Introduction

Current Issues in Clinical Education is a course within an online Master’s in Clinical Education at the University of Edinburgh, where over 300 students (themselves professional clinical educators), located around the world, learn about principles, theories, and practices of education. Current Issues is presented as “content-free”: beyond some general resources (e.g. how to write a position paper), content is curated by students and teachers on the fly. Over ten weeks, each student identifies and discusses a topic of personal and professional relevance that is not yet settled in policy, research, or public debate. Where other courses rely on journal articles and formal sources, Current Issues also turns to news items, blogposts, social media, and forms of grey literature. In the absence of a clear scientific evidence base, topics are often highly contentious and, potentially, intractable. Each student must explain how the issue matters to their context and argue for a clear position. This is assessed through individual, ten-minute video presentations (worth 30%), and a 2000-word position paper (worth 70%). In the iteration of the course discussed in this paper, the lead teacher was also positioned as a “student,” presenting her own assignment, and seeking feedback comments from student “peers.” While peers contribute to feedback, marks are allocated by tutors alone.

At the start of the 2021–2022 iteration of the course, Gill (lead teacher) and Tim (co-teacher) invited all students to co-author a paper about participation in Current Issues. Two students, Kanastana and Yathu, volunteered. At the time of writing, Kanastana, a General Practice trainee located in London, is interested in mental health, sexual and reproductive health, and improving health disparities. Yathu is an anaesthetics trainee located in Birmingham, interested in global health and curriculum design for undergraduate medical training. Gill is a dietician by background, senior lecturer (or is she … find out at the end!), programme director of the Master’s in Clinical Education, and head of Postgraduate Education at Edinburgh Medical School. Tim is also a senior lecturer and deputy director of the Master’s. He has a background in digital education and was previously a learning technologist. Gill originally designed Current Issues, and she and Tim have each led it in previous years. In 2021–2022, Gill was lead, and Tim helped out with occasional live sessions, assignment moderation, and some posting on the discussion board. Authorship of the chapter was led by Tim and Gill, with Kanastana and Yathu contributing their thoughts and perspectives and commenting on and editing drafts.

In the rest of our chapter, we draw on co-creation (Bovill et al., 2011) and postdigital literature (Fawns, 2019; Jandrić et al., 2018) to consider the forms of participation that occurred in this online, postgraduate course. Our postdigital view questions the dichotomy between digital and non-digital education, and rejects the idea that any course can be fully online or offline, since it is always embedded in social and material relations. Its content, activities, and learning spill into and out of any formal, digital, or physical spaces (Fawns, 2019). We look beyond a social focus and beyond digital/non-digital binaries to the embodied and material entanglements of people, technology, purposes, values, and contexts (Fawns, 2022). Further, rather than writing as academics researching students, we are teachers and students of the Current Issues course, co-authoring as colleagues. We use, as landmarks for our journey, assignments written by three of us: Kanastana’s on Critical Race Theory in medical education, Yathu’s on the role of medical students in the front-line response to COVID-19, and Gill’s on reward for expertise in university teaching. Through our collaborative writing process, we attempt to negotiate our different perspectives into a coherent or harmonious (to borrow from Taylor & Bovill, 2018) account of co-participation that unifies some of the richness and complexity of our online participation.

Emergent Content: What Happened?

In 2021–2022, 15 students took the course. Regular live conversations were held in Microsoft Teams and recorded for those unable to attend. Discussion boards (Blackboard Learn) were available for asynchronous conversations, and students could also meet or chat independently via their preferred technologies. Emails were sometimes sent by students seeking clarification, and answers were posted on discussion boards for all to see. Before the course started, Gill sent a short video about the course structure and asked for comments. Students negotiated more frequent synchronous conversations (from fortnightly to weekly), changed the proposed timings to better fit their schedules and time zones, and added the choice of presenting assignments in real time or pre-recording. During the course, they also negotiated extensions to assignment submissions. At the end of the course, Gill recorded another video reflecting on how she felt things had gone and inviting students to reply.

