Design continuously evolves in response to societal change, shaping and being shaped by how people live and care for one another. In healthcare, care is a central professional and ethical principle, yet its design dimensions remain underexplored in medical education. While clinicians understand care in daily practice, they are often unaware of how design can extend care beyond individual encounters toward systemic, technological, and societal transformation.
This paper reports on Designing Health Systems, an ongoing online course delivered by the Faculty of Medicine and Dentistry at University of Alberta, Canada, to 60 second-year medical students at the Wenzhou Medical University, China. The course invites students to explore how professional care could be expressed through meaningful innovations at different scales—individual, cultural, and systemic—and pathways such as products, resources, programs, and policy initiatives.
Situated within the emerging AI/Hybrid Design Paradigm, where human and technological forms of care increasingly intertwine and reconfigure clinicians’ roles, instructors wrote and shared letters of care as prompts for dialogue. These were synthesized into a collective letter to the cohort, followed by targeted letters providing feedback to project groups. The letters embodied care as both a relational and epistemic act—modeling rather than merely teaching what caring design entails.
Adopting a pedagogical design research approach grounded in reflective practice (Schön, 1983), we iteratively reflected in and on action by producing and discussing letters, student responses, and innovations. This process revealed that educating through care enacts the values we aim to teach. Analysis shows how students reciprocated this experience by developing a sense of care toward their projects, evident in the authenticity rooted in personal experiences and clinical reflections rather than AI content. Ultimately, this work aims to nurture clinicians who collaboratively create ethical, humane, and sustainable health-system innovations that uphold care as a foundational value in the AI/Hybrid Design Era.
