How Medical Students Negotiate Their Roles in the Figured World of Curriculum Co-Creation: A Longitudinal Qualitative Study.

Introduction: Co-creation, where students and faculty partner to develop curricular materials and learning, is increasingly recognised for its potential to enhance student engagement, ownership, and inclusivity. However, little is known about how students experience and navigate co-creation partnerships. Understanding this process is essential to maximise understanding of, and gains from, student-faculty partnerships. To address this gap, we explored how medical students navigate their roles and boundaries within the process of co-creation. Methods: This is a longitudinal, qualitative study, informed by a constructivist worldview. We conducted 15 semi-structured interviews with five students across three timepoints and collected supplementary data from students' reflective writing. Initial data analysis was thematic and iterative. We then used Figured Worlds theory to explore how co-creation enabled medical students to author identities, negotiate positionalities, and engage in world-making. Results: We identified three main themes. Students wanted to contribute but had to negotiate legitimacy with faculty within the co-creation figured world. They authored new identities as curriculum stakeholders, moving beyond learner advocacy to engage with broader curricular perspectives. They had to navigate tensions at the boundaries between being learners, collaborators, and future doctors, whilst negotiating constraints imposed by institutional structures and power relations. Discussion: Students authored identities as advocates, collaborators and aspirational future doctors, and moved across multiple figured worlds during the co-creation process, negotiating identities and the tensions that emerged through this process.