Service user involvement in healthcare education, enriches students, building deeper empathy and person-centred communication skills. However, there remain gaps in understanding service user perspectives on their role, with tokenism an ongoing risk to this educational experience for both service users and students. This study collected perspectives from healthcare service users about their role as educators, to gain clarity on how this potentially transformative and socially important element of healthcare education can be maximised safely. Methods A World Café methodology was employed, positioning the service user as expert, enabling a deep understanding of their experiences in health education. This method mitigates potential power imbalances between the service user and researchers. Twelve service users (or representatives of service users) attended a two-hour World café event. Data were analysed using content analysis and feedback was sought from participants on preliminary findings. Results Trusting relationships with both students and academic staff were fundamental for service users to engage as partners in healthcare education. Respect for the service user perspective, having students and staff recognise the value of their experiences and practical supports were core across recommendations. A series of recommendations generated during the World Café offer clear guidance for how this trust and respect can be initiated and maintained. Conclusion Service users must be recognised as full and active members of the healthcare community, and their direct involvement in educating healthcare professionals is vital to delivering authentic, person‑centred learning. Academic staff need to ensure robust orientation and induction for new service users as educators, as well as preparing students for respectful engagement, ensure students respectfully and actively engage with service users. Practical supports, such as teaching venue visits or availability of lecturers to tie service user experience to curriculum, are welcomed by service users.