International collaboration in research, development, and innovation (RDI) increasingly depends on well-known digital platforms. These tools enable broad participation across geographical boundaries and allow a large number of participants to work together.
We often take working through digital channels and devices for granted. In practice, coordinating complex processes online demands significant commitment, careful planning, and a strong sense of shared purpose. Moreover, as the geographical distance between team members grows, so do the time zone differences, which makes real-time communication and collaboration more challenging (Duarte & Tennant 1999; Morrison-Smith & Ruiz 2020).
Working and collaborating in full digital mode requires the ability to build trust, ensure active participation, and share responsibilities between partners. In virtual collaboration, trust is more difficult to identify and develop, yet crucial for a successful collaboration (Gibson & Manuel 2023). Trusting behaviour (trust reciprocity) has even been associated with increased oxytocin levels. In other words, perceptions of trust intentions influence circulating oxytocin levels, which in turn enhance overall well-being in trusting partners (Zak, Kurzban & Matzner 2005).
Leading co-creation and development work through digital platforms is not only about having productive meetings, but also about creating meaningful connections, fostering a collaborative spirit, and navigating doubt and uncertainty together. According to Duarte and Tennant (1999), cross-border work is complex due to linguistic, cultural, and technological differences that may delay communication and collaboration. Therefore, people who lead and work in virtual teams need to have special skills, such as an understanding of human dynamics, and knowledge of how to manage across functional areas and national cultures. In addition to meetings and fostering collaboration, time should be set aside for the practical aspects of the project and the research work itself (Blomqvist, Ruckenstein & Saranto 2021).
In this article, we highlight some of the elements of a year-long co-creation development process that was conducted solely through digital platforms. We offer insights into the lessons learned and provide practical tips for leading RDI processes in fully digital settings.
PALLIAKID – the project we worked on
The on-going PALLIAKID project, funded by the EU’s Horizon Europe programme, is dedicated to improving pediatric palliative care. PALLIAKID is focused on studying innovative interventions to improve the well-being and quality of life of children and young people who need palliative care and/or end-of-life support. The project is led by Fundació Sant Joan de Déu/Hospital Sant Joan de Déu in Barcelona, Spain. All in all, 17 partners from ten European countries, including five clinical sites in Spain, Denmark, Latvia, Italy and Finland are working together. Approximately 230 experts from different fields contribute to the project.
As one of the project partners, Metropolia University of Applied Sciences (MUAS) was responsible for a work package that aimed to identify stakeholder needs for the development of a digital platform and mobile application to be used in pediatric palliative care. A co-creation process was carried out to achieve this aim. The work package also included several parallel sub-processes with detailed objectives and expected outcomes.
What is needed in an international co-creation process?
Co-creation engages stakeholders with an aim to develop needs-based and inclusive solutions. It also promotes mutual understanding and encourages a sense of shared responsibility (Grindell et al., 2022).
To facilitate a collaborative co-creation process in international collaboration, MUAS coordinated follow-up meetings approximately every three weeks to support the progress of the process. During the first four months, the focus was on specifying the plan applicable to each clinical site and on the research authorisation process. This included research documents, such as consent forms and information notes, which were required for ethical review based on the European Code of Conduct for Research Integrity.
This phase was carried out collaboratively through live documentation and facilitated discussions. Based on the jointly prepared materials, each clinical site applied for ethical approval and research authorisation from their respective institutions. Before data collection, clinic-specific training sessions were held to review the practical implementation and address any questions. These sessions also included a joint discussion of the logic underlying the data analysis, as depicted below.
As mentioned, five clinical sites across Europe participated in the process, with 18 co-creation workshops and over 230 participants in total. These sessions allowed various stakeholders, including children, adolescents, siblings, family caregivers, and health professionals, to share their insights of needs and contribute to the development of a digital platform and mobile application for pediatric palliative care.
Lessons learned
What did we learn from this first year of working and leading a virtual team on such a high-level project? First of all, we observed that similar factors influence both offline and virtual teams, including training, on-the-job education and development, standard organisational and team processes, and the competencies of team leaders and team members (Duarte and Tennant 1999; Ünal 2023).
Moreover, in our experience, it is important to take into account the following issues when working on a high-level project (e.g. Horizon Europe) with a large number of participants:
- Schedule meetings consistently to create a dependable working routine.
- Work in pairs and as a team, to foster collaboration and encourage shared ownership.
