As a researcher, I learn most when I collaborate directly with health and social care providers. This happens, for example, in the planning stages of a project, when we jointly explore unique features, and anticipated interplay of dynamics, in a specific system. This shared knowledge is important to increase the odds that a pilot implementation of a new practice will be sustainable. In such meetings, I sense that collaborative learning definitely occurs. We integrate our competencies and perspectives, in a way that neither of us could do only with colleagues in our own field. It is my perception that both the research team and clinicians or practitioners view the outcome of these meetings as more than the sum of each contributing part.

Recently, I visited a number of health care practices/settings to report on the preliminary results from a study of the quality of health services, drawing on questionnaires from both patients and staff. In each setting, we learned more (and on a “deeper” level) when we discussed results with the specific group of health professionals, compared to when we analyzed the data in our group. Conversely, in every context, the health professionals enthusiastically expressed they learned more about their daily practice by seeing and jointly reflecting on the representation of the data. They explicitly described our meetings as an important learning opportunity. The first time I heard this, I was slightly surprised because I had viewed my task as primarily that of “reporting” results. In all meetings, however, the outcome ended being something more than reporting, also for myself. As a researcher, I learned more than I had done in a long time. I understand our data better and consider next logical steps for additional research in another light.

What I have not yet created, directly, is a forum for discussion of preliminary study results with patients. Given that health and social services increasingly strive towards “person-centeredness”, collaborative learning, also in research, should preferably include researchers, clinicians/practitioners and persons/patients. In quality improvement initiatives, we increasingly refer to co-production of health care services: a model services are produced as a result of patients and professionals interacting as participants within a healthcare system and in society (Batalden et al, 2015). This model bears clear resemblance with the literature on collaborative learning in topic 3. With coproduction of welfare service, power is shared, and practitioners and persons/patients collaborate (anything else would result in less effective services). With the term person-centeredness, an in itself important ambition and crucial move away from previous patriarchal traditions, however, I still sense some degree of unequal power balance. The system focuses on being centered around the person and the person’s needs, rather than the system’s collaboration with the person, with an overall the purpose of meeting needs. It is not the same.

Even the closely related term user-involvement is, in my view, tilted towards the clinicians or decision-makers power-wise, urging them to “involve” the user of health and social services. In some cases, such involvement (which is increasingly legislated) may only consist of formal representation on one board in local authorities. In several contexts, users report they cannot contribute on an equal basis. At its worst, they are asked to sign a form declaring they have been “included”.

In teaching courses on health and health care, I have at times, for specific sections, invited persons/patients to lecture and lead discussions. I have observed then that they convey something to the students which I am not able to do unilaterally. In collaboration, we jointly create a more comprehensive understanding of health and health and social services, an outcome also supported by student feedback. This awareness has prompted in me a desire to conduct research in collaboration (preferably, i.e. a step beyond cooperation) with persons/patients – the recipients of welfare services, or, (rather) the cocreators of welfare services. How we decide to view persons/patients depends on how we view ourselves and our own roles, how we view learning and, ultimately, how we view knowledge.

Batalden M, Batalden P, Margolis P, et al. BMJ Qual Saf 2016;25: 509–517.