Each student’s assignment formed a focus for conversations, research, and thinking. Topics included simulation in psychiatry, training for special needs dentistry in Pakistan, supporting the integration of international medical graduates, and more. Kanastana contrasted crude approaches to equality, diversity, and inclusion within undergraduate medical education, such as standalone courses and active bystander training, with a more integrated application of Critical Race Theory (CRT). She drew on literature from beyond medical education to demonstrate some negative consequences of simplistic approaches (Benjamin, 2017), and to argue that race is a social construct and not a biological fact (Ford & Airhihenbuwa, 2010). This underpinned her proposal for race-conscious medicine, where racism is a modifiable risk that impacts patients, rather than race-based medicine, where race is seen as a non-modifiable risk factor (leading to the pathologizing of racialised people) (Cerdeña et al., 2020). Kanastana examined widespread racial disparities in UK health and social systems, and how historical racial divisions are embedded in the Western medical knowledge base and continue to seep into policies and guidelines that attempt to reduce racial disparities. CRT helped her to identify normalised structures that continue to create barriers for racialised people, and to point to ways of deconstructing them. She proposed the introduction of CRT from the start of medical education in order to provide some immunity against the race-based lens, and to support a move towards a race-conscious delivery of care.

Yathu considered the role of medical students in the COVID-19 pandemic. He illustrated the lack of clarity in guidance from regulatory bodies (Association of American Medical Colleges, 2020; General Medical Council, 2021) and professional unions (British Medical Association, 2021), and how, due to widespread uncertainty and safety concerns, medical students’ participation in clinical care was suspended in many institutions (Kachra & Brown, 2020). Pointing out that students have played key roles in previous global healthcare crises (Martin et al., 2020), he argued that the importance of practice-based learning for future clinicians does not disappear in situations of crisis. Yathu’s position was that, in a climate of chronic challenges to doctors’ welfare, patient safety, and workforce retention, medical training cannot stop in response to any given healthcare threat. Instead, he argued, the medical education community should establish a clear framework for students’ roles in such circumstances.

In a change from previous years, Gill decided to take part in the course as a student. She had concerns about the variable levels of engagement of students in previous years and wondered whether her participation would act as a form of role-modelling. She also intended to generate an updated example of her work for the course workbook, and to use the course structure to help her do some focused reading for a related research project. For her assignment, Gill used her recent application for promotion to Professor of Clinical Education to explore teaching expertise in higher education, how it is understood, and how its conception by different stakeholders has implications for agency, recognition, and reward. She argued that teachers are exploited in an uncaring system, and that their voices are often de-privileged outside of their courses (e.g. in deference to student voices within a customer-service model, and often in deference to managers, IT staff and, sometimes, Ed Tech providers). Gill called for institutions to improve the clarity around how teachers can provide meaningful evidence of expertise in the context of new and emerging pedagogical practices, including forms of teaching, design, and educational administration and facilitation that are less visible. Gill also discussed tensions between teaching and educational leadership, where promotion criteria remove teachers from teaching practice (e.g. by requiring significant committee and policy responsibilities). She argued that good teaching and good educational leadership are not mutually exclusive, and that policies and processes should allow development in both without compromising the standards of either role.

Process: How Did It Happen?

At times, the course was conceptually and emotionally challenging. Kanastana remembers feeling “defeated” after her presentation: technologically challenged and ill-prepared in comparison to her peers (Yathu, Gill, and Tim all remember her presentation as excellent, well-structured, clear, and confident). However, she also felt surprised at her ability to answer questions comfortably, and this encouraged her to pursue further reading. In speaking about CRT, Kanastana felt she developed a stronger voice, encompassing her passion, motivation, confidence, and professional curiosity. In the end, she produced work that she was very proud of. Comfort, ownership, and developing a stronger voice were salient aspects of her participation. This shows that, even in our professional, postgraduate context, co-creation approaches entail an emotional as well as a conceptual shift for students and teachers (Cook-Sather, 2014). For the four of us, uncertainty and emotion made this course feel different from others within the programme. There was a sense of risk and potential reward, expectation, a feeling of not quite knowing where things would end up. While Gill and Tim had run the course before and had confidence in their abilities to cope with whatever happened, they still had a sense of anticipation and excitement about a course with such an open design. Would we produce a course together that generated valuable learning, fulfilled the requirements of Master’s-level study, and met the demands and expectations of the students? What topics would students choose, and how would they engage with the process?