- Act as a strong team and offer mutual support throughout the co-creation process.
- Build trust and offer support as the process progresses.
- Foster transparency by sharing information openly with accessible materials and clear communication.
- Keep meetings predictable by using consistent meeting times and materials.
- Ask all members to come prepared for each meeting to ensure productive sessions.
- Stick to agreed schedules and model commitment and responsibility.
- Discuss job roles and manage workload at various stages of the project.
- Acknowledge achievements to sustain motivation and collaboration.
- Enjoy new experiences and opportunities to learn as part of an engaging and demanding international environment.
Value-based development creates good conditions for effective projects (Meynhardt, 2021). This was a key factor for the success of the co-creation phase, due to strong human and social significance of the subject and the shared will to promote the wellbeing of children and their family members in pediatric palliative care. Thus, the content of the project itself motivated people to act with integrity and for the common good. We were honoured to be invited to coordinate one of the work packages with extensive expertise and top professionals in the field in the PALLIAKID project.
To sum up, trust is often considered even more crucial in virtual teams, yet it can be undermined by challenges related to managing risk and interdependence – particularly in multicultural settings (Gibson & Manuel 2023). However, this was not the case in this project. We observed a great deal of trust, enthusiasm, commitment and above all a shared willingness in the project group to work for the benefit of vulnerable children and their families in the co-creation process. We felt privileged to lead the process and proud to have successfully advanced such an important and meaningful cause together.
Disclaimer:
The PALLIAKID project is a multinational pediatric palliative development project funded by the European Union (grant nr. 101137169) and supported by Innovate UK. However, the views and opinions expressed in this article are those of the authors only and do not necessarily reflect those of the European Union or the European Health and Digital Executive Agency (HADEA).
References
Blomqvist, K., Ruckenstein, M., & Saranto, K. 2021. Luottamus dataan ja algoritmeihin syntyy ihmisen ja teknologian vuorovaikutuksesta. Tieteessä tapahtuu, 39(4). Accessed 2 May 2025.
Duarte, D. L., & Tennant, N. 1999. Mastering virtual teams: Strategies, tools, and techniques that succeed. Jossey-Bass. Accessed 28 April 2025.
ALLEA. 2023. The European Code of Conduct for Research Integrity – Revised Edition 2023. Berlin. Accessed 24 April 2025.
Gibson, C.B., & Manuel, J.A. 2023. Building Trust: Effective Multicultural Communication Processes in Virtual Teams. CEO Publication G 03-10 (438). University of Southern California. Accessed 2 May 2025.
Grindell, C., Coates, E., Croot, L. et al. 2022. The use of co-production, co-design and co-creation to mobilise knowledge in the management of health conditions: a systematic review. BMC Health Serv Res 22, 877. Accessed 28 April 2025.
Meynhardt, T. 2021. Public Value is Knowable, Public Value Creation is Not. Administration & Society, 53(10), 1631-1642. (Original work published 2021). Accessed 5 May 2025.
Morrison-Smith, S., & Ruiz, J. 2020. Challenges and barriers in virtual teams: a literature review. SN Applied Sciences, 2(6), 1096. Accessed 28 April 2025.
Zak P.J., Kurzban R. & Matzner W. T. 2005. Oxytocin is associated with human trustworthiness. Horm Behav. 2005 Dec;48(5):522-7. Accessed 24 April 2025.
Ünal, B. 2023. Influencing Factors of Team Effectiveness in Global Virtual Teams. International Journal of Interactive Communication Systems and Technologies. 12. 1-17.
Authors
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Eija Raatikainen
Principal Lecturer (PhD, Associate Professor) and Project ManagerEija Raatikainen is Principal Lecturer (PhD) and Project Manager in the School of Well-being, Metropolia UAS. She is also an Associate Professor at the University of Eastern Finland, Faculty of Social Sciences and Business Studies. Her interests revolve around social pedagogy, especially trust in organisations.
About the author -
Nea Vänskä
Project Manager, Senior LecturerNea Vänskä is Project Manager and Senior Lecturer, involved in Co-creating Child and Youth Wellbeing R&D Programme, Future-proof Health and Wellbeing Innovation Hub. She's interested in research and development projects, children's health and functioning, participation-based rehabilitation and meaningful participation in daily life.
About the author -
Linda Dinda
Senior Lecturer, Acute Care Nursing Team 3Linda Dinda is Senior Lecturer in Acute Care Nursing Team 3.
About the author