In this blog I reflect on experiences of working with medical students as pedagogical co-designers using two projects as examples.Project 1
: Diversifying the curriculum: a student-led initiative to include LGBT+ health in the medical curriculum.
Studies identified that medical curricula in the UK give limited attention to the health needs of Lesbian, Gay, Bisexual and Transgender (LGBT) patients. I recruited a group of 6 medical students to work on a project which involved 1) Developing learning resources. The students worked with a range of networks to identify LGBT volunteers willing to take part in a recorded interview to share their experiences of healthcare. The interviews were then edited into short digital stories and uploaded onto the university media platform as a resource for all medical students. ii) Literature review: the students undertook a review of relevant literature on LGBT health and produced this in a format suitable for their peers. 2) The students planned and organised an evening event for medical students. The event involved case discussions and a questions and answer session with LGBT individuals. From this project we developed a Year 1 teaching session that was modelled on the event and utilised the learning resources created. The year 1 session involved small group sessions run by those with personal LGBT+ experiences and a final whole class questions and answer session, during which the panel of tutors answers questions posed anonymously by the students. Project 2: Physical Activity in Medical Education: A Flipped Classroom Approach.
I recruited 6 medical students to develop resources for a flipped learning session on the health burden of physical inactivity and the potential role of the doctor in promoting physical activity. The students were integral to the project team in all stages of the project –developing the flipped learning resources; creating an introduction to flipped learning; evaluating the session.
• Developing learning resources: the students reviewed and selected existing online resources; developed bespoke cases for in-class discussion; created expert interviews (conducted the interviews, filmed and edited the videos). You can see one video example here Physical activity project video
• Introducing flipped learning: the students felt that an introduction to flipped learning would help students to engage with the need to do work in advance of the lecture. They chose to develop an animation to make this, potentially dry introduction, more engaging. Flipped classroom animation
• Evaluation: The students conducted a focus group interview to contribute to the survey evaluation of the flipped learning session. The evaluation highlighted that the flipped learning session was popular and has improved students’ understanding of physical activity and health.Reflection
I began to consider what is meant by partnership and whether this is an accurate description of the processes undertaken in my projects with students. There are many definitions of partnership in the context of staff and students working together (Healey 2014; Hubbard 2017). The difference between partnership and co-creation has also been noted; where partnership implies a greater equality between those involved (Bovill et al. 2015). Moreover, several models have been developed to illustrate different forms and levels of participation including Bovill and Bulley’s (2011) ladder of participation within the curriculum design process. Partnership has also been defined through the roles involved. For example Bovill et al. (2015) describe the roles as consultant; co-researcher; pedagogical co-designer; and representative.
In relation to my projects I would say that the students involved in these curriculum enhancement projects were engaged as pedagogical co-designers. In both, we shared responsibility for designing the learning resources and the learning events and it was the students who led as producers of the resources. So were these examples of partnership in curriculum development? Looking at Bovill and Bulley’s ladder the students were not entirely in control (top rung) but in some respects they did have ‘substantial influence’ and the curriculum was negotiated. For example in Project 2, we planned to use some videos from an existing MOOC that one of the team had developed but after reviewing these the students felt that it was not appropriate for medical students and so would not work for this session. We valued and trusted their input so dropped the plan to use the pre-existing videos; instead the students would create their own resources.
Yet I still feel that key aspects of the work on these projects highlight the implicit power differential that challenges the suggestion that they reflected a true partnership. First, the aim and broad agenda for each project was not co-created with students and while we were flexible to change, had the key parameters of the projects been challenged I am not sure that we would have agreed. Moreover, while partnership may not depend on equal levels of expertise, the limitations of students’ skills can be a challenge. In both projects the students worked incredibly hard and were undertaking quite complex tasks that required developing several new skills including video editing, interviewing, and literature reviewing. The results were mixed with some of the end products not being good enough for the purpose intended. Although I gave students relevant training, there were perhaps some tasks which were beyond them at that point in time, or that would require a significantly greater input both from them and from myself. Perhaps therefore the term co-creation, as a shared but less equal form of working together better describes this work rather than partnership.
Moving forward I will continue to work with students on projects such as these It would be great to hear about anyone’s experiences of working with students in this way. References
Bovill, C. and Bulley, C. J. (2011) A model of active student participation in curriculum design: exploring desirability and possibility. In Rust, C. (Ed.) Improving Student Learning (18) Global theories and local practices: Institutional, disciplinary and cultural variations (pp. 176–188). Oxford: The Oxford Centre for Staff and Learning Development.
Bovill, C., Cook-Sather, A., Felten, P., Millard, L., & Moore-Cherry, N. (2015). Addressing potential challenges in co-creating learning and teaching: overcoming resistance, navigating institutional norms and ensuring inclusivity in student–staff partnerships. Higher Education, 71, 195–208
Healey, M., Flint, A., & Harrington, K. (2014). Engagement through partnership: Students as partners in learning and teaching in higher education. York: The Higher Education Academy. Retrieved from https://www.heacademy.ac.uk/sites/default/files/resources/engagement_through_partnership.pdf
Hubbard K.E., Brown R., Deans S., Paz García M., Pruna M. & Mason M.J. (2017) Undergraduate students as co-producers in the creation of first-year practical class resources, Higher Education Pedagogies, 2:1, 58-78