Co-creation in action: Empowering students to empower each other

By Dr Sean Roe and Dr Mary McGahon

Centre for Biomedical Sciences Education, School of Medicine, Dentistry and Biomedical Science, Queens University Belfast

Sean is a long time Athena SWAN and Equity, Diversity and Inclusion (EDI) Representative for the Centre for Biomedical Sciences Education (CBMSE), having worked there since 1997. More recently he has been elected Chair of the QUB Faculty of Medicine, Health and Life Sciences EDI Committee. His passion for EDI activism comes from a desire to formalise compassion into science and medical curricula. He believes that recognition of differences in lived experience is central to the art and practice of teaching.

Dr Sean Roe

Mary is Widening Participation (WP) lead for CBMSE, with a similar passion to ensure education is for everyone, regardless of background. She has enthusiastically supported the QUB Pathway Opportunity Programme since its inception in 2019 and has led on summer schools for students who mightn’t otherwise have had an opportunity to study on our Science and Medicine courses.

Dr Mary McGahon

The inspiration behind co-creation

As advocates for all things EDI and WP in our Centre, we have always aimed to get beyond box-ticking exercises by changing attitudes among colleagues and fostering a culture of activism on behalf of a diverse student and staff cohort. There is an imperative to effectively educate our hugely diverse classes (in terms of race, varied ability, background, sexuality, gender and neural expression) to access the talents and resilience required to overcome their personal barriers. In the era of AI and large language models currently homogenising creativity and human experience, the ability to hear and recognise individual voices gains further urgency. Unique lived experiences are now, more than ever, at a premium. Put simply, culture change is required.

The most basic tenet of equity discourse in university education is that it is impossible to effectively learn unless you can see yourself represented in the curriculum itself and in the very structures of the University (Ahmet, 2020). A logical corollary of this is that involving diverse students in the construction and conception of their own curricula further cements their stake and investment in learning. It was with that in mind that we recruited three students from diverse backgrounds to co-design aspects of our Undergraduate Physiology curricula in Medicine Health and Life Sciences degrees at QUB.

As part of a six-week summer internship, students were given a wide brief to identify gaps in the physiology curricula regarding those with protected characteristics as described in the UK Equality Act 2010 (race, sex, gender reassignment, marriage or civil partnership, pregnancy and maternity, religion and belief, disability and sexual orientation; UK Government, 2013). The initial focus was on the classes carried out in the physiology practical laboratory. Our broad aim was to start the process of cultural change and create a learning environment that better celebrated difference and represented each individual student.

Themes identified

Very rapidly students coalesced around three main themes in their investigations. These were; self-recognition within the curriculum, cultural humility, and intersectionality. They rapidly identified areas in the physiology curriculum where the subject’s focus on the eponymous 70 Kg “physiologic man” has omitted large swathes of humanity. As a result, they started the process of incorporating information about various sex, gender, size and racial variations into our practical class supporting materials. Equally profound was their gravitating to the theme of “cultural humility” first coined by Tervalon and Murray-Garcia (1998). The term refers to a process of reflection and exploration outside of one’s culture to gain interpersonal understanding and awareness of others’ experiences. It is fundamentally an acknowledgement that we can never be an expert on anyone else’s lived experience and that everyone is potentially our teacher. To quote from the students “By understanding how each other’s lives have shaped each of us, we began a journey to uncover the beauty in things learned from alternative perspectives” (McGahon et al., 2024).

Finally, students resonated deeply with the concept of intersectionality incepted by the black feminist scholar, Kimberlé Crenshaw (1989). This refers to how individuals hold multiple identities and face unique challenges at the intersection of those identities. Our students liked this because it got away from the critique of EDI as putting people in silos with convenient labels. Intersectionality suits physiology as it encourages more precise and authentic descriptions of populations and avoids classifying them in broad boxes with crude labels. It was exciting to watch students with one evident protected characteristic argue just as passionately for all of the other ones. Whilst we, as academics, are aware of, and endorse intersectionality as a concept, watching students being reflexively intersectional, using their lived experience as “fuel” for compassion was truly inspirational and marks some of our most meaningful experiences of the past academic year (if not our entire careers).

Results and recommendations

Beyond the aforementioned meaningful experience for staff and students, more concrete outcomes have been publication in a discipline specific journal (McGahon et al., 2024) and useful background material and instructions for our science and medicine practical classes. As an education centre it is our (not unambitious) aim for everyone from a first year student to the Director of Education to have the opportunity to be an advocate and activist on behalf of all staff and students. Our recommendation would be simply to recruit your enthusiastic students to examine and cocreate your courses. To quote the epigram often attributed to Johann Wolfgang von Goethe “Whatever you can do, or dream you can, begin it. Boldness has genius, power and magic in it. Begin it now.”

References

Ahmet A. (2020). Who is worthy of a place on these walls? Postgraduate students, UK universities, and institutional racism. Area, 52, pp.678–686. https://doi.org/10.1111/area.12627

Crenshaw K. (1989). Demarginalizing the Intersection of Race and Sex: A Black Feminist Critique of Antidiscrimination Doctrine. The University of Chicago Legal Forum, 1989(1), Article 8. https://chicagounbound.uchicago.edu/cgi/viewcontent.cgi?article=1052&context=uclf

McGahon MK et al. (2024). Surprised by cocreation: building equality, diversity and inclusion in the physiology curriculum with undergraduate students. Advances in Physiology Education, 49(1), pp.37–40. https://doi.org/10.1152/advan.00184.2024

Tervalon M & Murray-Garcia J. (1998). Cultural humility versus cultural competence: A critical distinction in defining physician training outcomes in multicultural education. Journal of Health Care for the Poor and Underserved, 9(2), pp.117–125. https://muse.jhu.edu/article/268076

UK Government, 2013. Equality Act 2010: guidance. London: GOV.UK. https://www.gov.uk/guidance/equality-act-2010-guidance