"Seeing" the Difference: The Importance of Visibility and Action as a Mark of "Authenticity" in Co-production Comment on "Collaboration and Co-production of Knowledge in Healthcare: Opportunities and Challenges"

Abstract

The Rycroft-Malone paper states that co-production relies on ‘authentic’ collaboration as a context for action. Our commentary supports and extends this assertion. We suggest that ‘authentic’ co-production involves processes where participants can ‘see’ the difference that they have made within the project and beyond. We provide examples including: the use of design in health projects which seek to address power issues and make contributions visible through iteration and prototyping; and the development of ‘actionable outputs’ from research that are the physical embodiment of co-production. Finally, we highlight the elements of the Collaboration for Leadership in Applied Health Research and Care (CLAHRC) architecture that enables the inclusion of such collaborative techniques that demonstrate visible co-production. We reinforce the notion that maintaining collaboration requires time, flexible resources, blurring of knowledge producer-user boundaries, and leaders who promote epistemological tolerance and methodological exploration.

The TiM system: developing a novel telehealth service to improve access to specialist care in motor neurone disease using user-centered design

“…Our experience demonstrates the benefits of user-centered co-design. The use of creative visual methods enabled rich conversations between diverse groups (44). Capturing the current and desired experiences of users helped us understand what is important to an MND service and what could be improved.…”

What is a research derived actionable tool, and what factors should be considered in their development? A Delphi study

“…It demands a balance of flexibility and creatively with maintaining standards of research rigor. It involves time, navigation around difficulties, and epistemological tolerance [ 14 ]. This requires further exploration, with considerations on how we develop these skills in the applied health research workforce.…”

“…Specifically, the pen portraits helped both to make the research visible and facilitated action on the part of local and national commissioners. [ 14 ] The pen portraits were used as a resource in the National Cold Weather Plan; they informed policy making in local government, and supported volunteer organisations to target advice to vulnerable older people. As Rycroft- Malone et al [ 4 ] acknowledge, some effort is needed to plan cross boundary work and the CLAHRC pen portraits supports this.…”

‘Collective making’ as knowledge mobilisation: the contribution of participatory design in the co-creation of knowledge in healthcare

“…The discourse in healthcare Knowledge Mobilisation (KMb) literature has grown from simple, linear models of research knowledge production and action, to more complex and iterative models supporting co-productive approaches [ 2 ]. These more complex models are described as Mode 2 learning where knowledge is created within the context of its use [ 1 , 2 ]; working with those who are likely to use it [ 3 , 4 ], and boundaries between knowledge producer and knowledge user are purposely blurred and utilised [ 5 ]. We define KMb as the activation of available knowledge within a given context.…”