Sometimes, and particularly early in the course, all four of us felt like imposters. It was difficult to feel “at home” until we had populated the course with content and connections. In such an open space, students needed gentle welcoming and clear signposting to what they might do next, examples, reassurance, and a mutual acceptance of living with uncertainty. All of these things, along with elements of structure (e.g. tasks, formative and summative assignments), supported both Yathu and Kanastana to settle on a topic, build confidence, and produce work they were proud of. The end of the course was packed with strong emotions of achievement, gratitude, and relief at getting through an emotionally challenging and stressful, but immensely rewarding, learning experience. At the time of writing, it is still hard for Kanastana to fathom that she was able to openly challenge racial disparities in medicine. Yet, this did not signal the end of her engagement or learning. She is still coming to terms with what she has learned and achieved, and where she wants to take this project in the future. Kanastana and Yathu each wanted to go beyond producing work for an assignment and to develop personally meaningful ideas that they could carry forward to further projects (and, for Yathu at least, possibly a PhD).

The freedom to develop his own ideas was, for Yathu, an important reason for studying at Master’s level. Navigating the relative absence of structure, finding a topic, and developing and defending relevant arguments felt like good, albeit scary, preparation for further study at PhD level. Yet, while Yathu enjoyed the open nature of the course, he felt that collaboration with students and teachers played a crucial role in enabling this freedom. Similarly, within a supportive community, Kanastana found the courage to follow her interest in tackling CRT in medical education. Creativity needs constraint (Candy, 2007), and some initial structure was necessary in order to create a manageable space. For example, the formative and summative assignments helped Yathu to articulate his topic and justify his position, and to balance breadth with a focus on feasible solutions. The combination of such pre-designed elements and conversations with the community helped the students navigate the uncertainty of an open course.

The value of learning as a community was clearest at the start of the course, as the students developed confidence through constructively challenging conversations with peers from different disciplines and settings. Initially, having no clear focal topic was daunting. Yathu lacked confidence in identifying a workable area of interest. He worried that others might think his arguments were not worthwhile, or that someone else might think of a solution to the problem he had identified. Kanastana had wanted to discuss CRT in medical education for a long time but had not believed it possible within a postgraduate program. She did not feel confident enough to broach it; it felt disconnected from other students’ topics, and the literature seemed very broad. She would not have pursued this topic without encouragement and reassurance from teachers and peers. It took time, dialogue, and familiarisation with the course community to overcome her hesitancy.

Relationships are at the heart of the students-as-partners movement (Matthews, Cook-Sather, et al., 2019a). During the various, unpredictable contingencies of the course, students would sometimes help each other navigate challenges (Sun & Goodyear, 2020). At other times, students worked as individuals in parallel, rather than within a community (e.g. not communicating outside of scheduled sessions). Our postdigital view shows us that isolation is not a direct consequence of studying online (Fawns et al., 2019), but of the social and material conditions in which that study is situated. For instance, participation is constrained by professional and personal lives, caring responsibilities, unstable household conditions, or limited technological infrastructure. Indeed, while online learning is sometimes described as inferior, disembodied, and lacking social connections (Boys, 2022; Fawns, 2019; Fawns et al., 2019), it can help students work around some of these constraints, and can underpin rich social and material experiences. People log in from many different physical spaces (e.g. bedrooms, trains, corridors, storage cupboards in hospitals) and are interrupted by children, pets, or visitors ringing the doorbell. Through voice, video, images, and text, participants bring in elements of their homes, local surroundings, offices, clinical practice settings, and so on, revealing glimpses of each person beyond the student/clinician/teacher, while also highlighting the challenges of carving out conducive spaces for reading, thinking, and discussing complex issues (Sun & Goodyear, 2020, p. 20).

