Medical Teacher publishes Special Issue on sustainable healthcare!

Stefi Barna's picture

Medical Teacher is the official journal of the  Association for Medical Education in Europe (AMEE), publishing research on medical education teaching approaches and methods. It has in the past occasionally published articles by members of the Sustainable Healthcare Education network.

Volume 41, 2019 - Issue 10 is dedicated to understanding the why and how of teaching sustainable healthcare in medicine, nursing and the allied health professions. Here is a collection of the article abstracts, all of which are open source until the end of the year.

Stefi Barna, Filip Maric, Julia Simons, Shashank Kumar & Peter J. Blankestijn (2020) Education for the Anthropocene: Planetary health, sustainable health care, and the health workforce, Medical Teacher, DOI: 10.1080/0142159X.2020.1798914

Over the past few centuries, human activity has wrought dramatic changes in the natural systems that support human life. Planetary health is a useful concept for health profession education (health professional education) teaching and practice because it situates health within a broader understanding of the interdependent socio-ecological drivers of human and planetary health. It facilitates novel ways of protecting both population health and the natural environment on which human health and well-being depends. This paper focuses on the climate crisis as an example of the relationship between environmental change, healthcare, and education. We analyze how health professional education can help decarbonize the healthcare sector to address both climate change and inequity in health outcomes. Based on the healthcare practitioner’s mandate of beneficence, we propose simple learning objectives to equip health professional education graduates with the knowledge, skills, and values to create a sustainable health system, using carbon emission reductions as an example. These learning objectives can be integrated into health professional education without adding unduly to the curriculum load.

Nicole Redvers, Clinton Schultz, Melissa Vera Prince, Myrna Cunningham, Rhys Jones & Be’sha Blondin (2020) Indigenous perspectives on education for sustainable healthcare, Medical Teacher, DOI: 10.1080/0142159X.2020.1791320

A range of global environmental changes are contributing to an increasing global burden of disease. Since human health and well-being are intimately associated with the health of our planet, healthcare providers will not only be charged with caring for this expanding disease burden but will also need to become more environmentally sustainable in their professional practice. There is thus an urgent need in the health professions education community to prioritize environmentally sustainable healthcare practice, which must include and prioritize Indigenous voices and Indigenous knowledge systems. Critical global dialogue on the significance of Indigenous knowledge systems in educating health professionals for a sustainable future will be required if we are ready to ensure the generations that follow us are able to live healthy lives. Indigenous ways of ‘being’ in the world, which emphasize the importance of interconnection and reciprocal stewardship with everything in the natural world, are essential for advancing education for sustainable healthcare and overall well-being. Given the colonial legacy however, Indigenous people, despite their essential knowledge systems and abilities, still face many barriers accessing safe decolonizing spaces and presence in health professions education, which needs to be addressed.

Nayna Schwerdtle, Graeme Horton, Fiona Kent, Lorraine Walker & Michelle McLean (2020) Education for sustainable healthcare: A transdisciplinary approach to transversal environmental threats, Medical Teacher, DOI: 10.1080/0142159X.2020.1795101

Global environmental changes are dynamic and complex, crossing disciplines, sectors, regions, and populations and shaping the health of current and future generations. They present an unprecedented challenge demanding a response of equal scale and complexity involving unfettered collaboration beyond disciplines with implications for global health. At this critical point, health professions’ education should have moved on from building consensus about the relevance of education for sustainable healthcare to active implementation. In this commentary, we discuss why transdisciplinary problem-solving and interprofessional education should be considered in education for sustainable healthcare. We review types of collaborative educational practices, outline opportunities, challenges, and resources to enable implementation.

Norma Huss, Moses N. Ikiugu, Finola Hackett, Perry E. Sheffield, Natasha Palipane & Jonathan Groome (2020) Education for sustainable health care: From learning to professional practice, Medical Teacher, DOI: 10.1080/0142159X.2020.1797998

A number of planetary boundaries, including climate change as a result of greenhouse gas emissions, has already been exceeded. This situation has deleterious consequences for public health. Paradoxically, 4.4% of these emissions are attributable to the healthcare sector. These problems have not been sufficiently acknowledged in health professions curricula. This paper addresses two main issues, humanistic learning and the application of knowledge acquisition to clinical practice. Humanistic learning principles can be used to emphasize learner-centered approaches, including knowledge acquisition and reflection to increase self-awareness. Applying humanistic principles in everyday life and clinical practice can encourage stewardship, assisting students to become agents for change. In terms of knowledge and skills application to clinical practice, an overview of varied and novel approaches of how sustainable education can be integrated at different stages of training across several health care professions is provided. The Health and Environment Adaptive Response Taskforce (HEART) platform as an example of creating empowered learners, the NurSusTOOLKIT, a multi-disciplinary collaboration offering free adaptable educational resources for educators and the Greener Anaesthesia and Sustainability Project (GASP), an example of bridging the transition to clinical practice, are described.

