Table 3.

Synthesis of final sample to Activity Theory*

Papers	Subject	Object	Community	Artefacts and tools	Rules	Division of labour
1. Agarwal et al. (2020)	Fourth year psychiatry residents working alongside a patient advisor to explore mental illness and recovery. The learning objectives were co-produced	Transformation of the learner through the process of the theory of Liminality. The learning objectives were met using a constructivist transformative and reflective pedagogy	The work led to a shift in power between psychiatrist/residents and advisor/patient. The course was relationship building	Monthly supervision meetings for the advisor patients in mutually agreed places for safe non-judgemental environments		Longitudinal alignment of a learning partnership meeting monthly over a six-month period. Developed a relationship of trust. Changed relationships by shifting power dynamics
2. Anderson et al. (2019)	Patients become teachers in IPE workshop looking at what this means for all stakeholders across the whole system of learning using Activity Theory		While many patients wish to progress from telling their stories some patients do not wish to take on leading teaching roles and these thoughts were reflected by students. Need to build trust for all stakeholders where patients lead teaching	Support processes for patients in leading teaching roles—resources to offer training for patients. Patients required training and support for leading the class/small group; training concerning policy, professionalism in teaching, diversity being part of steering groups	Patients to become co-tutors working with an experienced teacher/practitioner Patients paid; remuneration system put in place Patients who lead teaching must be trained in order to build trust for all stakeholders	Patients can work as Co-Teachers. Mentor roles were needed to support new patients and those wishing to go on to become leaders as co-tutors in this workshop. Faculty needed to be supporters to co-tutors in the teaching
3. Cooper and Spencer-Dawe (2006)	IPE event involving trained patient teachers. Students’, patients’, and educators’ experiences of IPE event analysed through lens of Complexity Theory	Patient involvement advanced students’ understandings of patient-centred care and helped them make connections between theory and practice	The workshop established interprofessional team working between patients, carers, and educators However, building a learning community is complex and requires multiple components to be considered to ensure all stakeholders feel confident and safe, and benefit	Certain tools identified to support patient involvement in IPE Despite joint training on IPE facilitation, educators need specific training on working with patients in education as opposed to clinical practice Patients need training on IPE co-facilitation and aims, and support in administrative tasks and HEI building navigation	Patients valued the direct and open payment approach Students need patients’ roles to be well defined and feel patients should be trained to uphold teaching quality Patients need greater role clarity as ‘co-facilitator’ Educators feel that a clear person specification is needed to support patient recruitment and strengthen both partnerships and IPE quality	Patient positioned as co-facilitators to educators and equal members of interprofessional team External patient-led organisation recruited patients for involvement and supports during
4. Hache et al. (2020)	Undergraduate Pharmacy students learning from patient partners about patient education programmes	Students’ understandings on the role of the Pharmacist in patient education programmes advanced post-intervention and explained through the theory of Social Representations			Confidentiality addressed at the start of the workshop to protect patients involved	Workshop on Patient Education programmes developed by educators alongside patients Patients as co-facilitators of workshop with educators
5. Jha et al. (2015)	Patients’ narratives deployed in a patient safety intervention for Foundation Year 1 Medical Trainees	Trainees’ depth of understanding on patient safety enhanced through patient narratives and explained using Kumagai’s Conceptual Framework of Empathy and Moral Development, as a process of transformation			Preparation workshops for patients to create a supportive confidential environment in which to identify which aspects of their narratives were important for trainees’ learning Emotional support and debriefing provided for patients given distressing nature of their stories	Patients lead learning; following discussion facilitated by researchers/educators. Support provided by researcher
6. Kline et al. (2020)	Patient mentors teach medical students about their experiences of health and social care as part of IPE curriculum	Medical residents form patient-centred professional identities 3–4 years after IPE programme. This is attributed to patient involvement in preclinical IPE and explained by concepts from Identity Status Paradigm	The course fostered longitudinal relationships between patient mentors and medical students in a safe environment	Optional mentor support midway through programme	Pre-programme orientation for all mentors and students Patient recruitment policies developed by steering committee involving patients	Longitudinal learning partnership in preclinical IPE over 16 months Patient as mentor, medical student as learner. Educators absent at meetings but set discussion topics
7. Read et al. (2020)			Faculty-wide training developed with patient involvement viewed by patients as expression of their value to the University and combats feelings of isolation within each respective school	University investment of resources required to support patients involved in education to ensure ultimate engagement and continuity and affirm value Educators need to invest time to facilitate new patient training	Patients involved in the development, delivery, and evaluation of a training programme through Participatory Action Research Unmet training needs identified and incorporated into programme e.g., IT, communication, and interview skills, participation in meetings, and introduction to HEI	Patients involved as partners in all aspects of the training Academic staff act as co-facilitators in this Scope for patients to progress and take on bigger roles in training delivery to reduce time-burden on academic staff

*Theory is denoted by italicised text