fundamental characteristics of innovative paradigms in education, according to ^{Behrens (2005}). In this sense, the practices of active methodologies with the use of evaluative portfolios are inscribed in innovative aspects of educational processes, allied to “student protagonism” and “autonomous learning”, which is “in groups or teams”. The knowledge to be developed, resulting from the study and research in different sources and contact with reality, from the existing and the raised problems, requires activities of discussion, reflection, testing, creations, comparisons, syntheses, analysis, transpositions, conclusions, among others organized and provided by the teacher (^{BEHRENS, 2005}).

The expressions “critical-reflexive training”, “engaged citizen and professional training” (in the sense of transforming realities, especially in SUS services), “problematization of reality”, “emancipatory education”, and “dialogical education” are terms endorsed in Paulo Freire. This confirmation was sought through the “text search” feature on Atlas.ti, in all documents, obtaining the following results: of the total of 25 documents, 16 of them, that is, 64% of published research, referred to Paulo Freire. The most used work was Pedagogy of autonomy: necessary knowledge for educational practice, with 13 mentions (Art. 20, Art. 34, Art. 47, Art. 104, Art. 48, Art. 61, Art. 66, Art. 68, Art. 78, Art. 87, Art. 89, Art. 91 and Art. 98); The pedagogy of the oppressed had three mentions (Art. 21, Art. 61 and Art. 71), followed by the works Cultural Action for Liberty and Other Writings (Art. 21) and Extension or Communication (Art. 61), with a mention each. Paulo Freire's Pedagogy is part of the innovative paradigms in education in progressive trends, according to classifications recommended by ^{Behrens (2005}). The transformative education proposed by Freire (¹⁹⁹², ¹⁹⁹⁶) points out the need to transform realities in a critical, active, and conscious way, through knowledge built in a dialogical, loving, and sensitive relationship with other human beings. The constructed knowledge is a way of reading and acting in the surrounding reality, which seeks the autonomy of the learning subject.

According to ^{Behrens (2005}), the holistic vision or approach also characteristic of innovative paradigms, present in ten articles, is in most cases just mentioned without explanations. However, highlighted quotes refer to the vision of the health education process in which the traditional curricular structure is questioned, and organized into increasingly focused specialties, without considering the vision of the whole and the necessary relationship with social concerns, therefore, with the integration of theory and practice (Art. 21). Evidence was also found that a new educational vision suggests that, when relationships are established between study-service-community, the student starts to interact reciprocally with the context at its different levels and influences it and influenced by it. It is up to the student to discover, maintain or change the characteristics of this context (Art. 48). In this perspective, a view of the whole of reality is sought, in which it is seen as a complex system, with different and multiple facets, sensitive to changes, often chaotic and unpredictable, therefore, non-linear and stable. The whole is formed by the connections and relationships between the parts and the context, the whole being greater than the sum of the parts (Art. 67). Also, the holistic perspective seeks the integral formation of the human being, seeing it in the biological, psychic and social perspectives, integrating reason and emotion, as well as recognizing the importance of values, emotions and preferences that underlie rationalities (Art. 66). The holistic view is characteristic of the complexity paradigm, which seeks to overcome the fragmentation of knowledge, the view of pertinence on what to learn and a global, multidimensional and interdependent view of science, as well as the integral formation of the student in its multiple dimensions and relationship with the context (^{BEHRENS, 2005}; ²⁰⁰⁸).

As for the meaningful learning mentioned in the nine articles, it refers to the fact that the practice with reflective portfolios stimulates, produces, facilitates, promotes, transforms, and crowns meaningful learning, without making the concept used clear. Only the Arts. 48 and 65 refer to meaningful learning that incorporates new meanings to existing knowledge, generating new learning, through reflection and interaction between peers and contact with reality. This concept is similar to that advocated by ^{Ausubel (1980}), although one of the articles referred to Coll (²⁰⁰⁵). Art. 96 visualizes meaningful learning in terms of the practical application of what future professionals are learning.

Based on the above, the foundations that support the use of active methodologies and portfolios are Paulo Freire's critical-emancipatory conception and Edgar Morin's holistic approach or paradigm of complexity, although he is mentioned only in Arts. 66 and 78 and in Ausubel's significant learning, he is not even mentioned. The foundations of these precepts present a coherent relationship between theory and practice and demonstrate the intertwining of innovative educational perspectives.

