Absolutely agree. Use of logbooks requires commitment on the part of all parties. The starting point should be to educate faculty I think. 

I agree about the visual and documented agreement requirement which could be centralized  by share point where all parties including the administrative staffs have the access and regarding the effective use of it require periodic educational session with involovement of everyone.

The logbook can achieve the desired goal only when trainers/teachers are committed and models of standard practice. The trainees/students would desire easy way out yet  appreciate standard if rightly guided. Logbook can ensure adequate exposure and  uniformity of training as the required are clearly spelt out. Both trainers and trainees should act well their roles.

The million dollar question is what is the standard model of practice for logbooks! I don't think it is quite defined. Needs to have a  balance to address that the trainee has seen a minimal amount of procedures/clinical experience, while also allowing them an  opportunity to reflect, get feedback and improve their skills. It's a balance between quantity and quality of patient encounters!

log book help the undergraduate student to note down the daily activity of the student there postings may be stream lined as per medical council of India guide line,this can be daily signed by the teaching in-charge.depending upon their activity internal marks can be given at the end of  semister their evaluation can be carried out

I agree with Abdulkabir Ayanniyi  that "Logbook can ensure adequate exposure and uniformity of training as the required are clearly spelt out."  Do you use standard questions in your logbook?

In my opinion, logbooks are only good for counting episodes - number of patients seen, number of lectures attended, number of hours worked. As Pishoy implies, they provide an accreditation service.

"State of the art" is to accompany the logbook with a (brief) narrative component that allows the student and teacher/advisor to reflect on the benefit and needs that arose from the experience.

I completely agree Brian. It's the challenge of combining both quantitative and qualitative components into a logbook that will make it a successful exercise for both the trainee and acdemic staff.

Yes the activity/statement/question has to be standardised. Logbook is designed and specific on essential areas that trainees/students should accomplish while on specified posting. For instance while rotating in or at the end of Ophthalmology posting the trainees/students MUST be able to correctly handle and use ophthalmoscope to visualise optic disc, retina blood vessels and macula. Therefore, logbook may  spell out activity to be accomplished by trainees/students as follow:

1. Correct handling of Ophthalmoscope

2. Ability to locate/visualise optic disc

3. Ability to locate/visualise retina blood vessels

4. Ability to locate/visualise the macula

This of course will require the trainers/teachers' supervision.  If the trainees/students are divided into groups or of different set, the logbook can ensure that each group or set though, rotating at different periods, undergo standard/uniform exposure.

Abdulkabir in the above situation the logbook can be used in two very different ways.

The first is simple: A supervising physician can simply place his signature beside a line that says completed eye exam. This may or may not have included informal feedback. There may be up to 5-10 of these lines to be signed off before the end of the rotation.

The second is more complicated: For each eye exam, there may be a section for feedback from instructor, problems faced and new findings/observations learnt. This obviously takes more time. 

Which would you rather though as a rotation supervisor - 10 signatures demonstrating 10 learning moments of variable educational quality. Or 2 entries of the later?

For the second type of logbook to succeed, you need both students and staff motivated to allow it to succeed. Failure from either party, makes it just as useless as a numbers game.

Rejina, I think your sharepoint idea is an excellent idea, especially as more and more students are gradually getting access to smartphones and can readily update their data...

the log book should contain activities assigned to the student for  example during Gynecology & Obstetric posting they should fill 15 ANC cards and their detail in log book, Number of deliveries observed by then about 10 and detail of these in the log book, number suturing  done detail steps,number of Copper t insertions done, number of tube ligation  observed & write up of the same. this will help  to learn practical things which are done in the wards

evaluation done based on these activity will go in a long way in order to improve standard of  education

Iagree with Ravidra

I agree with Ravindra; in our programme final year medical students are asked to do a three week ambulatory care ( community health) rotation and they are instructed to log all the cases that they see. They are then expected to discuss three (3) of these cases in greater detail (one case is a discussion on their competencies; one case is a discussion of their management of a patient with diabetes & hypertension and how this management differs from the international guidelines; the last case is a discussion of how  the social determinants of health were addressed)(1- 2 pages of discussion for each case).

These log books are graded using a  rubric and these grades contribute to their end of clerkship grade.

    The access to logging was never an issue, I agree smart phones have made it easier. But, the importance of it has to be put across positively to an undergraduate. Their ability to understand its importance is the only factor which will assure compliance by them. And once explained that it would be a good tool for self appraisal and not compulsion would also motivate a lot of them to effectively put it to use. 

Although in some countries would think, being in a developing country would be technologically limited, most of our students regularly use tablets for that. Tables certainly are replacing logbooks. This is now common in Colombia and Venezuela.

Abhishek the point you just mentioned remains a massive challenge in medical education, in fact probably spans all disciplines of education. How do you motivate students to increase the efforts in their assignment? How are you going to demonstrate the importance of a logbook and reflection? 

Ideally logbooks wouldn't even be graded, just required for completion, which is the case in many institutions. In that case, you really have an even larger challenge on your hands!

-any thoughts?

Pishoy the challenge is about engaging the students in a learning process ins

following on from Abhishek, my biggest conceptual challenge with logbooks: Logbook for guidance (formative) or for assessment (summative); this question relevant both for numerical and qualitative data. I struggle with this a lot. Make the logbook optional and few will use it. Make it mandatory to complete it with certain numbers of x,y and z and suddenly it becomes a box ticking exercise, and getting the right number of ticks is seen as the endpoint of learning. (once I have taken blood four times, I'm clearly now good enough)

I remember a student who I asked what he had been up to the night before: "I stayed up all night in A&E waiting for a suturing to come in, it was the last thing in my logbook to complete" I asked if he'd seen anything useful whilst he was there "No, I didn't want to miss the suturing if it came in". So many unintended negative learning outcomes there!

I also doubt the use of log books in the medical field. A more useful version of it would be a portfolio with reflective logs of the students on their learning experiences and how they plan to improve on them.