Drawing a line from CO2 emissions to health-evaluation of medical students' knowledge and attitudes towards climate change and health following a novel serious game: a mixed-methods study.

BACKGROUND: Education is urgently needed to equip medical students with knowledge, values and skills to promote planetary health. However, the current literature offers little insight into evidence-based approaches and best practices. In response to this pressing need, a novel serious game was introduced into the medical curriculum at Erasmus Medical Center in 2023. The aim of this study was to evaluate the knowledge and attitudes of medical students after they had played a serious game that addresses climate change and health. METHODS: In accordance with a mixed-methods design, quantitative data were collected using pre- and post-intervention surveys. Differences were assessed using the Wilcoxon signed rank test. Focus group discussions were held after the game and thematically analysed. RESULTS: One hundred forty-five students (38.6% of the entire cohort) played the game, of which 59 students completed the pre- and post-intervention surveys. After the game, self-reported knowledge increased. Regarding objective knowledge, an increase in the proportion of students who answered one of the two questions correctly was observed, while the proportion of correct responses decreased for the other question. Student's responses to two out of five attitude questions were significantly more positive. The proportion of students who recognized the importance of climate change education, to inform patients and society about the health impacts of climate change, increased. Moreover, survey results indicated a significant increase in climate worry subsequent to the game. Eleven students participated in the focus group discussions. Thematic analysis highlighted participants' reflections on the roles and responsibilities in climate change and health, along with their realisation of the tools for action that climate and health co-benefits provide. Another significant aspect was the importance participants placed on learning alongside peers with diverse attitudes. Additionally, participants appreciated the tangible overview of climate change and health provided by the serious game. CONCLUSIONS: Our novel serious game addressed an important gap in the medical curriculum. The game can enable medical students to cultivate the necessary knowledge and attitudes to promote health in times of a climate crisis. The accompanying climate worry needs attention through the empowerment of students' agency to foster change.

[Planetary Health in medical education: rapidly catching up]. / Planetary health in medisch onderwijs.

Healthcare professionals have a responsibility to protect and promote human health, and thus also have a responsibility to protect ecosystems and to promote Planetary Health. Planetary Health arose recently in medical education and is growing exponentially. Planetary Health in medical education should entail three key themes: (a) Understanding of the complex relationship between humankind and nature - the core of Planetary Health. With related knowledge, students can develop the skills and attitude to: (b) act from their healthcare perspective; apply adaptation and mitigation measures; and (c) reflect on and act according to their role within society. Preconditions for successful implementation of Planetary Health in medical education are a broad support among stakeholders, formal ratification (in learning outcomes, assessments, accreditation), capacity building among educational institutes, resources for education development (finance, time), and transdisciplinary collaboration; From students to education headmasters, everyone has a role to fulfil in integrating Planetary Health into medical education.

[Call to integrate climate change in medical education]. / Klimaatverandering verdient meer aandacht in onderwijs.

Climate change forms an urgent health threat and gains attention in global medical literature as well as in Dutch healthcare. Climate change, however, is still absent in medical education. Health professionals must acquire knowledge concerning the health effects of climate change and train the values, skills, capacities, and motivation necessary to contribute to climate adaptation and mitigation. Dutch medical schools pay little to no attention to the theme of climate change and health in their curricula. In contrast, recent findings reveal that 83% of medical students in the Netherlands want to learn more about the health effects of climate change and that 72% of students believe the topic should receive more attention in their curriculum. Various research papers that have contributed to an outline for the implementation of climate and health education are discussed in this paper. We urgently call on universities, educators, and students to realise its implementation.