Essential elements of co-design

Ayoung man with a black beard and hair is talking to someone across a table with coloured paper and pens. We need elements of co-design.Co-design in an academic context is part of participatory action research, or PAR. It’s used to understand, inform and change the design of policies, programs and services. But what are the essential elements of co-design? As we know, community engagement or consultation is not the same as co-design. Including diverse stakeholder and user perspectives is essential for developing best practice.

Gabrielle Brand and her team have identified five core co-design principles in the field of health education. Briefly they are: inclusive, respectful, participative, iterative and outcomes focused. These principles apply in other fields too. 

Core co-design principles 

Inclusive: Key industry stakeholders and consumers are involved from the initial proposal design. That includes the development and framing of learning focus to final educational outcome and delivery.

Respectful: Health care consumers are considered “experts by experience”. All input is equally valued in design, development and delivery of education.

Participative: The research process is open, responsive and empathetic in co-creating education. It generates new understandings of health and healthcare experiences.

Iterative: A cyclic, collaborative process that takes time. It embraces movement towards a shared education vision. It includes the risk of failure.

Outcomes focused: The focus is on achieving a shared educational outcome co-created during the co-design process.

Brand and her team used conversational interviews transcribed verbatim for analysis. The data were analysed in an organic iterative approach to develop shared understandings. Artefacts were also used in the process for eliciting sensory triggers for participants and for developing vignettes. 

The article details part of a vignette to explain how it was used with learners. It’s based on a mother of an adult son with a psycho-social condition. Members of the research team benefited from knowing they had valuable and legitimate expertise on a research project. 

Title of the article is, A research approach for co-designing education with healthcare consumers. It has a mental health education focus, but the methods are applicable in other fields. 

One of the issues with co-design and PAR is passing ethics approval processes. When an ethics committee labels particular groups as ‘vulnerable’ they apply different approval criteria. However, including the voices of a broad range of people involves the participation of vulnerable groups. 

The end result of this kind of research is to “transform hierarchical health care relationships towards a more humanistic model of care”. The same could be said for architecture and other design field. 

Abstract

Context: Community and consumer involvement in health professions education (HPE) is of growing interest among researchers and educators, particularly in preparing health care graduates to effectively learn from, and collaborate with, people with lived experience of health issues. However, to date there has been limited direction on methodological approaches to engage health care consumers in the research and co-design of HPE.

Approach: In this paper, we describe the background to our work with health care consumers including the five core principles for successful co-design (inclusive; respectful; participative; iterative; outcomes focused) and how to apply them as a research approach in HPE.

We introduce the use of arts and humanities-based teaching methodologies including engagement, meaning-making and translational education strategies to illustrate how this research approach has been applied to reframe mental health education and practice in Australia. Furthermore, we share some reflective insights on the opportunities and challenges inherent in using a co-design research approach in HPE.

Conclusions: For the consumer voice to be embedded across HPE, there needs to be a collective commitment to curriculum redesign. This paper advances our understandings of the educational research potential of working with health care consumers to co-design rich and authentic learning experiences in HPE.

Co-design research approaches that partner with and legitimise health care consumers as experts by experience may better align education and health professional practice with consumers’ actual needs, an important first step in transforming hierarchical health care relationships towards more humanistic models of care.

Assoc Prof Gabrielle Brand is based at Monash University Peninsula Campus.