SanYuMay Tun (May Sanyu Tun), Caroline Wellbery & Arianne Teherani (2020) Faculty development and partnership with students to integrate sustainable healthcare into health professions education, Medical Teacher. DOI:10.1080/0142159X.2020.1796950

There is an urgent need for health professionals to address the impacts of accelerating global environmental change. Healthcare faculty therefore have to educate the rising generation of health professionals in subjects unfamiliar to themselves, such as planetary health and sustainable healthcare. This creates a new paradigm where faculty have to learn a new subject area and incorporate and teach it within their own material. It is important to develop faculty knowledge and confidence to integrate education for sustainable healthcare into their educational practice, as faculty can rapidly acquire and build on these skills. Partnership between students and faculty can enhance this faculty development as students bring fresh ideas and possibly greater knowledge of the climate and ecological crisis. Under supervision, they can co-create the necessary new learning. Students can also act as partners in advocating for social and environmental fairness and systemic change toward a sustainable healthcare system. We summarize the impact of various activities of health professions students around the world which advocate for institutional change and enhance faculty development in education for sustainable healthcare. Through diverse case studies from different countries, we illustrate faculty development in education for sustainable healthcare, highlighting student involvement which has enhanced educators’ learning.

Diana Lynne Madden, Michelle McLean, Meagan Brennan, Aishah Moore (2020)

Why use indicators to measure and monitor the inclusion of climate change and environmental sustainability in health professions’education?

Currently, health professionals are inadequately prepared to meet the challenges that climate changeand environmental degradation pose to health systems. Health professions’education (HPE) has anethical responsibility to address this and must include the health effects of climate change and envir-onmental sustainability across all curricula. As there is a narrow, closing window in which to takeaction to avoid the worst health outcomes from climate change, urgent, systematic, system-levelchange is required by the education sector. Measuring, monitoring, and reporting activity using indica-tors have been demonstrated to support change by providing a focus for action. A review of the litera-ture on the use of indicators in medical education for climate change and health, however, yielded nopublications. The framework of targets and indicators developed for implementation of the SustainableDevelopment Goals (SDGs) by 2030 and the UNESCO initiative of the Education for SustainableDevelopment provide a guide for the development of indicators for HPE. Engaging stakeholders andachieving consensus on an approach to indicator development is essential and, where they exist,accreditation standards may have a supporting role. Creating capacity for environmentally sustainablehealth care at scale and pace should be our collective goal as health professions’educators

Omnia El Omrani, Alaa Dafallah, Blanca Paniello Castillo, Bianca Quintella Ribeiro Corrêa Amaro, Sanjana Taneja, Marouane Amzil, Md. Refat Uz-Zaman Sajib & Tarek Ezzine (2020) Envisioning planetary health in every medical curriculum: An international medical student organization’s perspective, Medical Teacher, DOI: 10.1080/0142159X.2020.1796949

Background: With deteriorating ecosystems, the health of mankind is at risk. Future health care professionals must be trained to recognize the interdependence of health and ecosystems to address the needs of their patients and communities. Health issues related to, e.g. climate change and air pollution, are not, however, generally included in medical education. Objectives: To assess the inclusion of climate change and air pollution in medical curricula and to guide the International Federation of Medical Students’ Associations’ (IFMSA) Vision of Climate Change in the Medical Curriculum. Methods: A study comprising three surveys (March 2019, August 2019, March 2020) explored medical students’ perceptions of the current status of formal and non-formal elements of climate change and air pollution and health in their medical programs. Results: Respondents originated from 2817 medical schools in 112 countries. Only 15% of medical schools have incorporated climate change and health into the curriculum. Students led climate-related activities in an additional 12% of medical schools. With regard to air pollution and health, only 11% of medical schools have formal education on the topic. Conclusions: It is crucial to acknowledge the current omissions from medical curricula and the importance of meaningful student involvement in curriculum transformation.

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