| Sumario: | Objective: To evaluate the effectiveness of electronic portfolios (e-portfolios) as an assessment method for fifth-year pharmacy students in advanced pharmacotherapy courses focusing on complex comorbidity cases compared to traditional assessment methods, and to analyze their impact on Objective Structured Clinical Examination (OSCE) performance in the artificial intelligence era. Methods: A quasi-experimental study was conducted with 32 fifthyear pharmacy students at Fatima College of Health Sciences. Students were randomly assigned to either an e-portfolio assessment group (n=16) or a traditional assessment group (n=16). The e-portfolio group documented complex comorbidity cases with reflective components, while the control group completed traditional assessments. Both groups participated in identical OSCEs. Data were analyzed using independent samples t-tests, Mann- Whitney U tests, and thematic analysis. Results: The e-portfolio group demonstrated significantly higher scores in clinical reasoning assessment (mean 83.5±4.2 vs 76.3±5.1, p=0.008) and OSCE stations involving complex cases (mean 86.8±5.3 vs 79.2±6.1, p=0.001). Qualitative analysis revealed enhanced metacognitive awareness and therapeutic decision-making in the e-portfolio group. Cohen's d effect sizes ranged from 0.76 to 1.33, indicating medium to large effects. Conclusion: E-portfolios focusing on complex comorbidity cases provide significant advantages over traditional assessment methods in advanced pharmacotherapy courses, particularly for developing integrated clinical reasoning skills necessary for managing patients with multiple disease states. Implementation of e-portfolios may better prepare students for the complexities of modern pharmacy practice in the AI era.
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