Learner-Educator Co-creation of Student Assessment in Health Professional Education Courses: A Scoping Review.

Background: Co-creation means engaging learners in working collaboratively to make decisions about course planning, implementation, or student assessment. Involving students in these decisions potentially enhances learning. When co-creation is part of assessment, it may reach more learners but may also pose pragmatic challenges. In this review, we focused on co-creation of assessment that may occur at any time during a health professional course. Systematic examination of learner-educator co-creation is needed to inform how educators can engage strategically in co-creation with healthcare students. Objectives: The objective of this scoping review was to examine strategies for collaborative learner-educator decision-making during the design, implementation, or evaluation of student assessment in health professional education. Search Methods: Searches were conducted until August 1, 2024, in six databases with no date limitation (MEDLINE, Embase, Education Source Complete, CINAHL, ERIC and APA PsycInfo). Reference lists of included full-text papers and papers close to meeting inclusion criteria were manually searched, along with publications by conference abstract authors. Selection Criteria: We included all papers focused on how learners and educators share decision making regarding student assessment during a health professional course. Information about co-creation that occurs outside of a course or is not related to student assessment was excluded. Data Collection and Analysis: Standard procedures for reviewing and summarizing data according to JBI methodology were used. Two reviewers independently screened documents and extracted data. Data about paper characteristics, where co-creation occurs, decisions that are co-created, process descriptions, and author conclusions were extracted and summarized. Main Results: We screened 11,517 titles and abstracts, then 341 full-text reports for eligibility. In total, we identified 27 reports published between 1980 and 2025 that describe 25 unique courses where co-creation of assessment has been reported in the literature.Co-creation of assessment was reported in nursing, social work, medicine, health services navigation, paramedicine, pharmacy, occupational therapy and dental technology disciplines, at the undergraduate, graduate, and postgraduate levels. Most courses where co-creation occurred were mandatory. Reports spanned various years of study. Many assessment decisions were made together, predominantly assessment instructions and grading criteria. Diverse ways of co-creating with different levels of student influence over decisions were reported. The most reported strategy for co-creation was discussion during class time or in individual meetings. A wide range of benefits and ways to support co-creation were reported. Barriers, disadvantages, and future considerations were also reported. Conclusions: This review identifies and synthesizes existing examples of co-creation of assessment that have been integrated into health professional education. While it was mainly portrayed positively across included literature, there remains a lack of rigorous and diverse research in this area. The interventions identified in this review are diverse and highly contextual, limiting generalizability. Our findings provide a preliminary list of reported cases of co-creation of assessment and highlight contextual influences on implementation. Implementation processes need to be described in more detail to promote replication. Future research is needed to explore educator and student experiences, evaluate learning outcomes, and evaluate applicability across contexts to support evidence-informed practice. Co-creation of assessment offers a promising yet under-researched approach to creating more collaborative and authentic assessment strategies. It warrants thoughtful, context-specific application, research, and reporting in the literature.