Over the recent years, the need for international collaboration in all sectors has become increasingly vital; we only have to consider the speed at which the new Covid-19 vaccines have been developed and rolled out to appreciate the importance of global collaboration.

In health professions’ education (HPE) too, multiple examples exist of individuals, groups, organisations, and associations collaborating to respond to the crisis and share educational practice. This response includes AMEE, which has provided educational and collaborative support through webinars, specific publications and conference activities.

However, collaboration does not happen only in response to an international crisis: it has a long history in education and healthcare (Ramani et al 2020; McKimm et al 2008). Many examples exist in HPE of international collaborations and the benefits and learning that accrues from these. The literature and practice often conflate the terms ‘partnership’ and ‘collaboration’ and we recognise that what we term ‘collaboration’ for the purpose of the award may be described as a ‘partnership’ by entities, and vice versa. Some collaborations are actual partnerships, such as schools working with international partners to provide student elective and international training opportunities (Waterval et al 2018), curriculum development (Rashid et al 2020) and faculty development. Such partnerships tend to be more transactional, where one partner provides a service for another, either for a fee or other benefit in kind. Whilst we acknowledge the benefits of such activities and the increasing internationalisation of HPE curricula (Wu et al 2020), for this award, we are focusing on collaboration where all entities work together towards common goals and benefits.

For the purposes of the ASPIRE award in International Collaboration, we define collaboration as “the purposeful action of working with others for mutual benefit that extends beyond the organisations themselves and involves a sharing of responsibilities and power”.

Collaborations should be able to demonstrate the additional benefits and value that the collaboration brings, over and above what each entity can achieve alone; some examples are described below.

Collaboration can occur at various levels with wide and varied benefits to multiple stakeholders. Examples include curriculum development in nursing (Didion et al 2013), strengthening research capacity (Noormahomed et al 2018; Hall et al 2016), optimising the reach and impact of interest groups (Walpole et al 2017), linking departments and organisations (Hall et al (2016). It can involve multiple partners or a small number of entities. For example, Walpole et al (2017) report how an international collaboration worked successfully to build an environmentally accountable medical curriculum. Since this publication, this collaboration has been expanded to develop a consensus statement on Education for Sustainable Healthcare (ESH) (Shaw et al., 2021), a special issue in Medical Teacher on ESH in September 2020, established an AMEE Special Interest Group, and carried out several additional activities on planetary health with international groups, including student associations. Another collaboration on Medicine and the Humanities between universities in Canada, China and France was established to develop shared resources, faculty and student exchange and shared learning experiences (see https://med.uottawa.ca/department- innovation/medicine-humanities/international- collaboration).

In East Africa, Yarmoshuk et al (2016) mapped international university partnerships aimed at strengthening medicine, nursing and public health programmes and found 129 university-to- university partnerships from 23 countries. Each university reported between 25 and 36 international university partners. A later study exploring reciprocity between the entities found that, although exchanges were often unequal in terms of financial benefits, the sharing of values, ways of working and cocreating the terms of the partnerships were valued highly by all entities (Yamoshuk et al 2020).

Universities highly value collaborations with international partners and this is reflected in the QS World University Rankings (https://www.topuniversities.com/qs-world-university- rankings), with international collaboration as one of the key criteria; there is huge impetus for universities to encourage and support collaboration. Much international collaboration has involved developing common accreditation standards e.g., for continuous professional development (McMahon et al 2016) and standards and outcomes for undergraduate and postgraduate training programmes, for example in the Caribbean region (van Zanten et al 2009). Such collaborations have greatly improved the quality of HPE in many countries, facilitated the ability of practitioners to live and work around the world, and improved healthcare in underserved regions. As organisations recognise the value of bringing scientists, educators, researchers, and practitioners together for research and development, academic, health science and healthcare partnerships have also proliferated (DeBoer et al 2019; Phillips et al 2004). Whilst many of these are collaborations within a region or country, international collaborations can have huge impact, such as during the Covid-19 pandemicwith not only the development of treatments and production of vaccines, but also in the improvement of training and education, e.g., in surgery (Riviello et al 2010), cancer care (Meade et al 2011), Obstetrics and gynaecology (Anderson & Johnson 2015) and HIV prevention (Dill et al 2020).

International collaborations often intentionally occur between partners in the Global South and Global North aiming to address global inequities in health and educational capacity (Farmer, 2016). Many international collaborations are therefore operating in a broad context of inequity in which power may be unequally held by constituent individual and institutions (Eichbaum et al,. 2021). Development of equitable, ethical collaborations can be challenging precisely because they are occurring in a context of historical and cultural inequality. When opportunity or privilege between partners is uneven (one-sided) collaborations can pose ethical problems and can entrench inequality (Kraeker and Chandler 2013).

In summary, a large body of evidence exists about the value of international collaboration in health professions’ education which provided an impetus for developing this ASPIRE Award.