Up front, up until now I have avoided shared first-authorships, and I have no experience with this construct first hand.
However, I am working on a manuscript (as a 1st author) on a clinical study based on retrospective analysis of electronic patient files. Two undergrad students have contributed substantially during their internship. These two folks both deserve a second authorship imho.
The field is picky in term of author order, in that there are three interesting positions on a paper; 1st, 2nd, and last. The 1st is credited with writing up the paper and is considered the main author. The 2nd typically was hands-on involved in the work, and ideally has co-written the paper. The last author is often the department head who secured funding, generated the research question and looks at drafts of the MS. Intermediate positions are worth the effort, but seen as 'less important'. First authors are often PhD students, second authors often are postdocs or senior researchers, last authors typically are professors or department heads.
To illustrate the roles of the students' respective contributions:
Student #1 (MSc Medicine) started on the project and supplemented the database with a lot of missing data by manually sifting through electronic patient files. They wrote an excellent Introduction in their report, and an OK Discussion. I didn't really copy anything ad verbatim into the MS, but I sure am leaning a lot on their original report in terms of the cited literature, the pros and cons of our study, and overall report structure.
Student #2 (BSc Biomedical Sciences) re-analyzed the whole dataset based on new insights, and they finetuned the variables in the database. I am using their data preprocessing pipeline, their analyses and outcomes, and I am using their tables and graphs by polishing them up to publication standards.
Imho, they both deserve a 2nd authorship. Is this appropriate given their respective contributions? More importantly, is a shared 2nd authorship something that's done more often in the first place?