Current Issues involves whole-class co-creation in but not of the curriculum (Bovill, 2020). Loose design and minimal content were intended to encourage participation while allowing clarification, well in advance, of what students should expect. There are exciting examples of co-design of the curriculum (see, e.g. Bovill & Woolmer, 2018), but these involve considerable up-front investment from teachers and students and an amplification of risk, trust, and community-building. Co-creation within the curriculum is already very uncertain, and already of great potential value. During Current Issues, students negotiate content, conversation topics, deadlines, conversation schedules, and adjustments to the ways technologies are used. However, this is not a new course. Each year teachers modify the design rather than redesigning from scratch. The formal course descriptor, learning outcomes, structure, and centrally supported educational technologies are set in advance by teachers in combination with other institutional stakeholders. Institutional policies and technological infrastructure are held as fixed design constraints (Ellis & Goodyear, 2009), and the culture of the program as well as students’ existing relationships with peers and teachers shape what is possible. For example, Current Issues runs in the second year of the Master’s. Those who continue beyond the first year are more heavily invested, have had longer exposure to the program philosophy, and have an appreciation of the general approach. Teachers can build on prior trust- and community-building, and thus introduce greater risk and flexibility into the design.

Pedagogical Space

From an idealistic view, Current Issues can be seen as an open space where new knowledge is generated through co-participation (Bovill & Woolmer, 2018) and the interrogation of identities and relations (Gutiérrez, 2008). One of the defining features of distance learning is that it happens across multiple places (physical settings of teachers and students, physical infrastructures of the university and the Internet, and material representations on digital devices), and materially and virtually interweaving locations and contexts (Ellis & Goodyear, 2016) can be valuable in international, interdisciplinary programs like ours (Aitken, 2021; Fawns, Mulherin, Hounsell, & Aitken, 2021b). Current Issues students are working professionals who teach other healthcare practitioners in a range of settings, mixing clinical and educational commitment, bringing concerns and controversies to the course for consideration, and returning to their practice settings with new insights (Aitken, 2021). This is combined with a seamful approach to design and orchestration, in which students and teachers work together to understand the mechanics of their negotiated ways of teaching and learning (Fawns, Mulherin, Hounsell, & Aitken, 2021b). The aim is that dialogue around the educational approach exposes students to their teachers’ thinking about the course and allows them to negotiate designs and configurations. This approach seems, to us, to make particular sense in relation to our context of cultivating (clinical) educators.

However, there are a number of challenges to this ideal. Firstly, it would be misleading to suggest that our Current Issues course started from a blank slate. It was already bounded by timescales (schedules, deadlines), technologies (e.g. virtual learning environments, home setups, devices), who was involved (students, teachers, disciplinary professionals, the wider community), where people were (across countries and continents, in clinical settings, home offices, distributed via online networks), and what was to be learned (learning outcomes, resources, assessments). There were already systems and policies in place, standards, cultures, traditions, and practices. In the design phase, educators sketched out further constraints for the educational activity that might occur, and then further limited this during the course through forms of orchestration (setting tasks, giving guidance, scaffolding through dialogue, etc.).

Secondly, as we have discussed above, some structure is necessary for agency, and some constraint is necessary for creativity. Space is a widely used concept in education, though often in vague, ambiguous, or inconsistent ways (Ellis & Goodyear, 2016; Turnbull, 2002). Here, we distinguish space as abstract, potential, and multiple; from place as specific, lived, and value-laden (Massey, 2005; Tuan, 1977). Loose designs, such as Current Issues, create considerable space as well as expanded possibilities for reinterpretation, creativity, and unpredictability. This can support students to go beyond the “normal” and expected (Boys, 2016), allowing a more inclusive and responsive design for those students who enrol and the topics they pursue. Too much space, however, can lead to some students straying too far from the design intentions, or becoming paralysed from lack of structure (Boys, 2010). For example, Kanastana and Yathu had the freedom to learn things they could not have predicted, but found it difficult to establish the scope of what was to be learned. Discussions with peers and teachers helped them to fine-tune the focus and depth of their explorations, but their engagement and participation will not reflect all students (some may have remained “lost” in the openness of the course even after the final assignment). At stake is not just the final outcomes (i.e. the assignments), but the “quality of the space” in which they are constructed, through dialogue (Wegerif, 2013, p. 5).

