Sustainability taking centre stage at TransformMedEd 2020

Dear Colleagues

We are pleased to announce that planetary health and sustainable healthcare are on the agenda in quite a big way at TransformMedEd. It would be great to have as many of us turn up as possible. It's a London based conference on 13-14th March 2020 aimed at transforming medical education.

• Sarah Walpole has been invited to present at the Partnerships in Medical Education symposium “Learning about climate change, community engagement and our duty to protect health: The UK's Planetary Health Hub at Extinction Rebellion”
• San Yu May Tun has been invited to join the Global Challenges, Local Solutions: Evidence-Based Education for Future Healthcare panel discussion (hopefully chaired by Anthony Costello, me facilitating)
• San Yu May also has a poster “Students and educators as partners in learning and teaching sustainable healthcare”
• Frances and I together with sustainability/quality/educational leads from five medical schools (Imperial College London, King's College London, Manchester, University College London and Dundee) have had our oral accepted “Extinction rebellion for doctors: incorporating concepts of social and environmental accountability into clinical learning” (see abstract below)

Note the early bird registration rate closes on 30^th November! http://www.transformmeded.org/

All the best

Kathleen (Kay) Leedham-Green

Extinction rebellion for doctors: incorporating concepts of social and environmental accountability into clinical learning

Introduction/background

The degradation of eco-systems, climate change and social inequalities are at a tipping point and are already impacting on health and healthcare on a global scale. The response within health professional education however lags advances in research on how to address and mitigate these factors.

Issue to be addressed

Medical students and trainees have an increasingly high stake in working with patients, colleagues and communities to create resilient, more equitable and less intensive models of care. Through an analysis of the drivers to sustainable healthcare, the Centre for Sustainable Healthcare has created recommendations for clinical practice based on prevention, patient empowerment, lean pathways, lower impact swaps and effective resource management. The challenge is to incorporate these into health professional education.

Methods/methodology

We present a series of educational case studies designed to address these factors, aimed at creating a regenerative culture within a consultation, at a team/facility level and within communities. We also present the results of a national question-writing workshop involving eight medical schools designed to promote learning on sustainable healthcare through constructive alignment.

Results/observations

There is wide variation in how sustainable healthcare can be taught, with successful models including patient-centred coaching for health and direct action through service learning and quality improvement. The principles are applicable widely across specialties and at every stage of healthcare. Despite 17 peer-reviewed single best answer questions being submitted to the Medical Schools Council Assessment Alliance, only one was accepted into their national question bank.

Discussion

The principles and practices of sustainable healthcare align closely to national models of excellence in healthcare: reducing waste, over diagnosis and over prescription; improving efficiency, safety and resource management; addressing the social and behavioural determinants of health; and driving the focus of activity upstream towards preventative and community services.

There appears however to be a hidden curriculum which is driving educational activity towards the ongoing privileging of high-end medicine and less sustainable kinds of clinical care. This may be related to our prevailing assessment modalities and clinical/academic incentivisations, rather than resistance to the learning itself.

Conclusion/recommendation

Sustainable healthcare can be integrated effectively into medical curricula however it requires us to openly challenge our academic practices including assessment strategies. In particular we need to value and reflect on our educational approaches to the social and behavioural sciences and actively mitigate for the hidden curriculum across clinical, academic and educational paradigms.

Leedham-Green K ¹ , Park S ² , Mortimer F ³ , Ryan N ¹ , Hothersall E ⁵ , Dayala S ⁶ , Sethi G ⁴

¹ Imperial College London, London, United Kingdom

² University College London, United Kingdom

³ Centre for Sustainable Healthcare, Oxford, United Kingdom

⁴ King’s College London, United Kingdom

⁵ University of Dundee , United Kingdom

⁶ University of Manchester, United Kingdom