Elsevier

Public Health

Volume 150, September 2017, Pages 134-148
Public Health

Original Research
Evaluation of a collaborative project to develop sustainable healthcare education in eight UK medical schools

https://doi.org/10.1016/j.puhe.2017.05.014Get rights and content

Highlights

  • Over 1 year, sustainable healthcare education was introduced in seven medical schools.

  • Sustainable healthcare education was accepted and enhanced students' knowledge and skills.

  • Interschool collaboration fostered impetus and expertise for education development.

Abstract

Introduction

Environmental change poses pressing challenges to public health and calls for profound and far-reaching changes to policy and practice across communities and health systems. Medical schools can act as a seedbed where knowledge, skills and innovation to address environmental challenges can be developed through innovative and collaborative approaches.

Objectives

The objectives of this study were to (1) explore drivers and challenges of collaboration for educational development between and within medical schools; (2) evaluate the effectiveness of a range of pedagogies for sustainable healthcare education; and (3) identify effective strategies to facilitate the renewal of medical curricula to address evolving health challenges.

Methods

Medical school teams participated in a nine-month collaborative project, including a one-day seminar to learn about sustainable healthcare education and develop a project plan. After the seminar, teams were supported to develop, deliver and evaluate new teaching at their medical school.

Results

New teaching was introduced at seven medical schools. A variety of pedagogies were represented. Collaboration between schools motivated and informed participants. The main challenges faced related to time pressures. Educators and students commented that new teaching was enjoyable and effective at improving knowledge and skills.

Conclusions

Collaborative working supported educators to develop and implement new teaching sessions rapidly and effectively. Collaboration can help to build educators' confidence and capacity in a new area of education development. Different forms of collaboration may be appropriate for different circumstances and at different stages of education development.

Introduction

Anthropogenic environmental change, including climate change, is one of the greatest public health challenges of our era.1 Actions to mitigate destruction of ecosystems, to improve the health and well-being of humans now and in the future, require judicious use of natural resources.2, 3 The environmental impact of health services is substantial but can be reduced through joined-up services, good communication between healthcare providers and patients, selection of high-value interventions, focus on prevention and promotion of patient autonomy and person-centred care.4 Sustainable healthcare services provide high-quality care, without significantly impairing the ability of future generations to do the same.

Education in medical schools can help to ensure that future doctors are competent to inform, research and advocate about environmental determinants of health and to manage transition to provision of sustainable health care.5 We define sustainable healthcare education as teaching and learning which prepares future health professionals to promote sustainable health and deliver sustainable health care. Priority learning outcomes (PLOs) for sustainable health care (Fig. 1) can guide implementation of teaching.6

This study aimed to evaluate a collaborative education project which facilitated the design, implementation and evaluation of sustainable healthcare education in eight UK medical schools. Specific aims were to

  • 1.

    explore drivers and challenges of collaboration for educational development between and within medical schools;

  • 2.

    evaluate the effectiveness of a range of pedagogies for sustainable healthcare education; and

  • 3.

    identify effective strategies to facilitate the renewal of medical curricula to address evolving health challenges.

Section snippets

Methods

Participatory action research (PAR) can be applied to the study of complex adaptive systems that are constantly evolving, are affected by external factors and comprise multiple and varied sites.7 We used PAR methods to stimulate reflection and learning during a collaborative educational project. PAR enabled learning about participants' experience of collaborative working and the impact of diverse local educational contexts (including factors internal and external to the project) on education

Results

Eleven medical schools applied, and eight were accepted (Table 1). Opportunities identified by medical schools included senior support, strategic alignment, forthcoming curriculum/module reviews and availability of educators and/or curriculum space.

Lessons about collaborative education projects

This study highlights the potential to stimulate and support innovation through collaborative working. Bringing together individuals with different levels of experience and expertise in medical education and sustainable health care led to mutually beneficial exchanges. A face-to-face seminar educated participants (including through peer-education), stimulated participants and enabled networking. Videoconferencing enabled collaboration between remote sites but does not provide all the benefits

Acknowledgements

This study would not have been possible without the hard work and dedication of the participants and the support of colleagues at Centre for Sustainable Healthcare. The authors would like to thank Aditya Vyas, Andrew Punton, Alexander Clark, Alisha Patel, Andrew Lee, Ann Wylie, Anna Jones, Audrey Skidmore, Danny Ruta, Eleanor Hothersall, Emmanuel Okenyi, Ingeborg Steinbach, Jason Horsley, Kathleen Leedham-Green, Kiran Eyre, Madeleine Gabony, Mairead Boohan, Neil Merrylees, Priya Paudyal, Rachel

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    The Institute for Health Care Improvement Open School (Institute for Healthcare Improvement, 2018) can build core skills in healthcare improvement, safety, system design, and leadership, and is well-suited for integration of educational opportunities in sustainable healthcare. To prepare the future healthcare workforce, educators are integrating core learning objectives for planetary health and healthcare sustainability science into pre-clinical and clinical training (Zuegge et al., 2019; Walpole and Mortimer, 2017) and fostering the notion of environmental stewardship as a core professional responsibility (Thompson et al., 2014; Teherani et al., 2017; Wellbury et al., 2016; Sherman, 2016; Barna and Vyas, 2015; Barna et al., 2015; Bland et al., 2000; Butterfield et al., 2014; Pearson and Barna, 2015; Walpole et al., 2019; The Lancet, 2020). Steps are also underway to set training mandates to close the education gap (Environment and Health, 2017).

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