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Walpole S, Popat A, Blakey EP, Holden E, Whittaker B, Saggu R, Fennell-Wells A, Armit K, Hothi D. Health and social care professional standards need to be updated to advance leadership and action for environmental sustainability and planetary health. BMJ LEADER 2024:leader-2023-000889. [PMID: 38233120 DOI: 10.1136/leader-2023-000889] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/01/2023] [Accepted: 12/19/2023] [Indexed: 01/19/2024]
Abstract
BACKGROUND Human health is inextricably linked to planetary health. The desire to nurture and protect both concurrently requires the mitigation of healthcare-associated environmental harms and global initiatives that support sustainable lifestyles. Health leadership is important to bring adequate attention and action to address planetary health challenges. Health professionals are central to this endeavour, but the will and energy of a few will not be adequate to address this urgent challenge. STUDY We present an appraisal of the current UK health professional standards, frameworks and curricula to identify content related to planetary health and environmental sustainability. RESULTS No current UK health professional standard provides statements and competencies to guide practising and trainee health professionals to focus on and advance the sustainability agenda within their clinical practice and across wider healthcare systems. CONCLUSION Update of health professional standards is needed to ensure that health professionals in every specialty are supported and encouraged to lead the implementation of environmentally sustainable practices within the health sector and advocate for planetary health.
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Affiliation(s)
- Sarah Walpole
- Faculty of Medical Sciences, Newcastle University, Newcastle upon Tyne, UK
- Centre for Clinical Infection, James Cook University Hospital, Middlesbrough, UK
| | - Aneka Popat
- General Medical Council, London, UK
- Occupational Health, London North West University Healthcare NHS Trust, London, UK
| | | | - Eleanor Holden
- Medical Physics and Clinical Engineering, Guy's and St Thomas' NHS Foundation Trust, London, UK
- Office of the Chief Scientific Officer, NHS England, London, UK
- Medical Physics, The Harley Street Clinic, HCA, London, UK
| | - Ben Whittaker
- Centre for Sustainable Healthcare, Oxford, UK
- Sussex Partnership NHS Foundation Trust, Brighton, UK
| | - Ravijyot Saggu
- Central London Community Healthcare NHS Trust, London, UK
| | | | - Kirsten Armit
- Faculty of Medical Leadership and Management, London, UK
| | - Daljit Hothi
- Faculty of Medical Leadership and Management, London, UK
- Nephrology, Great Ormond Street Hospital for Children NHS Foundation Trust, London, UK
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Pettinger C, Tripathi S, Shoker B, Hodge G. Collaborative leadership to support sustainability in practice for dietitians as allied health professionals. J Hum Nutr Diet 2023; 36:2323-2335. [PMID: 37489277 DOI: 10.1111/jhn.13211] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2023] [Accepted: 07/06/2023] [Indexed: 07/26/2023]
Abstract
BACKGROUND Allied health professionals (AHPs) have an important role to support the Greener National Health Service (NHS) agenda. Dietitians are AHPs who are already demonstrating strong influence on food sustainability advocacy. There is call for more collaboration across the health professions to optimise "green" leadership in the pursuit of planetary health. The present study aimed to investigate the perceived role of AHP leaders and future leaders around more sustainable healthcare practices. METHODS A mixed methods approach using audio-recorded semi-structured interviews with strategic AHP leaders (n = 11) and focus groups with student AHPs (n = 2). Standardised open-ended questions considered concepts of (i) leadership, (ii) green agenda, (iii) collaboration and (iv) sustainability. Purposive sampling used already established AHP networks. Thematic analysis systematically generated codes and themes with dietetic narratives drawn out specifically as exemplars. RESULTS The findings represent diverse AHP voices, with six of 14 AHPs analysed, including dietetic (future) leaders. Three key themes emerged: (1) collective vision of sustainable practice; (2) empowering, enabling and embedding; and (3) embracing collaborative change. Dietetic specific narratives included food waste, NHS food supply chain issues, and tensions between health and sustainability advice. CONCLUSIONS The present study shows that collaborative leadership is a core aspiration across AHP leaders and future leaders to inform the green agenda. Despite inherent challenges, participant perceptions illustrate how "change leadership" might be realised to support the net zero agenda within health and social care. Dietitians possess the relevant skills and competencies, and therefore have a fundamental role in evolving collaborative leadership and directing transformational change towards greener healthcare practices. Recommendations are made for future leaders to embrace this agenda to meet the ambitious net zero targets.
