Asthma Exacerbation Triggered by Wildfire: A Standardized Patient Case to Integrate Climate Change Into Medical Curricula

Clearing the air: Assessing healthcare professionals' awareness of air pollution's health consequences

Air pollution (AP) significantly jeopardises health, with the Royal College of Physicians accepting the adverse effects of AP are not being sufficiently communicated to patients by healthcare professionals (HCP). To explore HCPs' understanding and attitudes toward AP and its health impacts, we conducted a service evaluation survey in a group of hospital doctors. A questionnaire comprising 20 questions about AP and its health associations was completed by 133 hospital doctors working at University Hospital Southampton NHS Foundation Trust, UK. While 65% (n = 86) of respondents strongly agreed that AP is relevant to health, 79% (n = 105) felt insufficiently trained on AP and its health associations. The survey shows that HCPs' knowledge of AP and its connection to poor health is a major barrier in discussions with patients. Further research is needed to understand whether these views are nationally shared among HCPs and to explore the most effective strategies for enhancing AP awareness.

An Interactive Mapping and Case Discussion Seminar Introducing Medical Students to Climate Change, Environmental Justice, and Health

Introduction

Integrating climate change and health into a medical school curriculum is critical for future physicians who will manage health crises caused by a rapidly changing climate. Although medical schools have increasingly included climate change in the curriculum, there remains a need to address the link between the climate crisis, environmental justice, and historical policies that shape environmental health disparities in local communities.

Methods

In academic years 2021-2022 (AY22) and 2022-2023 (AY23), second-year medical students participated in a 2.5-hour seminar utilizing didactic teaching and small breakout groups that included interactive mapping activities and case scenarios. Learner knowledge and attitudes were self-assessed using pre- and postcurriculum surveys and a quiz. Qualitative thematic and content analysis was used to evaluate short-answer quiz responses and feedback.

Results

Of 357 students who participated in the seminar, 208 (58%) completed both the precurriculum and postcurriculum surveys. Self-assessed ability increased significantly for all educational objectives across both years. Attitudes on the importance of climate change knowledge for patient health also improved from a mean of 3.5 precurriculum to 4.2 postcurriculum (difference = 0.7, p < .01) in AY22 and from 3.6 pre- to 4.3 postcurriculum (difference = 0.7, p < .01) in AY23 on a 5-point Likert scale.

Discussion

This climate change and health session highlighting the link between environmental policy and climate change health vulnerability in the local context was successful in improving students' self-assessed ability across all stated educational objectives. Students cited the interactive small-group sessions as a major strength.

Short animated video increases knowledge and perceived comfort in clinical counseling on inequitable health impacts of air pollution among interprofessional health learners and clinicians

BACKGROUND

Air pollution is a major health risk contributing to global morbidity and mortality, yet clinicians do not routinely engage in counseling patients on this topic. Clinicians cite their lack of education as a common barrier. We developed a two-minute animated video on mitigating air pollution health risks and evaluated the efficacy of this video as an educational tool.

METHODS

In March-June 2021, a convenience sample of Minnesota interprofessional health learners and clinicians viewed the video and completed an electronic survey that assessed pre-/post-video intervention changes in (a) didactic and clinically applied knowledge on health impacts of air pollution, (b) perceived comfort in identifying at-risk patients and counseling them on relevant preventive health behaviors, (c) intentions/barriers to counseling patients, (d) beliefs and attitudes related to the health harms of air pollution, and (e) perceptions of the overall acceptability of the intervention.

RESULTS

The 218 participants included learners and clinicians in medicine, nursing, and advanced practice provision. Respondents' knowledge scores and self-reported level of comfort in identifying high-risk patients and counseling them on preventative health behaviors increased significantly pre-/post-intervention. The video also effectively altered participants' misperceptions about the health impacts of air pollution. While less than half of participants (43.6%) reported they intended to engage in counseling patients as a result of watching the video, 52.3% indicated they might do so. Lack of time during clinical encounters and lack of training were reported as persistent barriers to engaging in this counseling. Overall, participants found the video to be an effective educational tool, indicating that they wanted their colleagues and patients to watch the video and would like to see further short, animated videos on other environmental health topics.