Further, the openness of the space is limited by power structures, the agency of teachers and students to navigate perceived or actual institutional constraints, and the expectations of a range of stakeholders. In our program and many others, the marketing of programs, the requirements of course descriptors and design guidelines are oriented towards pre-set content and reading lists, the prediction of learning outcomes, and so on. Yet, an obstacle to good education may lie, ironically, in views of teaching as disseminating knowledge that is already known, as opposed to research as the generation of new knowledge. Universities are sites for knowledge production, not just passing on old stuff (Neary, 2016). Neary proposed students as producers as a critical response to a culture of students as consumers (Neary & Winn, 2009). Teaching as generating new knowledge, rather than passing on the already known, aligns with our own university’s emphasis on research. It follows that teaching should become part of an ongoing knowledge-generation process. Within this, teachers cannot be constantly generating new knowledge for students and then passing it on to them; instead, knowledge must be generated through student and teacher collaboration in teaching and learning. Partnering with students, therefore, while potentially increasing uncertainty, can help us to understand what is important about higher education (Peseta & Bell, 2020) and how we can generate knowledge that will benefit educators, the institution and, perhaps, society.

There is a significant risk that this potential will be unrealised because some students and teachers are insufficiently supported to navigate the pedagogical space created through participative approaches. While some may relish the freedom and potential of co-creation, others will find it daunting and stressful and require more support, and such differences may be exacerbated in very open designs. There may be too much collaborative work for teachers and students to do, and not enough time or energy to do it successfully. Trusting conversations and transparency become crucial in order that students can appropriately interpret the design intentions (Goodyear, 2015), and negotiate appropriate support. A related risk is around the requirement for not only students but also teachers to embrace vulnerability and uncertainty. A co-participation lens can widen the usual focus on “engagement” beyond students to include how teaching staff are motivated in relation to their own courses (Matthews, Cook-Sather, et al., 2019a). It can support an expanded perspective through which more can be seen (Cook-Sather, 2014), and common-sense assumptions about teaching can be interrogated (Brookfield, 2017).

Co-participation between teachers and students creates the potential for all parties to make sense of conversations from an insider perspective (Wegerif, 2013). The purpose of such conversations is not to change the students’ minds to align with the teachers’ pre-conceived knowledge, but to change the understandings of all parties and thus generate something new: an expansive, rather than a linear, view of development that includes horizontal learning across contexts (Aitken, 2021; Engeström & Sannino, 2010; Gutiérrez, 2008). The boundaries are unclear between teaching and learning, or between academic and professional work: everyone is negotiating multiple contexts at the same time, rather than crossing from one to another (Fawns, Mulherin, Hounsell, & Aitken, 2021b). For all participants this requires confidence and a willingness to embrace uncertainty. Gill and Tim are relatively at home in uncertainty, having many years of online teaching experience and a philosophy of openness, vulnerability, and honesty. However, this way of thinking about postgraduate education is not common or comfortable for many teachers or students.