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Affiliation(s)
- Clare Pettinger
- School of Health Professions, Peninsula Allied Health Centre (PAHC), Faculty of Health, University of Plymouth, Plymouth, UK
| | - Smita Tripathi
- Plymouth Business School, Faculty of Arts, Humanities and Business, University of Plymouth, Plymouth, UK
| | - Benji Shoker
- Plymouth Business School, Faculty of Arts, Humanities and Business, University of Plymouth, Plymouth, UK
| | - Gary Hodge
- School of Nursing and Midwifery, Faculty of Health, University of Plymouth, Plymouth, UK
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MacKenzie-Shalders K, Zadow G, Hensley-Hackett K, Marko S, McLean M. Rapid review: Guides and frameworks to inform planetary health education for health professions. Health Promot J Austr 2023. [PMID: 37866347 DOI: 10.1002/hpja.819] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/07/2023] [Revised: 09/27/2023] [Accepted: 09/27/2023] [Indexed: 10/24/2023] Open
Abstract
ISSUE ADDRESSED Human actions have led to a range of global environmental changes. Health professionals must be prepared to deliver systemic changes to mitigate and adapt to the ecological crisis. This rapid review aimed to describe exemplar frameworks that inform planetary health education across health professions. METHODS The rapid review methodology was informed by a scoping review process. A targeted search strategy was conducted using one representative database and additional strategies such as expert consultation and citation searching were used. Results are described narratively. RESULTS Of the 11 637 articles, 17 were eligible for inclusion. The frameworks differed, with many recently developed for health professions broadly using a range of methodologies, including qualitative research, opinion/consensus data, literature reviews, and adaptation of previous models. Models such as metric-based scoring indicators and Sustainable Quality Improvement were featured in the frameworks, as were the application of First Nations Natural Laws. CONCLUSION This rapid review identifies and showcases accessible, interdisciplinary frameworks to inform the integration of planetary health in curricula, highlighting a rapidly evolving field through which interdisciplinary collaborations in healthcare are important to inform its pedagogy and application. Health education is an important component of health promotion; and thus this rapid review offers a range of approaches that health professionals, health promotion practitioners, and educators can use to inform the integration of planetary health, including sustainable healthcare, into curricula. SO WHAT?: Educational frameworks are informed by research and practice and provide key guidance to practitioners and educators; summarising key available planetary health education frameworks consolidates and guides effective education and builds on the existing body of knowledge to support urgent pro-environmental change.
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Affiliation(s)
- K MacKenzie-Shalders
- Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - G Zadow
- Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - K Hensley-Hackett
- Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - S Marko
- Nutrition and Dietetics Research Group, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
| | - M McLean
- Medical Education, Faculty of Health Sciences and Medicine, Bond University, Robina, Queensland, Australia
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Stanhope J, Maric F, Rothmore P, Weinstein P. Physiotherapy and ecosystem services: improving the health of our patients, the population, and the environment. Physiother Theory Pract 2023; 39:227-240. [PMID: 34904927 DOI: 10.1080/09593985.2021.2015814] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/19/2023]
Abstract
INTRODUCTION The relevance of ecosystems to physiotherapy has traditionally been overlooked, despite its potential for health impacts relevant to conditions often managed by physiotherapists. PURPOSE The purpose of this article is to introduce the concept of ecosystem services to physiotherapists, and to discuss how understanding ecosystem services may improve patient care, and population and planetary health. DISCUSSION AND CONCLUSION Physiotherapists with an understanding of ecosystem services may improve patient care by value-adding to management through patient education, empathy, advocacy, and broader population health approaches. Physiotherapists are also well placed to promote the conservation and restoration of ecosystem through participation, advocacy, and the development of public health measures, to the benefit of global sustainability and population health. Further research is required into how physiotherapists currently use nature-based interventions, and the barriers and enablers to their use. To be adequately prepared to meet the challenges that climate change and environmental degradation pose to patient care, population health and health systems, both current and future physiotherapists need to take a broader view of their practice. By including consideration of the potential role of the environment and green space exposure in particular on their patient's health, physiotherapists can ultimately contribute more to population and planetary health.