CONCLUSIONS

A two-minute animated educational video significantly improved knowledge of inequitable health impacts of air pollution and improved perceived comfort in identifying and counseling at-risk patients among health professional learners and clinicians regardless of profession, level of training, or pre-intervention knowledge level. Academic health professional training programs and health systems should consider adopting this modality as a tool for educating learners, clinicians, and patients on environmental health risks.

Climate Change as a Social Determinant of Health: An Interactive Case-Based Learning Activity

Introduction

Despite consensus on climate change's impact on humans, medical schools have not widely adopted inclusion of environmental topics into their mandatory curriculum. This educational activity explicitly addresses climate change as one of the environmental determinants of health (EDH).

Methods

We developed a required, 1-hour module for all first-year medical students. This interactive, case-based, small-group activity was incorporated into a curriculum within an advising program but could be run independently. Before and after the session, participants completed evaluations assessing knowledge gains and attitude shifts.

Results

Of 183 first-year students, 155 completed both pre- and postmodule surveys. Participants' rating increased on the postmodule survey item "priority should be given to the discussion of EDH in medical education." The Wilcoxon signed rank test determined this difference in priority was statistically significant (p < .001). Reported strengths of this activity included the cases, informative content on EDH, the video, the discussion, and highlighted EDH resources. Suggested areas for improvement included more information on how to apply concepts to clinical contexts, guidance on how to engage in EDH concepts, and more discussion time. As a result of the module, students planned to engage in recycling, reduced consumption, advocacy, and changes to mode of transportation.

Discussion

Climate change remains the greatest global threat to human health, and future physicians must be equipped to educate patients and policymakers on the harms of environmental hazards. This brief yet effective module offers one approach to incorporating this topic into medical school curricula.

Planetary Health Education and Capacity Building for Healthcare Professionals in a Global Context: Current Opportunities, Gaps and Future Directions

The emerging concept of planetary health needs to be discussed in a more organized and sustainable way within the global public health and healthcare disciplines. Therefore, planetary health should be considered a cardinal component of the global academic framework for healthcare professionals. The availability of related curricula and courses is crucial to equip health professionals in this relatively new discipline of planetary health. In this review article, we aimed to explore published articles and online databases of courses to summarize the available planetary health education opportunities and discussions for health professionals, to identify the gaps in resource allocation and to suggest future recommendations. We observed a visible resource inequity in the global south with the lack of a universal planetary health module for healthcare professionals. Additionally, there is minimal inclusion of allied health disciplines in this learning process. We therefore recommend a dedicated network of motivated healthcare professionals and regional hubs with an agenda to ensure a comprehensive, uniform, and inclusive planetary health education curriculum and practice.

Developing and implementing core competencies in children's environmental health for students, trainees and healthcare providers: a narrative review

Knowledge of the health impacts of environmental exposures (such as pollution disasters, poor air quality, water contamination, climate change) on children's health has dramatically increased in the past 40 years. The World Health Organization (WHO) estimated that 23% of all deaths worldwide were attributable to the environment, and 26% of deaths in children less than 5 years old could be prevented with removal of environmental risks factors. Yet, little has permeated medical education, leaving pediatric providers ill equipped to address these issues. To address this gap, members from the Pediatric Environmental Health Specialty Units, a United States nationwide network of academically affiliated experts who have created numerous environmental health educational materials and programs, have identified fifteen core environmental health (EH) competencies needed by health care providers to enable them to effectively address environmental health concerns. These competencies can serve as the foundation for the development and implementation of relevant educational programs. The core EH competencies are based upon these foundational elements: 1) Definition of "children's environmental health" that describes how environmental exposures (positive and negative) in early life influence the health and development in childhood and across the entire human life span 2) Children are not "little adults" and so have unique vulnerabilities to environmental hazards; 3) Environmental health inequities exist, causing some children to have a disproportionate amount of unhealthy exposures and consequently a greater risk of adverse effects; 4) Climate change will translate to numerous adverse health effects that will particularly affect children worldwide. In this article, the authors describe the core environmental health competencies and provide resources, online tools, strategies, and examples targeted to all levels of training and practice to better enable leaders and educators to bring this important content to the forefront.