How to Co‐Create Online Continuing Professional Development With People With Lived and Living Experience

Health professionals often turn to online asynchronous courses for their continuing professional development (CPD) [1], as online courses can overcome barriers related to location and scheduling which might otherwise prevent them from engaging with content [2]. The creation of online courses is typically overseen by a planning committee comprised of educational developers (e.g., staff at university CPD offices) and representatives from the target learner population (e.g., family physicians), who may also be experts in the content area. Committee members collaboratively define the scope of the course and its contents; common tasks include developing learning objectives, identifying appropriate educational methods (e.g., videos) and creating course content (e.g., writing scripts) [3]. In Canada, a planning committee is required for a course to be eligible for physician continuing education credits, based on the assumption that oversight from representatives of the target population will ensure that the course is more responsive to the needs of that population [4]. By the same token, we propose that it is essential to involve people with lived and living experience (PWLLE)—including patients, family members and caregivers—as members of planning committees, to ensure that courses are responsive to the needs of those the healthcare system is ultimately accountable to: patients and their support systems. However, PWLLE face several barriers which may prevent their fulsome participation on planning committees. The aim of this article is to describe a practical strategy that committee chairs or organisers can use to support PWLLE's meaningful involvement as committee members. We focus on the co-creation of online asynchronous courses, as the responsibilities of planning committees can differ across other educational modalities. However, we encourage readers to consider how they can apply our strategy when developing other CPD modalities. CPD scholars have increasingly called for the involvement of PWLLE in the design and delivery of CPD [5, 6]. Involving PWLLE can help health professionals understand patients' values, goals and preferences and draw attention to important variations in these beliefs [7]. Involving PWLLE has also been framed as a democratic issue, as PWLLE ought to have a say in the education that informs their care [7]. PWLLE ought to have a say in the education that informs their care. PWLLE can be involved in online course creation to various degrees [8]. Lower levels of involvement are characterised by less autonomy and influence over the educational content (PWLLE as ‘data sources’). For example, PWLLE's experiences receiving care may be elicited as inspiration for the case studies included in a course. By contrast, higher levels of involvement are characterised by greater autonomy and influence (PWLLE as ‘co-creators’). Inviting PWLLE to serve as members of planning committees can set the stage for higher levels of involvement, which CPD scholars argue is necessary to fully realise the benefits of their inclusion [9]. However, simply inviting PWLLE to join a planning committee may not be sufficient to ensure their fulsome participation [10]. Some PWLLE may be excited to participate but lack the confidence to speak up or question what they have to offer to course design and development [11]. Other members of the committee may doubt the value of lived experience and foster a dismissive environment during meetings. These attitudinal factors may discourage PWLLE from speaking up and sharing their lived expertise. Simply inviting PWLLE to join a planning committee may not be sufficient to ensure their fulsome participation. Unfortunately, there are few practical resources available for committee chairs or organisers to address these attitudinal barriers. To address this gap, the aim of this article is to describe a ‘backwards course design’ activity that we use during the inaugural meeting of new planning committees. The activity demonstrates the value of PWLLE and their lived expertise in course co-creation and sets the tone for their subsequent involvement. In the sections that follow, we describe the activity and the factors to consider when implementing it with PWLLE. CF and YG are educators who work in a university CPD office and developed the backwards design activity. AG is a researcher who works in a university CPD office. We recently completed this activity during the initial committee meeting for a new course on Fetal Alcohol Spectrum Disorder (FASD). The committee included PWLLE, clinicians and researchers. PWLLE were recruited based on recommendations from other committee members, and we prioritised diversity of PWLLE perspectives, recruiting a person living with FASD, their parent and two birth mothers. PWLLE were compensated $100/h for their participation and received one-on-one orientation from the committee organiser before the first meeting to discuss expectations. At the outset of the initial meeting, the committee organiser stressed that members were experts in complementary domains, which can all inform the course, a principle that was exemplified in the subsequent activity. Table 1 presents the contributions that PWLLE made across several sections of the template. Their contributions were substantial and significantly shaped the design and development of the course. For example, the entire first lesson was built around the observation that people with FASD and their families often feel they are not listened to or understood by health professionals. Disagreements between committee members were discussed as a group until consensus was reached. Following the meeting, PWLLE remained involved in course co-creation by contributing personal stories, writing sections of the course and reviewing other members' contributions. PWLLE responded positively to this process and were pleased with the course that was created. People with FASD struggle to find healthcare providers willing to take them on, leading to challenges in maintaining continuity of care. An FASD diagnosis is an origin story, not a destination, so FASD should be met with optimism (treat the treatable and the destination changes). While people with FASD are not broken and do not need ‘fixing’, they do need understanding and support to attain their health, personal and vocational goals. The effects of FASD are varied and individualised, but there are trends. A person's diagnosis does not tell you their specific impairments and needs. It also does not tell you what their strengths are. It is not only about focusing on the diagnosis but also about helping the individual meet the goals they have in their lives. FASD occurs across the lifespan and people do not ‘grow out of it.’ People with FASD do best when they have a supporter present. We find the backwards course design activity valuable because it illustrates the unique insights PWLLE can offer to course co-creation, challenges perceptions that their involvement is of little value and sets the tone for their subsequent participation. To further support PWLLE's participation during the activity, we draw on the following strategies [13]. The backwards design activity can demonstrate the value of PWLLE in course co-creation and set the tone for their subsequent involvement. In this article, we have described our approach to involving PWLLE in a backwards course design activity to set the tone for their participation on a planning committee. Though there are plenty of other barriers that must be addressed to fulsomely involve PWLLE in course co-creation (e.g., recruitment barriers), this activity can potentially address some of the attitudinal barriers that may otherwise discourage PWLLE from fully participating on the planning committee. It should also be noted that PWLLE involvement can extend beyond the co-creation of single courses [8]. In the CPD context, this could involve PWLLE serving on CPD offices' strategic planning committees. C.F.: conceptualization, writing – review and editing. Y.G.: conceptualization, writing – review and editing. A.G.: conceptualization, writing – original draft. We would like to express our sincere gratitude to the people with lived and living experience who we have worked with over the years to co-create continuing education for health professionals. The authors declare no conflicts of interest. The authors have nothing to report.

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