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The term ‘patient’ no longer denotes a passive recipient of healthcare. Patients have demanded, and are increasingly given, the opportunity to influence health services and policies.1 Similarly, in health research patients are sought as partners in study design and governance.2 This is reflected in The BMJ ’s patient partnership initiative (www.bmj.com/campaign/patient-partnership),3 the Patient-Centred Outcomes Research Institute (PCORI) in the US,4 and the National Institute for Health Research (NIHR) in the UK.5 Because of the history of (un)ethical conduct in research, including patients as partners in research studies requires clarity about what the role includes. Patients’ roles must be defined so that we achieve meaningful patient partnership and well conducted, ethical research. ‘The patient’ is a construct that assumes an inherent imbalance of power and includes expectations of compliance by those inhabiting it.6 That it has taken so long to acknowledge the value patients bring to healthcare and research emphasises just how difficult it can be to broaden their role beyond passively receiving treatment. Many …

In order to develop potentially transformative Web 2.0 tools in higher education, the complexity of existing academic practices, including current patterns of technology use, must be recognised. This paper describes how a series of participatory design activities allowed postgraduate students in education, social sciences and computer sciences to contribute to the development of new Web 2.0 tools to enhance an existing virtual collaboration environment. In the course of these design activities, students reflected on and articulated the existing and emerging academic practices in which they were involved as they managed their transition from undergraduate courses to postgraduate research. The tools that were developed can therefore be seen as reifications of participants' emerging academic practices and the challenges they face as new researchers. This highlights the need for flexible design approaches and adaptable technological frameworks if Web 2.0 tools are to be successfully integrated into higher education settings.