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Digital Education Studio

Co-Designing Medical Education:

Reflections after 1 Year of Delivery, Thomas Hinks, Michael Page, Annie Noble-Denny

Co-Designing Medical Education:

The MA Medical Education delivered by the Institute of Health Sciences Education (IHSE) was one of the first courses to be co-designed as part of the Digital Education Studio’s CARE Digital project. This co-designing process is a multidisciplinary approach that brings together academics, experts in digital learning, multimedia producers, interactive web designers, and others to create high-quality online courses.

As one of the original courses in the project, the MA Medical Education is celebrating a key milestone as students have just completed their first year. As a Senior Learning Designer who worked on this co-creation project, I sat down with the programme team, Mike Page and Annie Noble-Denny, to reflect on the journey, from deciding they needed an online course, to delivering their first year of modules co-designed with the DES.

The road to becoming online

The programme was not always envisaged as fully online. As Mike explained, he originally wanted a hybrid programme. This was driven by the need for a structure that would support their busy students, who are often doctors and nurses and need flexibility, Mike noted:

I don't want any doctor or nurse to have to think twice if they should go to their masters teaching that day because they've got called away on something urgent

When considering these needs there was an initial sense that a hybrid approach may allow the programme team to provide flexibility and accessibility without too much disruption to how they would regularly teach their modules. But after some time looking into this solution, Mike found:

Rather than having the best of both worlds, it kind of compromised both modalities. The online modality was compromised by people feeling like they were watching teaching on TV and not really participating, and the in-person experience was compromised by us hopping around trying to make sure that people online did feel included and knew what the activities were and so on. And so we had kind of decided on the back of that. No, we need to do this properly, which means we need an in-person program and an online program.

This revelation happened to coincide with the arrival of Professor Chie Adachi, Dean for Digital Education to FMD and the establishment of the Digital Education Studio. Mike had been working with IHSE’s institute director to develop this plan, so when opportunities to work with DES through the Care Digital project were made available, IHSE was in an ideal position to put the programme forward.

What is it like to work with DES?

Working with the DES and our process of co-design is a new experience for many, and this was no different for Mike and Annie. As Annie puts it:

In terms of expectations, it just was not what I was anticipating at all, but in a really great way

She went on to highlight what she felt made the process work well:

It was just a really nice blend of expertise to be quite honest, and it also opened my eyes to other sorts of modalities and platforms and those sorts of things that we can use to really maximise that student engagement. I think that's been the real sort of key message, when we have been designing the content is like always constantly thinking about the students and what they do and how they're going to manage it. And I think that might have been missing before.

But, as with all course development, there were parts of the process that were more difficult than others. One issue that came up, which in my experience is very common, relates to the time pressure of developing online courses. With online courses, all the resources and activities are made available to students at the beginning of the module which means there is a fair amount of work involved in getting a module ready. To develop a module in this way, the design team also needs to keep track of the student's journey across the module more closely, which Mike and Annie found challenging at first.

What has stood out to you in the final programme?

Talking to Mike and Annie about the first year of delivery there were a couple of areas they were drawn to:

Firstly, one of the key takeaways for them was the level of engagement the programme has received, as Annie highlighted:

I'm genuinely quite impressed that they just kind of get on and they contribute to the discussion forums and write position pieces… I think they're busy people, you know, they could really kind of skim through

Secondly, they noted that moving to more asynchronous tasks has had unexpected benefits, particularly in assessment design and supporting students with assessment. Where the in-person course would sometimes need class time dedicated to assessment preparation, the online modality allowed a better integration of support without sacrificing the learning of subject matter.

Overall, there was a feeling that they have developed a programme that is more flexible, and more accessible but doesn’t compromise on the quality of teaching and support.

Transforming practice

During our conversation, it was interesting to hear about the experience the programme team had of co-designing with the Digital Education Studio, and the impact that had on how Mike and Annie think about teaching. As Mike explained:

There was a part of me traditionally that has always been a little sad at the idea of trying to do teaching and learning online, even though I've done quite a bit of it, because the programs that I've worked on in the past, the teaching doesn't feel like teaching…And I think one of the massive perspective shifts for me… was seeing what we do in all respects as teaching, not just when we're live on camera and in a very immediate kind of synchronous dialogue with our students. And so it wasn't something I was anticipating… the whole experience has been transformative, not least because it has allowed me to retain, albeit a different identity, it's allowed me to retain my identity as a teacher as opposed to someone who facilitates online learning and the teaching being limited to that concept.

And the transformations went beyond just thinking about online courses, Annie noted she was using ideas from our design process in the development of some on-campus modules and Mike noted he is now much quicker to support any campus-based teaching with online content and activities.

Final thoughts

I finished by asking Mike and Annie what advice they would give to programme teams just about to embark on the process of co-designing a course with DES. They offered the following advice:

  1. Start early and embrace the ABC Learning Design workshops DES runs.
  2. Be prepared to rethink your programme, to go back to square one, and be open to suggestions from DES
  3. Argue your case as the subject matter expert, you will know where the threshold concepts are and what the important elements of your course are.
  4. Make it truly collaborative and make space for the different expertise involved in co-design.
  5. Trust the process, as Mike noted:

It does feel sketchy as anything because we know what we already do. So, a departure from that feels risky, feels like: What if the students aren't studying? What if they don’t post in the discussion forums? You know, are they going to not submit their assignment? It's like the first time you step on the skateboard feels sketchy as anything but as we found, you can trust the process and you can trust the students and the materials that you've designed and published.

Working with different course teams is always a learning opportunity for us in the Digital Education Studio as well. I’m fascinated to see how different fields employ pedagogical concepts and in medical education, the idea of competency was particularly interesting to me. Obviously, we want doctors and nurses to be individually competent, but professionals never act alone and we also need to develop collective competency where actors within a healthcare setting work together effectively. But how do we assess collective competence in a higher education system that is geared towards individual achievement? Thinking about these issues within medical education has helped me reframe some of the problems we have in higher education relating to the valid, reliable, and authentic assessment of our students and what solutions may be possible.

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