Pedagogical relations - attributes of active methodologies

We identified that the scientific productions analyzed did not deal with reflection on the concept and meaning of active methodologies. On the contrary, when they mentioned its use, they did so about the professional profile to be developed, especially the critical-reflective one, and the problematization necessary for understanding and professional performance, with intervention, in reality, establishing relationships between theory and practice (Art. 20, Art. 21, Art. 81 and Art. 67).

However, the construction of knowledge (Art. 5, Art. 48, Art. 66, Art. 66, Art. 71, Art. 87, and Art. 91), the role of students (Art. 104, Art. 20, Art. 47, Art. 68 and Art. 61), interaction (Art. 5 and Art. 55), problem-solving (Art. 20, Art. 21, Art. 81, Art. 104, Art. 61 and Art. 67) were aspects in the productions when mentioning active methodologies, reinforcing what was previously exposed about the concept of education. By understanding active methodologies on this prism, a similarity to that advocated by ^{Ferrarini, Saheb, and Torres (2019}) is identified.

On the other hand, there were mentions of buzzwords characteristic of active methodologies, using terms such as “learning by hands-on”, emphasizing “learning by doing” and “learning through action” (Art. 96). Only the specific production of basic education (Art. 89) linked active methodologies to the use of digital technologies and problem-solving.

Therefore, the concept of active methodologies implicit in the productions concerns the centrality of the student in the process of solving problems, building knowledge among peers, acting in reality and changing it, and mobilizing different resources.

Pedagogical relationships - active methodologies combined with the use of portfolios

Using in vivo coding, according to ^{Saldaña (2013}), all active methodologies presented and used in the analyzed productions can be identified and named. In vivo coding uses the term found in the data.

Source: The authors, Atlas.ti (2021).

Box 4 - Types of active methodologies mentioned in the analyzed productions 

An interesting and unexpected finding, present in eight articles, is that the portfolio was nominated and used as an active methodology. This aspect will be explored further in the analyses.

One of the most used active methodologies in the publications was problematization, present in eight articles and named simply that way. This term is typical of progressive trends in education for the formation of a critical and active profile. The well-known ones were also mentioned - problem-based learning and problem-solving (the latter, for basic education), resulting from problematization, but with a bias more towards active methodologies -, as well as those customized for the health area, such as Arch of Maguerez and the constructivist spiral. Research in action, although it addresses problems, refers to scientific research and was used in the experience of the Pedagogy course.

The case study was explicitly mentioned in two articles, although they are clinical cases, and not the concept of case studies generally applied in areas such as Law, Administration, and others. Although not mentioned as methodologies, their presence in the composition of the portfolios was also identified in five articles (Art. 62, Art. 98, Art. 69, Art. 47 and Art. 55) as clinical case studies experienced in internship situations and professional practice.

For the area of health education, terms of specific methodologies or techniques were found, such as realistic simulation (constituting a simulated scenario for the experience of patient care) in Arts. 47 and 67; psychodrama (approaching individual and group conflicts through theater-inspired techniques) in Art. 61; educational trips (artistic educational actions aimed at articulating rationalities and emotions) in Art. 61 and 66; and simulated ethical plenary (problem-situation, which can even be dramatized and which explicitly contains ethical problems to be identified and debated in plenary), present in Art. 61. On the other hand, roundtables, seminars, films, workshops, concept maps, and dialogued exhibitions, found in certain articles, as shown in Box 4, are more active strategies than methodologies.

In addition to the DCN recommending innovative teaching and learning processes, according to ^{Ferreira et al. (2019}), health training, especially Medicine, has gone through three generations of educational reforms. According to the authors, the first extended the concept of training for professional practice to hospitals; the third promoted rethinking the meaning of health, especially the concept of collective health by the SUS. The second, object of this reflection, refers precisely to the training models of future professionals, although the authors do not mention a specific time:

The second reform introduced pedagogical innovations, such as Problem-Based Learning (PBL), active methodologies, and work in small groups in the training of health professionals. Medical faculties, in particular, were encouraged to break with hierarchical structures and traditional teaching models to adopt student-centered teaching-learning methodologies (^{FERREIRA, 2019}, p. 1).

