Beyond dissatisfying satisfaction surveys: principles for meaningful coproduction in medical education

Medical education increasingly values coproduction-the collaborative design and execution of educational services by faculty and learners. At the same time, institutions often fall short of genuine coproduction, engaging with learners through superficial feedback processes such as satisfaction surveys. The Liaison Committee on Medical Education emphasizes these surveys in its accreditation review process. As Artino and colleagues discuss, learner satisfaction surveys suffer from weak validity evidence. Further, reliance on these surveys can exacerbate dysfunctional learner-faculty dynamics and detract from the shared educational goals of improving teaching, learning, and patient care. Medical education's overreliance on satisfaction surveys exemplifies the phenomenon of codestruction, where efforts at collaboration create unintended burdens, inefficiencies, and conflicts that undermine educational value.