Identification of core objectives for teaching sustainable healthcare education

Abstract

Background: Physicians will be called upon to care for patients who bear the burden of disease from the impact of climate change and ecologically irresponsible practices which harm ecosystems and contribute to climate change. However, physicians must recognize the connection between the climate, ecosystems, sustainability, and health and their responsibility and capacity in changing the status quo. Sustainable healthcare education (SHE), defined as education about the impact of climate change and ecosystem alterations on health and the impact of the healthcare industry on the aforementioned, is vital to prevention of adverse health outcomes due to the changing climate and environment. Objective: To systematically determine which and when a set of SHE objectives should be included in the medical education continuum. Design: Fifty-two SHE experts participated in a two-part modified-Delphi study. A survey was developed based on 21 SHE objectives. Respondents rated the importance of each objective and when each objective should be taught. Descriptive statistics and an item-level content validity index (CVI) were used to analyze data. Results: Fifteen of the objectives achieved a content validity index of 78% or greater. The remaining objectives had content validity indices between 58% and 77%. The preclinical years of medical school were rated as the optimal time for introducing 13 and the clinical years for introducing six of the objectives. Respondents noted the definition of environmental sustainability should be learned prior to medical school and identifying ways to improve the environmental sustainability of health systems in post-graduate training. Conclusions: This study proposes SHE objectives for the continuum of medical education. These objectives ensure the identity of the physician includes the requisite awareness and competence to care for patients who experience the impact of climate and environment on health and advocate for sustainability of the health systems in which they work. Abbreviations: CVI: Content validity index; SHE: Sustainable healthcare education

Medical, nursing, and physician assistant student knowledge and attitudes toward climate change, pollution, and resource conservation in health care

“…This is similar to the finding from the survey of NMA physicians that "a majority of respondents said that physicians have a responsibility to bring the health effects of climate change to the attention of their patients (75%) and the public (71%)" [17]. The similarities in these findings suggest that there is a need to include education on pollution, climate change and health in health professional education, both at Yale and nationally [23]. This education should train health professionals to understand the complex ways in which climate change and pollution impact health [31], how to effectively communicate these health impacts to patients, and how to conserve resources and prevent pollution in clinical practice.…”

“…Previous research has examined physician knowledge and attitudes about climate change and health, medical waste, and duty to educate patients [17][18][19][20][21][22]. Physicians have identified a need for improved health professional education to prepare them to respond to climate change related harm and to better communicate with patients, the public, and policy makers [17,23,24]. A recent study found that medical students in China understood the health impacts of climate change but did not feel adequately prepared to address these impacts [25].…”

“…The results of that work echoed calls to incorporate climate change and health education into medical school curricula to prepare future physicians to address health needs [27][28][29]. Core objectives for education about climate change and health and the environmental impact of the health care sector have been developed [23], but currently there is no health professional education mandate.…”

AORN Position Statement on Environmental Responsibility

“…• Education for health care professionals on environmental sustainability should include o general knowledge about the climate crisis effects on population health, including 10,11 ▪ air pollution, ▪ exposure to toxins, ▪ heat-related illnesses, 10,11 ▪ extreme weather events, 10,11 ▪ physical and mental health effects of natural disasters, 12 ▪ need for reliable access to clean food and water, and ▪ modification of vector-borne, zoonotic, and waterborne diseases 13 ; o disaster preparedness 10 ; o health system infrastructure resilience [14][15][16][17] ; o supply chain engagement 18 ; o financial, social, and environmental benefits of environmental best practices 19 ; and o real-world examples of environmental best practices in health care services. • Environmentally responsible decision-making in health care delivery should align with local, state and federal regulations and support patient safety and optimal clinical outcomes.…”

Preparing medical graduates for the health effects of climate change: an Australasian collaboration

“…For example, in the United Kingdom, the General Medical Council consulted widely in the development of sustainability learning objectives, 7 which have been identified in a recent best‐evidence medical education guide 8 as providing an appropriate framework for health professions' education. An international collaboration developed learning outcomes and activities for an environmentally accountable curriculum, and a recent Delphi study has also developed learning outcomes 9 , 10 . Despite this, there are few examples in the literature where climate change and health has been integrated into medical curricula.…”