Co-creation of a fit-for-purpose Feedback Toolkit for clinical clerkships

Feedback is a powerful educational intervention in clinical education, yet its effectiveness depends on how it is integrated into teaching and learning activities. Previous studies have shown that productive feedback in clinical education relies on sociocultural factors such as a supportive feedback culture, trustworthy relationships, and student agency. Co-creation is a promising approach for designing educational interventions that are contextually relevant and aligned with the needs of teachers and students. This study aimed to advance both theoretical and practical understanding of co-creation as a design strategy in health professions education, particularly in developing productive feedback processes tailored to undergraduate clinical education.

Eight co-creation sessions were conducted with faculty, clinical teachers, students, and researchers. The process was iterative and grounded in feedback design principles informed by the literature. Co-creation led to the development of a prototype of a Feedback Toolkit, which was piloted in two dyads of clinical-teacher students in a seven-week physiotherapy clerkship. Weekly audio diaries were collected from participants and analyzed using content analysis.

Data from the co-creation sessions informed the development of a Feedback Toolkit specifically designed for the clinical teacher-student dyad. The toolkit was built upon three design principles: (1) Contributes to a trustful relationship based on continuous mutual support, (2) Envisioned learning opportunities and feedback scaffolding, and (3) Plan the use of feedback. To operationalize these principles, the toolkit included practical materials such as podcasts, infographics, feedback prompts, and a Mini-CEX. The pilot study demonstrated the toolkit's usability and acceptability and highlighted its value in structuring feedback interactions. Challenges included limited time for full implementation and difficulties in providing constructive feedback.

The co-creation approach enabled the development of a fit-for-purpose feedback toolkit that aligns with the dynamic needs of clinical education. This study highlights co-creation as a feasible strategy for designing feedback processes in workplace-based learning.