Further, “student-led” educational design is still entangled in the power relations and political economics that permeate contemporary postgraduate education (Gravett et al., 2020), and mechanisms of participation are mostly controlled and initiated by universities or teaching staff (Carey, 2018). In Current Issues, this was evident in the assessment of individual work, weighted towards a relatively traditional form of written text, and in the imposition of teachers’ values. Gill and Tim follow aspirational principles of openness, authenticity, vulnerability, and honesty (Fawns, Aitken, Jones, & Gravett, 2021a), but students have little say in this philosophy. In Current Issues, there is no feasible option for students to learn within a more familiar structure. We see this as neither inherently good nor bad: education cannot be entirely student-led because it is a negotiation of values and relations between institution, educators, and students. While this highlights a limitation of the partnership metaphor (since students rarely get much say in how “student-led” a course will be), all design contains gaps between design intentions and what students, teachers, and others do, and important elements of pedagogical space are found in these gaps. Design cannot cover all emergent activity, learning conditions are not entirely predictable, and students cannot help reinterpreting designs and instructions (Sun & Goodyear, 2020). Gaps can lead to misunderstandings, but they can also be richly generative, allowing choice, creativity, self-management and, ultimately, meaningful participation (Sun & Goodyear, 2020). Dialogic space, where new meanings are contested, can be created through the tension and contradictions between multiple perspectives (Wegerif, 2013).

Postgraduate Education: Who Is Teaching Whom?

The participation of students and teachers in our loosely designed course entailed not only the negotiation of the content to be learned by students, but a surfacing of questions—relevant to all education but often neglected—of who is learning what, and the roles of different participants in supporting the learning of others. A turn away from teacher-centeredness (Neary, 2016) towards “student-centredness” (Ramsden, 2003), “student voice” (Cook-Sather, 2018b), social justice (Brennan & Naidoo, 2008), critical pedagogy (Bovill & Woolmer, 2018), and a recognition of complexity (Goodyear et al., 2021; Goodyear & Carvalho, 2019) has moved research into fertile new territory around students as partners (Matthews, Cook-Sather, et al., 2019a), producers (Neary, 2016), co-creators (Bovill & Woolmer, 2018), and co-configurers (Sun & Goodyear, 2020). This movement looks to draw on and develop students’ educational and learning expertise (Matthews, 2017), as well as to support their agency within educational processes and designs (Bovill et al., 2011). It encourages us to consider students’ creativity and their potential to make relevant that which they have chosen to study (Bovill, 2018). At the same time, it prompts us to think about teachers as learning from their students in various ways (e.g. about course topics, about their students’ hopes and ideas, about teaching and learning).

However, while partnerships with students are often conceived of as equal or aspiring to be equal (Cook-Sather et al., 2014), it can be unclear how students actively acquire power within institutional constraints (e.g. around grading or admissions) (Carey, 2018). As Kanastana’s work on CRT highlighted, there are often entrenched and invisible obstacles to equity of participation and access (i.e. who is participating in the first place). We know from previous research (Aitken et al., 2019) that students on our program arrive with various forms of cultural and social capital, without which they may not have the necessary qualifications, professional experience, capacity to negotiate the application requirements, or funding to enrol. This capital influences the experiences and perspectives they bring as well as their potential to participate in the social, material, and cognitive activity of the program.

Some co-creation literature focuses on equity as an aspirational value (Cook-Sather, 2018a, 2018b), which is illustrated by Gill’s “student” role. Gill thought that if she did the assignments and shared how her thinking was developing, it would reduce the gap between teacher and students. In fact, she found this very onerous and did not complete the position paper. This was acceptable because she was neither seeking qualification nor paying fees, and her “failure” was simply used as a prompt for discussion within the course (e.g. around the tension between personal development activity and urgent demands such as marking). Gill also designed the initial course structure, schedule, and assessments; orchestrated conversations; helped students understand course expectations; and offered guidance around appropriate topics. At the end of the course, she allocated grades to students and was not graded herself (but did seek and receive feedback from others on the course). She was far from a typical student in her role, power, and insider knowledge of the course. Her aspirational positioning as “student” did reconfigure some power dynamics (e.g. by inviting suggestions for her assignment, emphasising all feedback as peer feedback, and learning about the demands of the assignment from a student perspective), but the lack of consequences for not completing her student role exposed the inequitable positionality of teacher and students. For us, equity remained a principle from which we could learn about the nature of our teaching, learning, and design rather than a reality embedded within the course.