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Affiliation(s)
- Jessica Stanhope
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Filip Maric
- Department of Health and Care Sciences, UiT the Arctic University of Norway (Tromsø), Tromsø, Norway
| | - Paul Rothmore
- School of Allied Health Science and Practice, University of Adelaide, Adelaide, Australia
| | - Philip Weinstein
- School of Public Health, University of Adelaide, Adelaide, Australia
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McLean M, Phelps C, Smith J, Maheshwari N, Veer V, Bushell D, Matthews R, Craig B, Moro C. An authentic learner-centered planetary health assignment: A five-year evaluation of student choices to address Sustainable Development Goal 13 ( Climate Action). Front Public Health 2022; 10:1049932. [PMID: 36408043 PMCID: PMC9671629 DOI: 10.3389/fpubh.2022.1049932] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 10/17/2022] [Indexed: 11/05/2022] Open
Abstract
A Code Red has been declared for the planet and human health. Climate change (e.g., increasing temperatures, adverse weather events, rising sea levels) threatens the planet's already declining ecosystems. Without urgent action, all of Earth's inhabitants face an existential threat. Health professions education should therefore prepare learners to not only practice in a changing world, but authentic educational activities should also develop competencies for global and planetary citizenship. Planetary health has been integrated across the five-year Bond University (Australia) medical curriculum. It begins in the second week of Year 1 and ends with a session on Environmentally Sustainable Healthcare in the General Practice rotation in the final year. The purpose of this article is to describe the outcomes of the first 5 years (2018-2022) of a learner-centered planetary health assignment, underpinned by the 2030 United Nations (UN) Sustainable Development Goals (SDGs), in the second year of a five-year medical program. Using systems and/or design thinking with a focus on SDG13 (Climate Action) plus a second SDG of choice, self-selected teams of 4-6 students submit a protocol (with feedback) to develop a deliverable "product" for an intended audience. Data analysis of the first 5 years of implementation found that the most frequently selected SDGs in addition to SDG13 were: SDG12 Sustainable Production and Consumption (41% of teams), mostly relating to healthcare emissions and waste; SDG3 Health and Well-being (22%), generally involving the impact of air pollution; and SDG6 Clean Water and Sanitation (15%). A survey at the concluding conference garnered student feedback across various criteria. The planetary health assignment is authentic in that teams provide solutions to address climate change. Where appropriate, final "products" are sent to local or federal ministers for consideration (e.g., policy proposals) or integrated into the curriculum (e.g., learning modules). We believe that the competencies, attitudes, and values fostered through engagement with planetary health. Throughout the medical program, as evidenced by their evaluations, stands students in good stead to be change agents, not only in clinical practice but in society. An awareness has been created about the need for planetary citizenship in addition to global citizenship.
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Seritan AL, Coverdale J, Brenner AM. Climate Change and Mental Health Curricula: Addressing Barriers to Teaching. ACADEMIC PSYCHIATRY : THE JOURNAL OF THE AMERICAN ASSOCIATION OF DIRECTORS OF PSYCHIATRIC RESIDENCY TRAINING AND THE ASSOCIATION FOR ACADEMIC PSYCHIATRY 2022; 46:551-555. [PMID: 35314961 PMCID: PMC8936385 DOI: 10.1007/s40596-022-01625-0] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/14/2023]
Affiliation(s)
| | | | - Adam M Brenner
- University of Texas Southwestern Medical Center, Dallas, TX, USA
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Shaw E, Walpole S, McLean M, Alvarez-Nieto C, Barna S, Bazin K, Behrens G, Chase H, Duane B, El Omrani O, Elf M, Faerron Guzmán CA, Falceto de Barros E, Gibbs TJ, Groome J, Hackett F, Harden J, Hothersall EJ, Hourihane M, Huss NM, Ikiugu M, Joury E, Leedham-Green K, MacKenzie-Shalders K, Madden DL, McKimm J, Nayna Schwerdtle P, Peters S, Redvers N, Sheffield P, Singleton J, Tun S, Woollard R. AMEE Consensus Statement: Planetary health and education for sustainable healthcare. MEDICAL TEACHER 2021; 43:272-286. [PMID: 33602043 DOI: 10.1080/0142159x.2020.1860207] [Citation(s) in RCA: 100] [Impact Index Per Article: 33.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to 'rapid, far-reaching and unprecedented changes' to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet.The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals.This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. 'Consensus' implies broad agreement amongst all individuals engaged in discussion on a specific issue, which in this instance, is agreement by all signatories of this Statement developed under the auspices of the Association for Medical Education in Europe (AMEE).To ensure a shared understanding and to accurately convey information, we outline key terms in a glossary which accompanies this Consensus Statement (Supplementary Appendix 1). We acknowledge, however, that terms evolve and that different terms resonate variably depending on factors such as setting and audience. We define education for sustainable healthcare as the process of equipping current and future health professionals with the knowledge, values, confidence and capacity to provide environmentally sustainable services through health professions education. We define a health professional as a person who has gained a professional qualification for work in the health system, whether in healthcare delivery, public health or a management or supporting role and education as 'the system comprising structures, curricula, faculty and activities contributing to a learning process'. This Statement is relevant to the full continuum of training - from undergraduate to postgraduate and continuing professional development.
