Table 1
Transformative SLE Example.
| ESSENTIAL ELEMENTS OF A TRANSFORMATIVE SLE | EXAMPLE OF ENACTMENT WITHIN AN AUTISM SERVICE DELIVERY TRANSFORMATIVE SLE |
|---|---|
| Education Theory Informed Design | Learning was grounded in cognitivist-constructivist and critical-constructivist principles. These principles shaped the program’s goals; namely, to foster adaptive expertise and critical reflection while supporting co-creation and collaborative leadership among health professions students. Further, it informed the approach to facilitation. Facilitation integrated clinical, educational, and lived expertise, prioritizing dialogue and collective inquiry to support co-construction of strengths-based responses to emergent needs. Educational approaches were grounded in dialogic engagement, critical reflection, and co-creation within a psychologically safe learning environment, fostering engagement with uncertainty and shared decision-making. |
| Anchoring the SLE in an Identified Real-World System or Practice Gap | This Student-Led Environment (SLE) initiative was developed in response to workforce capacity challenges and limited access to early identification and intervention services for autistic children and youth in Ontario. Rather than replicating existing service models, this SLE initiative adopted an innovation-oriented approach, co-created with community clinicians and families to address locally identified needs. Two complementary outputs emerged: (1) the development of a wraparound early intervention education program and (2) the creation of a tool to enhance the efficiency of early identification processes for both families and clinicians. |
| Facilitation Team | The facilitation team included a clinician-scientist, an education lead, and caregiver-partners, integrating clinical, educational, and lived expertise and modelling collaborative, distributed leadership. |
| Collaborative Organisational Partnership | The SLE was enabled through a multi-institutional partnership spanning academic, clinical, and community organizations, supporting alignment with system priorities and implementation in a real-world context. |
| Interprofessional and Collaborative Leadership Structure | Students from multiple health professions worked in interprofessional teams with facilitators supporting shared meaning- and decision-making. Leadership was enacted through co-creation of innovation projects aimed at addressing identified service gaps. This structure emphasized flattened hierarchies and collective responsibility for system improvement. |
| Embedded Evaluation and Sustainability Planning | A developmental evaluation approach was integrated from the outset to assess feasibility, acceptability, and impact within a complex and evolving service context. Feedback was gathered from learners during facilitated sessions via polls and responses to questions posed to the group. Voluntary exit interviews with individual learners were also conducted after each cohort completed the program. Evaluation findings were used iteratively to refine the Transformative SLE and inform decisions related to sustainability, including alignment with organizational priorities and potential for scale. |
[i] This table illustrates how core elements of the Transformative SLE approach are operationalized within a real-world autism service delivery context.
Table 2
Types of activities students could collectively lead within an SLE.
| TYPES OF ACTIVITIES | EXAMPLES |
|---|---|
| Management/Administration | Supporting caregivers of children with complex care needs to complete forms for funding opportunities, and community support |
| Teaching/Education | Delivering public education about the impact of concussion at local community centres |
| Service/Advocacy | Delivering group social programs for patients with aphasia |
| Research or Evaluation Studies | Quality improvement initiatives in autism diagnosis communication across teams |