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Moving from tokenism to co-production: implications of learning from patient and community voices in developing patient centered professionalism



Moving from tokenism to co-production: implications of learning from patient and community voices in developing patient centered professionalism




Professional practice in hea
lthcare is under increasing ch

allenge from changes in

society and modes of care delive

ry. It is widely held th

at deep cultural shifts, both

individual and systemic, are required to tran

sform relationships in

healthcare towards

co-production to improve outcomes in health.

The movement to involve the public in

health professional learning in education a

nd service development to help make these

shifts, is now mandated in the UK but what th

is means in practice

is only beginning to

be understood. In both the UK and US,

our long term programmes of public

involvement have found that both professi

onals and patients can benefit and practice

can change, but how and why it works or

not, is not yet fully articulated.

We have argued that the deficit model

of the patient and the wider community

remains a significant barrier to learning pa

tient-centred professionalism as espoused

by professional leaders. The dominant rese

arch paradigm in medicine, privileging

reductive over experiential

evidence and ignoring power rela

tions and context, is not

adequate for understanding the value, pr

ocesses, meaning and impact of the

contribution of patient and community voi

ces to the developm

ent of professional

practice. This paper reports an interdis

ciplinary and multi-professional approach to

developing a practice-based unde

rstanding of the impact and outcomes of patient and

community involvement " based on shared

participatory processes across our

programmes " that recognises community capaci

ty and builds this vo

ice in healthcare.

The project aims to strengthen the conn

ection between theory and practice towards

the development of collaborative research.

All participants engage in a spiral of

reflection to explore their own experiences

during this mutual enquiry. Examples

of patient, community and professional

experience in learning together are explored

and analysed from

diverse social and

learning perspectives, with patient and co

mmunity voices at the heart, to gain

understanding of the effects of

public participation in the emergence of new ways of

thinking about professionalism. Resistance

to real and effectiv

e participation and a

tendency to manipulate participation for pr

ofessional ends, rather than pursue co-

production, will be examined. Modes of

involving the public in the design and

implementation of their roles in professiona

l education are compar

ed. Implications

for future conceptualising within the

field and current practice are drawn.

Bibliographic Citation

Conference Paper: Professional Lifelong Learning: Critical Debates about Professionalism. (2007)