To form the expected profile, form competences, and develop innovative teaching and learning processes, these methodologies are in line with what is desired.

Pedagogical relations - concepts and meanings attributed to portfolios

Portfolios have been found to go beyond simply a resource, tool, or assessment procedure. As explained above, it is considered an active methodology, as well as a learning strategy + assessment or simply a learning strategy. We sought to understand these concepts, exploring the composition of the portfolios, in addition to the context of use, a form of elaboration, and periodicity of delivery or analysis. Through the synthesis matrix in Annex 2, some findings can be elaborated; however, some fundamentals are presented first.

According to existing experiences regarding the composition and delivery of portfolios, it was identified that, according to ^{Behrens (2008}), the combinations of what will be part of this composition are carried out at the beginning of the process, via a didactic contract, which can be reviewed at any time. ^{Villas Boas (2005}) also suggests building the portfolio in the process. This leads to understanding the portfolio to support learning progressions over time, as exposed by ^{Scallon (2015}). However, in Alves (2003) and ^{Miranda (2017}), after all the processes are carried out, the student analyses, selects, and chooses will compose his portfolio, showing delivery only at the end of the period. In this case, ^{Scallon (2015)} attributes the purpose of certifying the learning carried out by the student, whether partial or final of a course.

By these signs, we identified that the composition of the portfolio can be defined by the teacher a priori and negotiated with the students, defined by the students and selected by them, as well as thought and defined by the school in its evaluation policy (^{SCALLON, 2015}). Thus, the teacher must have a clear objective for using the portfolio, which, according to ^{Scallon (2015}), may vary, as shown in Box 5.

Source: The authors, based on ^{Scallon (2015}, p. 361-365; 374-382).

Box 5 - Emphasis, objectives, and purposes of portfolios 

Although ^{Scallon (2015}) mentions these possible differences in composition and purposes of using the portfolio, the author recognizes that, in practice, they often get mixed up and gain the same contours.

In this investigation, concepts related to structured and open models were elaborated. The structured ones are those that follow a list of items, stages, or phases, to compose the portfolio, in a sequence to be followed with circularity in the process. There were 12 articles in this sense. Examples will be explored next. The open models, identified in 13 articles, are those that only indicate that the portfolio must contain reports, pointing out some elements to consider in writing, usually narrative. For example, Art. 55 requests the recording of actions, tasks, and learning through a narrative discourse about the educational activities experienced in nursing internships. It emphasizes that it seeks to stimulate the creative resolution of the problems experienced, trying to understand the limits, the options for coping, and the difficulties of the action and the issue, subsidizing the decision-making process. Proposed in this way, although with an open composition, it presents a priori evaluation criteria.

Portfolios as a teaching, learning, and assessment method

One of the important findings refers to the portfolio as an active methodology (Art. 15, Art. 20, Art. 91, Art. 48, Art. 62, Art. 69, Art. 77, and Art. 104). However, there is no conceptual pattern that highlights this finding. We identified the use in undergraduate and graduate courses, in which the portfolios cover subjects such as Health Policies, but also Professional Practice Units, such as extramural internships and modules or disciplines in which Health Care makes living in the SUS possible. Its structured composition gains strength from the portfolio being mentioned as an active methodology. This was found in seven (Art. 15, Art. 20, Art. 91, Art. 104, Art. 48, Art. 62, and Art. 69) of the eight studies analyzed. The portfolio as a methodology, in this sense, presents a step-by-step, but cyclical in some stages, giving the movement of learning the discipline or professional practice.

Analyzing more deeply the models of structured portfolios, we identified that the most widespread comprises the composition shown in Box 6. This model was used exclusively in the disciplines of Health Policies and Health Promotion (Art. 15, Art. 20, Art. 21, Art. 91, and Art. 96), with exclusive moments for the portfolio analysis stops, being from three to four during the semester. They conceptualize the portfolio as a method of teaching, learning, and assessment, which is inferred that corresponds to the structure and development of the discipline, with the 2nd and 3rd topics of the portfolio taking place in cycles. Cotta, professor and author at the Federal University of Viçosa, is one of the authors who references this concept of the portfolio, with learning, focused on training through skills and specificities of the SUS, present in Art. 15, Art. 65, Art. 69, Art. 91, and Art. 96.

