Preparing the next generation of health researchers by embedding public and patient engagement into Canadian graduate education: reflections from graduate students.

Public and Patient Engagement (PPE) in health research has become an established practice and is increasingly now an imperative for publicly funded health research grants. Graduate students represent the next generation of health researchers; therefore, it is essential they gain PPE knowledge and skills within academic landscapes that promote collaborative research with those whom research is intended to benefit. By securing theoretical knowledge and practical experience early in their research careers, effective PPE can become well-established in all academic, health research and healthcare domains. However, many academic institutions struggle with implementing the necessary systemic and cultural change to moving the science and practice of PPE forward within their institutions. Nine students enrolled in a graduate level PPE course at the University of Calgary, Alberta, Canada engaged in an end-of-term reflexive class exercise that centred on the question "What would make patient engagement more possible for graduate students during their graduate degrees?" As a result of iterative review and discussion of the responses, four key themes were identified: (i) embed PPE elements into health research graduate program structure, (ii) offer opportunities to support hands-on learning and practice of PPE, (iii) integrate public, patient, and community members into graduate program design and delivery, and (iv) emphasize ethical community-based research considerations and researcher reflexivity. For health science graduate students to inclusively integrate PPE theory and principles into their research work, it is important that the academic institutions they are enrolled in keep pace with current research imperatives, and ethical and funding practices. This means regularly assessing and evaluating ways their institutional systems, processes, and programs are responding and evolving. In this reflective commentary we offer our considerations, and suggested guidance on best practices to continue to 'move the needle' on embedding PPE culture and practice in academic institutions in Canada and globally. We hope to initiate response and further discourse from other graduate students and from patient partners who have shared their lived experience insights to graduate student research studies, and mentorship and governance roles in health science graduate level curriculum and program planning.