Volume 16: Issue 6s

Background Climate change is a public health emergency, yet planetary health education is absent for many medical and health professions trainees.

Objective To perform a scoping review exploring the inclusion of planetary health in undergraduate and graduate medical education.

Methods A search strategy was developed with a health sciences librarian and run on 6 databases from their inception to February 2022: MEDLINE, Embase, APA PsycInfo, CINAHL, Global Health, and Scopus. The Arksey and O’Malley framework was employed to broadly select publications that described the implementation of planetary health in undergraduate and postgraduate medical education. Commentaries were included if they outlined a potential curriculum. Extracted data was grouped thematically using an iterative approach based on competencies described, key considerations, and anticipated barriers.

Results After screening 2407 articles, 42 were included. Thirty articles involved medical education at undergraduate or postgraduate levels, while 10 discussed multidisciplinary education including veterinary medicine, public health, and nursing. Two articles discussed planetary heath education for staff physicians. Reported competencies included eco-medical literacy, environmental inequity, and planetary health advocacy. Key considerations for curricular development included longitudinal implementation, interprofessional collaboration, and experiential learning through quality improvement projects. Barriers to implementation included time constraints and the lack of knowledgeable educators and administrative support for curricular change.

Conclusions This scoping review outlines key recommendations and barriers to help facilitate the implementation of planetary health education in medical training.

Background Climate change threatens humanity’s health and well-being. While climate change topics have been increasingly incorporated into undergraduate medical education, it is unclear to what extent they have been incorporated into graduate medical education (GME) curricula in the United States.

Objective To examine how climate change has been incorporated into GME curricula in the United States.

Methods We conducted a scoping review of published literature from January 2013 through November 2023. PubMed and Scopus were searched, with articles assessed by 3 reviewers in a blinded fashion. Resources were included if they described how climate change is incorporated into GME curricula in the United States, and if they discussed topics such as disaster medicine, mass casualty events, environmental medicine, public health, health policy, wilderness medicine, quality improvement, and sustainability. Articles were analyzed using descriptive numerical analysis and qualitative assessment to identify article characteristics and themes.

Results The inclusion criteria generated 17 articles that examined climate change incorporation into GME curricula and curriculum interventions covering topics used for inclusion. The most common type of article (5 of 17, 29%) employed surveys of program directors on the inclusion of climate-related topics.

Conclusions Published accounts of climate-related topics in US GME program curricula are few. More content is found in topics related to emergency medicine. Curricula frameworks have been proposed for pediatric and internal medicine residency programs, but we know little about their efficacy. Future scholarship should fill these gaps to educate learners to improve health care sustainability and resiliency.

Background Physicians require climate-related training, but not enough is known about actual or desired training at the graduate medical education level.

Objective To quantify the climate curriculum provided within a network of family medicine residency programs in the Northwestern United States, to assess barriers to adoption of climate curricula, and to identify preferred climate-related content, delivery methods, and program actions.

Methods In fall 2021, residents and faculty in a family medicine residency network responded to a 25-item, anonymous, online survey about climate-related training within their programs. Likert scales were used to assess the extent of current and desired climate curricula in respondent programs, and a paired samples t test was used to compare them. Drop-down menus and frequencies were used to identify top barriers to integration of a climate curriculum, and preferred curricular content, delivery methods, and program actions.

Results Responses were received from 19.3% (246 of 1275) of potential respondents. Nearly ninety percent (215 of 240) reported little or no climate content in their programs. Respondents desired significantly more climate-related training (t[237]=18.17; P<.001; Cohen’s d=1.18) but identified several barriers, including insufficient time/competing curricular priorities (80.7%, 192 of 238), concern about the political/controversial nature of the topic (27.3%, 65 of 238), and perceived irrelevance (10.9%, 26 of 238). More respondents selected integration of climate content throughout relevant didactics (62.2%, 145 of 233) than other delivery methods. Over 42% of respondents selected each of the climate-related topics and program actions suggested.

Conclusions Despite a number of barriers, most family medicine faculty and residents desire significantly more climate-related content in their training curricula.

Setting and Problem

In 2014, educators in the United Kingdom began to define planetary health and sustainable health care education (SHE) objectives¹ by outlining physician and health professional skills in categories of practitioner, scholar and scientist, and professional. Curricula that equip residents to practice in a future with climate change and highlight the practical relevance of planetary health, regardless of specialty choice, is critical to climate adaptation in health care. Quality improvement (QI) presents an opportunity for SHE in graduate medical education.

A SHE-augmented QI (SHE-QI) curriculum overcomes curricular space limitations, improves applicability, and lowers barriers for educators

Setting and Problem

Leading medical organizations recognize climate change as the greatest public health crisis of the 21st century and recommend that medical training include climate change education.^1,2 However, no standardized approaches exist to incorporate climate change topics into graduate medical education.² To address this challenge, we created a multipronged intervention focusing on climate-specific improvements to clinical care, advocacy, research, and education (CARE).

Intervention

Resident leaders designed the intervention with support from residency program directors and faculty mentors with the goals of improving (1) clinical practice through climate change–related resources and training; (2) opportunities