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Affiliation(s)
- Emily Shaw
- Newcastle University, Newcastle Upon Tyne, UK
| | - Sarah Walpole
- Newcastle University, Newcastle Upon Tyne, UK
- Newcastle Upon Tyne Hospitals NHS Foundation Trust, Newcastle Upon Tyne, UK
- Centre for Sustainable Healthcare, Oxford, UK
| | - Michelle McLean
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | | | - Stefi Barna
- Centre for Sustainable Healthcare, Oxford, UK
| | - Kate Bazin
- Department of Physiotherapy, King's College London, London, UK
| | - Georgia Behrens
- School of Medicine Sydney, The University of Notre Dame Australia, Sydney, Australia
| | | | - Brett Duane
- School of Dentistry, Trinity College Dublin, Dublin, Ireland
| | - Omnia El Omrani
- International Federation of Medical Students' Associations, Copenhagen, Denmark
| | - Marie Elf
- School of Education, Health and Social Studies, Department of Nursing, Dalarna University, Falun, Sweden
| | - Carlos A Faerron Guzmán
- Planetary Health Alliance, Harvard University T H Chan School of Public Health, Boston, MA, USA
| | | | | | - Jonny Groome
- Greener Anaesthesia & Sustainability Project, Great Ormond Street Hospital for Children, London, UK
| | - Finola Hackett
- University of Calgary, CFMS Health and Environment, Lethbridge, Alberta, Canada
| | - Jeni Harden
- University of Edinburgh Usher Institute of Population Health Sciences and Informatics, Edinburgh, UK
| | | | - Maca Hourihane
- Irish Society of Chartered Physiotherapists Special Interest Group for Healthcare Professionals in International Health and Development and Irish Red Cross Society, Dublin, Ireland
| | | | - Moses Ikiugu
- Occupational Therapy, University of South Dakota School of Health Sciences, Vermillion, SD, USA
| | - Easter Joury
- Institute of Dentistry, Barts and The London School of Medicine and Dentistry, Queen Mary University of London, London, UK
| | - Kathleen Leedham-Green
- Medical Education Research Unit, Imperial College London Faculty of Medicine, London, UK
| | | | - Diana Lynne Madden
- School of Medicine Sydney, The University of Notre Dame Australia, Sydney, Australia
| | - Judy McKimm
- Medical School, Swansea University, Swansea, UK
| | | | | | - Nicole Redvers
- Department of Family & Community Medicine, University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
| | - Perry Sheffield
- Departments of Environmental Medicine and Public Health and Pediatrics, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Judith Singleton
- Pharmacy, School of Clinical Sciences, Faculty of Health, Queensland University of Technology, Brisbane, Australia
| | - SanYuMay Tun
- Imperial College London Centre for Environmental Policy, London, UK
| | - Robert Woollard
- Family Practice, The University of British Columbia, Vancouver, Canada
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McLean M, Gibbs T, McKimm J. Educating for planetary health and environmentally sustainable health care: Responding with urgency. MEDICAL TEACHER 2020; 42:1082-1084. [PMID: 32721202 DOI: 10.1080/0142159x.2020.1795107] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Affiliation(s)
- Michelle McLean
- Faculty of Health Sciences & Medicine, Bond University, Gold Coast, Australia
| | - Trevor Gibbs
- AMEE, Dundee, United Kingdom of Great Britain and Northern Ireland
| | - Judy McKimm
- Program Director, MSc Leadership for the Health Profession, Swansea Medical School, Swansea, Wales
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McKimm J, Redvers N, El Omrani O, Parkes MW, Elf M, Woollard R. Education for sustainable healthcare: Leadership to get from here to there. MEDICAL TEACHER 2020; 42:1123-1127. [PMID: 32776858 DOI: 10.1080/0142159x.2020.1795104] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/11/2023]
Abstract
The current global crises, including climate, COVID-19, and environmental change, requires global collective action at all scales. These broad socio-ecological challenges require the engagement of diverse perspectives and ways of knowing and the meaningful engagement of all generations and stages of personal and professional development. The combination of systems thinking, change management, quality improvement approaches and models, appreciative/strength-based approaches, narratives, storytelling and the strengths of Indigenous knowledges, offer synergies and potential that can set the stage for transformative, strengths-based education for sustainable healthcare (ESH). The need for strong leadership to enact a vision for ESH is outlined here with the intent to enable and nurture the conditions for change, ultimately improving health and well-being across generations.
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Affiliation(s)
- Judy McKimm
- Swansea University Medical School, Swansea, UK
| | - Nicole Redvers
- University of North Dakota School of Medicine & Health Sciences, Grand Forks, ND, USA
| | - Omnia El Omrani
- International Federation of Medical Students' Association (IFMSA), Copenhagen, Denmark
| | - Margot W Parkes
- University of Northern British Columbia School of Health Sciences and Northern Medical Program, Prince George, Canada
| | - Marie Elf
- Dalarna University School of Education, Health and Social Studies, Falun, Sweden
| | - Robert Woollard
- Department of Family Practice, University of British Columbia, Vancouver, Canada
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