Source: The authors, adapted based on Arts. 15, 20, 21, 91 and 98, as Annex 1.

Box 6 - Composition of portfolios more widespread in the studies carried out 

Four articles refer to group elaborations (Art. 20, Art. 21, Art. 91, and Art. 68), being three in experiences with interprofessional groups (Art. 21, Art. 91, and Art. 96). In this way, teaching, learning and evaluating are mixed in this process, an action materialized by the portfolio. We identified that there is a search for truly holistic paradigms, in which multi-professional teams study together and work in teams, overcoming the unilateral and fragmented views of the phenomenon under study and of the conception of professional practice and, therefore, of the curriculum.

Although the Arts. 65 and 77 also consider the portfolio as a teaching, learning, and assessment method, they present open models for composition. Art. 65 refers to the pedagogical training of professors in the health area and considers all the activities carried out in the ten training meetings for the composition of the portfolio. Art. 77, when approaching the internship for the Dentistry course, does not make clear the movement of the portfolio during the process as a method of teaching and learning, and evaluation.

Portfolios as learning and assessment strategies

Although other models of structured portfolios also indicate learning cycles (Art. 5, Art. 104, and Art. 48), they do not conceptualize them as a method. They mention them as strategies that favor the learning and evaluation process. However, when analyzing the composition of the portfolios, Art. 5 shows that it is considered close to the methodology of problematization for historical-critical pedagogy (^{GASPARIM, 2002}), a trend that is also progressive. The Arts. 48 and 104 approach the problem as they define the problems, raise hypotheses, learn from the group and make decisions. In all cases analyzed, the problems are those experienced and brought from the practice that students experience in the Health Units.

Source: The authors, adapted based on Arts. 5, 48, and 104, as Annex 1.

Box 7 - Portfolio composition according to problematization and PBL 

In these cases, the portfolio could also be conceptualized as a teaching, learning, and assessment method because its composition reflects the movement adopted in the subject, which takes place in cycles, with different practical situations, in which teaching, learning, and assessment take place simultaneously.

Although the other articles that name the portfolio as a learning + evaluation strategy (Art. 66, Art. 47, Art. 61, and Art. 34) advocate the composition of the portfolio in an open way, highlighting some composition criteria, they value the production individually, during the process as a continuous act of delivering activities and reflections that support the collective discussions of the subject. These findings indicate coherence with the concept adopted: learning strategy + assessment, using other active methodologies simultaneously. There is a clear separation between what is a methodology and what is understood as learning and evaluating. The fact that they unify learning with evaluation means an advance in the concept of evaluation, in addition to being summative. The case of basic education (Art. 89) also followed this line, although with a structured model of portfolio composition.

Portfolios as a learning strategy

The articles (Art. 98, Art. 87, Art. 67, and Art. 55) that conceptualize portfolio only as a learning strategy do so using it simultaneously with some specific methodology, but all related to problematizations. The composition of the portfolio is always open, in the sense of highlighting what has been learned (synthesis of knowledge in theoretical or training subjects, case reports, and/or experiences in practical and internship situations), and, mainly, to reflect on them. Portfolios are designed individually, but delivery varies depending on the application context. These articles did not mention or reflect on the evaluative aspect of using the portfolio.

Portfolios as an evaluative resource

The articles that showed the portfolio only through the prism of evaluation (Art. 81, Art. 62, Art. 71, Art. 68, and Art. 78), as they are conventionally used in the literature, did not present a pattern to be considered. Three presented open models, and two others, structured models, although all are individual records. A clear definition of the delivery of productions was not identified, occurring in two cases at each meeting, as well as at the end of the semester. In the structured models, a crossing between still traditional models can be identified (Art. 62), in which the composition of the portfolio is fragmented into different activities, each with its value, as well as more innovative models, which integrate all elements of the learning process, as Art. 69, in a more unison way.

Source: The authors, adapted on Arts. 62 and 69, as in Annex 1.

