Introduction:
One of the crucial changes healthcare system is facing is preparing the workforce and patients for participatory medicine (PM) approach in which the role of patients is changed to more proactive. PM suggests that patients work in collaboration with their doctors and nurses and take more responsibility for their own health. The change in patient's role has neither been reflected in classrooms nor in the offer of continuous professional development for the teachers. DesignCARE addresses the gap identified in schools in field of PM. The main objective was to design, pilot, implement and evaluate DesignCARE curriculum and course for medical vocational schools that will help them to engage in participatory medicine through the promotion of communication skills and diversity competence, in line with ethical principles. The goal was also to train the teachers to design a course that encourages skill development, research-based learning, and student cooperation.

Methods:
The participants were secondary and post-secondary level nursing students in three schools: Colegiul Mihai Eminescu (CME) in Romania, Medicinska skola (MS) Pula and MS Split in Croatia. The focus groups were organized to get input from relevant stakeholders. A series of professional development workshops were conducted for twelve educators, focusing on essential topics: curriculum design, diversity competence, participatory medicine, and ethics. The workshops were followed by pre- and post-training surveys to evaluate knowledge acquisition and shifts in attitudes toward these concepts. Building on the insights from the focus groups and workshops, DesignCARE was developed and piloted. A post-course evaluation was conducted to assess the effectiveness of the course in meeting its learning objectives and to capture students’ perceptions of their acquired skills and knowledge.

Results:
The DesignCARE curriculum framework with learning outcomes for developing communication skills and diversity competence in participatory medicine was created. The course had five topics: Participatory medicine, Diversity, Communication with patients and relatives, Empathy, Ethics and Responsible Research and Innovation. The materials included 23 videos, 6 obligatory texts, quizzes and 14 activities and assignments to be performed online or in person in a classroom were uploaded onto the Moodle Mod platform. Twelve trained teachers implemented the DesignCARE module with 52 students during a two-week or one-week period. The overall mean grade was 79.4 out of 100, with difference between MS Pula students (67.9) and their colleagues from CME (90.6) and MS Split (90.4). CME students were at postsecondary level; however MS Split students were secondary medical vocational level students, just like MS Pula students. This strongly implies that it was a time-management issue and not an educational level one.

Conclusion:
While the mean grade indicates a positive performance, the significant difference in grades underscores the importance of considering external factors influencing student outcomes, highlighting the need for flexibility and support mechanisms to accommodate diverse student schedules and responsibilities, fostering an environment conducive to equitable learning experiences and academic success. Developing and practicing diversity competence at this level can help to promote equality in the healthcare systems later, ensuring patients receive treatment in accordance with their needs.

Keywords: Participatory Medicine, Medical Education, Communication Skills, Diversity Competence, Curriculum Development, Healthcare Education.