Integrating climate change and health topics into the medical curriculum - a quantitative needs assessment of medical students at Heidelberg University in Germany.

Objectives: Climate change (CC) is of major importance for physicians as they are directly confronted with changing disease patterns, work in a greenhouse gas intensive sector and can be potential advocates for healthy people on a healthy planet. Methods: We assessed third to fifth year medical students' needs to support the integration of CC topics into medical curricula. A questionnaire with 54 single choice-based items was newly designed with the following sections: role perception, knowledge test, learning needs, preference of educational strategies and demographic characteristics. It was administered online to students at Heidelberg medical faculty. Data sets were used for descriptive statistics and regression modelling. Results: 72.4% of students (N=170, 56.2% female, 76% aged 20-24 years) (strongly) agreed that physicians carry a responsibility to address CC in their work setting while only 4.7% (strongly) agreed that their current medical training had given them enough skills to do so. Knowledge was high in the area of CC, health impacts of CC, vulnerabilities and adaptation (70.1% correct answers). Knowledge gaps were greatest for health co-benefits and climate-friendly healthcare (55.5% and 16.7% of correct answers, respectively). 79.4% wanted to see CC and health included in the medical curriculum with a preference for integration into existing mandatory courses. A multilinear regression model with factors age, gender, semester, aspired work setting, political leaning, role perception and knowledge explained 45.9% of variance for learning needs. Conclusion: The presented results encourage the integration of CC and health topics including health co-benefits and climate-friendly healthcare, as well as respective professional role development into existing mandatory courses of the medical curriculum.

The Green Nephrology Group of the SFNDT: initial reflections / Groupe Néphrologie verte de la SFNDT : premières réflexions

Preserving the environment is becoming a universal priority. Human activities must be redesigned to best adapt them to available resources and to reduce their deleterious impact on the planet. The Green Nephrology Group of the "Société française de néphrologie, dialyse et transplantation" (SFNDT) has started a reflection on these issues, in particular on dialysis, a vital treatment but with high carbon production, associated with high water consumption. The data available on these points are presented such as, among others, the collection of indicators and action plans, the recycling of waste from water treatment, the reduction of dialysate flow, the reuse and regeneration of spent dialysate as well as calculations of carbon emission by dialysis activity. Architectural experiences are reported as well as the regulatory constraints applying to manufacturers and organizations in the sector. Potential solutions require the mobilization of all stakeholders, ranging from patients to health authorities, including caregivers, pharmacists, technicians, nephrologists and facility managers. They will be formalized very soon in a guide being prepared by the SFNDT Green Nephrology Group.

La préservation de l'environnement devient une priorité universelle. Les activités humaines doivent être repensées pour les adapter au mieux aux ressources disponibles et réduire leur impact délétère sur la planète. Le groupe Néphrologie verte de la Société francophone de néphrologie, dialyse et transplantation (SFNDT) a entamé une réflexion sur ces problématiques, en particulier sur la dialyse, traitement à caractère vital mais à production de carbone élevée, associée à une consommation d'eau importante. Les données disponibles sur ces points sont présentées comme, entre autres, le recueil d'indicateurs et les plans d'action, le recyclage du rejet du traitement d'eau, la réduction de débit du dialysat, la réutilisation et régénération du dialysat usé ainsi que les calculs d'émission de carbone par l'activité de dialyse. Les expériences architecturales sont rapportées de même que les contraintes réglementaires s'appliquant aux industriels et établissements du secteur. Les solutions potentielles nécessitent la mobilisation de tous les acteurs, allant des patients aux autorités de santé, en passant par les soignants, pharmaciens, techniciens, néphrologues et les directions d'établissement. Elles seront formalisées très prochainement dans un guide en cours de préparation par le groupe Néphrologie verte de la SFNDT.