Box 8 - Composition of portfolios evidencing different conceptions of learning 

There are two similar ways of conceiving the portfolio as an evaluation procedure but with different learning concepts.

It is important to mention that the use of portfolios, to their composition, in the articles in which this identification was possible, in the field of health education, refers to internship and residency practices. In these practices, students can reflect on the actions taken, the problems faced, the decisions they made, the reflections, the learnings, and the reconstructions carried out with tutors, teachers, and colleagues, relating theory and practice and developing criticality, autonomy, and responsibility in the professional qualification. Teaching, learning, and assessment take place in real contexts, with authentic problems experienced. On the other hand, the other uses, more frequently, refer to the discipline of Health Policies, which, although it takes place within academic walls, proves to be critical and requires new visions and ideas, and new practices in the face of SUS.

Therefore, there are two fronts for using portfolios that refer to problem-solving. One of them is a teaching, learning, and assessment method, in which the portfolio is the methodology, or a learning and assessment strategy, where the portfolio is combined with other active methodologies. These findings go beyond the classic view of the portfolio as an evaluation procedure.

Pedagogical relations - portfolios and evaluative concepts

Deepening the analysis regarding assessment as a guiding element for the use of portfolios, concepts were identified such as formative assessment (also related to mediating assessment); formative + summative assessment (there are cases in which they are used together); assessment by competences; comprehensive assessment (in addition to cognitive skills); and diagnostic evaluation. Formative assessment, combined with competency and summative assessments, was the most used in the productions studied.

Box 9helps to understand that, according to the emphasis placed on the relationship between teacher, students, and knowledge, the practice of assessment may change. Thus, we can say that innovative paradigms tend to practice a formative and training assessment, as the concern with student learning is evident as a continuous act and resulting from its autonomous production in the process.

Source: The authors, based on ^{Pinto (2016}, p. 25-34).

Box 9 - Concepts of evaluation and emphasis on the triad of the pedagogical relationship 

Formative assessment, present in Art. 15, Art. 20, Art. 34, Art. 62, Art. 65, Art. 68, and Art. 71, is understood beyond the concept adopted in the reference above, that is, although the term formative is used, assessment is applied as a formative and coherent way from a theoretical-practical point of view. Therefore, the term “training evaluation”, according to ^{Pinto (2006}, 2016), is not commonly used in Brazil, in this study context.

Although not explicitly using the term formative assessment, Art. 5, Art. 61, Art. 87, Art. 91, Art. 96, and Art. 98, in the highlighted quotes, reveal this concept. Formative assessment in the productions, in addition to encompassing monitoring during the process, sharing what was built, teacher feedback, with indications for continuity and improvements in the process until the final delivery, involves self-assessment by students, as well as the metacognition, peer assessment, and teacher assessment.

When questioning the self-assessment purposes, ^{Scallon (2015}), for example, refers to the current use of forms with predefined assessment criteria about the task, so that the student self-assesses his production. For him, this is about self-correction, which can also be done in pairs or even in teams. In addition to self-correction, the student can perform self-regulation, which, according to Scallon (2015), consists of reflecting and recording or communicating the procedures followed to perform a task, a set of tasks, or the demonstration of the development of competence. In this report, the student indicates the paths followed, the facilities, the difficulties, and the strategies adopted to overcome them, in which he demonstrates thinking and reflecting on his learning process. These processes refer to metacognition as the possibility for the learner to demonstrate the awareness he has of himself in his learning process, to recognize his strengths and difficulties, and make decisions to improve what is necessary. Therefore, metacognition is related to self-regulation and self-assessment (^{BEBER; SILVA; BONFIGLIO, 2014}; ^{SCALLON, 2015}).

The formative assessment associated with the summation was highlighted in Art. 104, Art. 48, Art. 66, Art. 67, and in Art. 89, which mentioned the possibility that, in the formative process, records are generated that can eventually be transformed into grades, meeting the institution's assessment system, to overcome the traditional models of only summative assessments.