Coming to see students as partners may be a threshold concept (Cook-Sather, 2014; Marquis et al., 2016) for teachers and students. It can be uncomfortable, troublesome, and transformative of how we see and do education (and of whom we see as involved). In Current Issues, students taught each other, and the teachers, in a very direct sense (Gill and Tim learned about CRT from Kanastana and about trainees’ medical practice during the COVID-19 pandemic from Yathu). There was a messy and often unarticulated overlapping of roles beyond the binary of teacher/student. Indeed, maintaining a clear delineation between teacher and student roles may obstruct co-creation. In Current Issues, students and teachers negotiated not only content and process, but also pedagogy (Bovill et al., 2016). For example, they learned about, and reconfigured, relations between education and professional practice and the horizontal learning that happens across those contexts (Aitken, 2021). Distinctions between teacher and student did not completely unravel; they were held together by assessment, perceived authority, policy, and culture (e.g. Kanastana still privileged Gill’s voice within the feedback process, in part because she would mark the work). But there are more elements involved in education than just teachers and students, including other stakeholders and technology. To talk of “equality” is to separate out the contributions of different elements, rather than seeing their contributions as relational and entangled (Fawns, 2022). If power cannot be equally shared, perhaps it can be “distributed appropriately” with all participants constructively challenging practices that reinforce existing inequalities (Healey et al., 2014, p. 15). We see this as an important and challenging aspiration for co-creation approaches, while recognising that it also raises a further power-related question of who decides what is “appropriate.”

Evaluating Postdigital Co-Creation

Studying is expensive and time-consuming. A course with no content may seem a poor investment when viewed through instrumental conceptions of teaching or reductive measurement of outcomes. Indeed, students are asked to do some of the work traditionally done by teachers around generating content and feedback. Yet, an interesting challenge for evaluation is that, through the process of education, we can come to new purposes and values, a new sense of what matters, a new understanding of teaching expertise. The learning process may produce very different values and conceptions of teaching from those with institutional power in relation to evaluation, recognition, and reward (Aitken & Hayes, 2021; Aitken & O’Carroll, 2020; Fawns & Sinclair, 2021).

Many institutional conceptions of teaching expertise need reframing in relation to co-participation. It is common to conflate expertise and experience in teaching (Berliner, 2005; Brookfield, 2017), but how teaching is done matters (Fenstermacher & Richardson, 2005). For example, Gill has heard many clinical educators talk about inspirational teachers who, upon further scrutiny, are charismatic and entertaining but not necessarily effective at designing, curating, or orchestrating learning activities and environments. Elsewhere, Gill and colleagues have written about the shortcomings of teaching awards that privilege more overt and visible practices while marginalizing the careful background work that underpins successful learning activity (Fawns, Aitken, & Jones, 2021c).

Approaches in which students explicitly share responsibility for the quality of their education fit uneasily with traditional conceptions of “good teaching,” instrumental evaluation, or the “value-for-money” rhetoric of Higher Education, where students are positioned as consumers of an educational product or service that is provided by an institution and its teachers (Bishop et al., 2018; Fawns, Aitken, & Jones, 2021d; Matthews, Dwyer, et al., 2019b; Neary, 2016). Through the course, we all learned much more than what showed up in assessments (Ellis & Goodyear, 2009) and centralised evaluations (Fawns & Sinclair, 2021). From a postdigital view, unfamiliar approaches, including (even now) online courses and co-participation approaches, shine a light on aspects of education that we should have been examining all along (Fawns, 2019). For us, education is always a collaborative endeavour between teachers, students, and others (Fawns, Aitken, & Jones, 2021d), all of whom are also “learners.” In an ecology of participation (Taylor & Bovill, 2018), each participant sets out their own direction and set of values that may not correspond with ideas of economic value (i.e. “value for money”). Who, then, is fit to judge teaching expertise or quality of teaching, particularly in co-creation approaches where the teacher takes a less prominent role, yet one that requires a different and potentially unfamiliar expertise (Aitken & Loads, 2019; Bovill et al., 2016)?

