oa Samen veranderen is samen leren

This article describes the first three stages of an action research project. Following eight methodological principles of participatory action research, this article aims to give insight in the nature of the challenges and dilemmas involving internists, patients and patient representatives in the research process mention. Dilemmas included giving space versus limiting participation together with operating efficiently versus being flexible and honoring the input of all participants equally. It was a challenge to reflect not only on the content and procedures but also on everybody’s role in the learning process. In conclusion, action research offers a critical base for a participative and reflective method but it is also a challenge for busy healthcare practices that focus on content and concrete action and less on the learning process. Because reflection on the learning process is important for scientific standards, we suggest to give monitoring and reflection a central place in the action research cycle.