The concept of assessment by competences is highlighted as necessary and important to meet the expected training profile. The following articles - Art. 15, Art. 20, Art. 62, Art. 66, Art. 69, Art. 78, and Art. 98 - mentioned this possibility, since evaluation forms accompanied the portfolios to identify the competencies to be presented, such as critical analysis, the proposal of solutions, leadership, teamwork, among others. Art. 15, presents an assessment and self-assessment instrument by competences. Thus, they develop the self-correction and self-regulation advocated by Scalon (2015).

Together with the assessment by competence, Art. 69 used the summative assessment with relevant discussion on this issue. Art. 78 uses the term integral assessment, alongside assessment by competences, to indicate that, in addition to the cognitive domain, the psychomotor and socio-affective domains are also assessed. Finally, the diagnostic evaluation was mentioned by the experience of the portfolio in mathematics in basic education (Art. 89), combined with the concepts of formative and summative evaluation, and, in Art. 15, with competence-based and formative assessment.

Pedagogical relations - portfolios and evaluation procedures

Box 10shows that the evaluation process, although with different concepts, involves other procedures along with the use of the portfolio.

Source: The authors, Atlas.ti (2021).

Box 10 - Evaluation procedures used with the portfolio 

By adopting these assessment procedures, the portfolio goes beyond the students' productions, demonstrating the self-assessment process. For ^{Butler (2006}), this highlights the fact that the portfolio contains “evidence” of learning as well as “reflections” on this process. Thus, theoretical-methodological coherence is demonstrated, applying the concept of formative and training as indicated by ^{Pinto (2006}, 2016), which guarantees to care with learning, its progression, and reflection on this process.

Regarding the “reflections” that must be present in the constitution of portfolios, seven productions (Art. 15, Art. 20, Art. 81, Art. 48, Art. 65, Art. 91, and Art. 98) used the term “reflective portfolio”. However, mentions of thought and reflective processes were also prominent in the various productions. Two main meanings were identified for the term reflective: as a reflection on the learning process and as a reflection on the context in which the professional practice is being built.

Reflection on learning, as already mentioned, is about documenting, with records, the progress, advances, and potentialities, as well as the weaknesses and difficulties in the learning process, when constructive changes must point out transformations that have occurred. This was demonstrated in 20 of the 25 articles, that is, 80% of the productions (Art. 15, Art. 20, Art. 21, Art. 5, Art. 81, Art. 104, Art. 48, Art. 55, Art. 61, Art. 62, Art. 65, Art. 67, Art. 69, Art. 71, Art. 77, Art. 87, Art. 89, Art. 91, Art. 96 and Art. 98). The Art. 78 goes beyond the reflection on the student's learning process, highlighting the student's elaboration of a plan that helps him to deal with his difficulties, in search of personal, social and professional growth.

Reflection on the context of professional practice is another important aspect, especially in internship and residency practices (Art. 21, Art. 81, Art. 48, Art. 61, Art. 62, Art. 67, Art. 69, Art. 71, Art. 77, Art. 87, Art. 91, Art. 96 and Art. 98). Reflection constitutes a relevant critical process of lived experiences, in its multiple dimensions. It proposes to think about reality critically and look at it with clarity, scope, and depth, identifying problems and making decisions on ways to solve them to seek articulation and integration between theory and practice. It is also a time to review concepts, reaffirm ideas and attitudes, re-signify learning, establish relationships, and seek new knowledge, among other needs felt in the constitution of their professional identity.

Still using the “reflection” attribute, Art. 34, 65, and 66 mention it in the sense of “reflection of teaching practice”, in which the teacher, when narrating his professional experiences, transforms the representations of himself and his pedagogical practice. Thus, it is involved in the construction, reconstruction, and sharing of concepts, reflections, proposals, and actions, giving meaning to reports, studies, and theories, as well as feelings and values.

These attributes are in line with international trends, as ^{Butler (2006}) emphasizes that the use of the portfolio provides and encourages discussion with teachers and tutors and encourages reflection. In this sense, the term “reflective portfolio” is used indicating that, “while in teacher education, reflection is on the individual identities and beliefs of teachers”, in Medicine the focus is on the action, as well as on “teaching students to learn continuously” so that they can follow the changes and advances in medicine” (^{BUTLER, 2006}, p. 6), which can be understood as important, for any area, beyond Medicine.