Both co-creation and postdigital literature highlight the value of processes of collaboration, negotiation, and shared decision-making to personal and professional development (Lubicz-Nawrocka & Owen, 2022). Gill found it empowering to talk with an interested group of peers (i.e. her students) about the continuing development of educators and the challenges of an academic career. Kanastana and Yathu found it useful to collaborate with Gill on their projects and to gain insight into some often invisible aspects of their tutor’s role. Little et al. (2012) suggest that such open discussion of the terms and intentions of collaboration can help students not to be exploited. Open discussion of how a course works erodes the distinction between teaching and evaluation, and these new understandings are part of the value of education that can only be appreciated after the fact (Aitken et al., 2019). Conversations between colleagues are a noted means of academic development (McCune, 2018; Roxå et al., 2011) and, by including students in what would traditionally be teaching conversations (how to run the course, what the content should be, what is working and what isn’t), teachers could not only gain valuable insights from students about what they needed, but all parties concerned could broaden their perspectives on the educational process (Fawns, Mulherin, Hounsell, & Aitken, 2021b).

How we evaluate teaching influences the capacity of teachers and others to enact principles of equitable or inclusive participation. Evaluation methods that isolate educational elements (e.g. teaching methods, technologies, or the expertise of individual teachers) (Fawns, Aitken, & Jones, 2021d), or miss less conventional or visible forms of engagement (Fawns & Sinclair, 2021), do not encourage teachers to consider the diversity and complex interplay of factors that influence the quality of educational experiences (Fawns, 2022). Much learning happens in unconventional ways, and outside of the view of teachers (Boys, 2022; Ellis & Goodyear, 2009; Gourlay, 2015). If we want to be inclusive and understand what is really going on, it is important to look beyond familiar forms of learning and teaching, and beyond methods and overarching designs, to the complex entanglements of people and the conditions in which they are learning.

Conclusions

In this chapter, we have considered our experiences as students and teachers on a “content-free” course. Co-creation is not a method, but a collaborative enterprise that must be carefully designed and orchestrated, including trust-building before the start of the course. We found a number of parallels between the challenging aspects for students and those for teachers, and a blurring of the distinction between teacher and learner roles. Such approaches can develop educational expertise for students and teachers, and increase agency and creativity, but are sometimes deeply uncomfortable. Navigating an open and loosely defined course structure was particularly challenging in combination with the pursuit of a potentially confrontational and exposing area of enquiry such as Kanastana’s assignment on Critical Race Theory. Our postdigital view questions the dichotomy between digital and non-digital education (Fawns, 2019), and emotions are not absent simply because a course is “online” (Fawns et al., 2019). In our Current Issues course, there was a need to build confidence for both teachers and students and to foster a supportive space for the safe expression of emotion.

Co-design is still entangled in tradition and entrenched institutional constraints, such as assessment, and limitations around recognition and reward of non-traditional teaching. The delegation of agency through content, tasks, and processes does not automatically produce a course that challenges convention: in their negotiation of educational practices, students may simply reinforce existing norms (Boys, 2016). It can be scary to challenge the familiar and to push for something different. As Boys points out, education presents an opportunity to expose the often invisible “spaces in-between” of different disciplines, educational designs, and the perceptions of students and teachers. We can question the “assumed practices and boundaries” of educational design (Boys, 2016) and examine the seams between different practices (Fawns, Mulherin, Hounsell, & Aitken, 2021b).

Combining co-creation and postdigital views, we have argued for a need to go beyond the social to consider the material. Technology plays an important role in co-creation, where different elements mutually shape possibilities for collaboration. Students always “co-configure” tasks and social and technological arrangements with their teachers (Sun & Goodyear, 2020). In the case of Current Issues, this co-configuration was amplified through a loose design in which the teachers’ initial design intentions made space for students to contribute ideas and resources and to negotiate changes to schedules, tasks, and assessments. All of this contributes to a “pedagogical space” made up of the parameters that shape what might be learned and how, the gaps between design intentions and actualised activity, and space for the production of new knowledge.

Epilogue

We are pleased to write that Gill was promoted to Professor of Clinical Education in 2022, during the writing of this chapter.