Planetary Health and the Sustainable Development Goals in Health Professions’ Education

The increasingly concerning context of climate change and environmental degradation are well recognised as major threats to global health and wellbeing. Evidence abounds regarding the environment’s impact on disease burdens, the health effects of extreme weather events, as well as climate change’s influence on air pollution and on food and water security. Global health systems are rapidly working towards adaptation and urgent mitigation measures.

It is critical that frontline health professionals, including nurses and midwives, are well informed on the environmental impact of healthcare, can advance sustainable practices and are equipped with appropriate knowledge to engage in adaptation. The UN Sustainable Development Goals (UNSDGs) provide a useful framework to ensure a holistic approach to societal as well as planetary health. We therefore designed this module to align sustainability within a final year curriculum as a unique elective module offering.

Purpose: The purpose of this module was to help students to gain an understanding of the UNSDGs and their relevance to healthcare. We wanted to ensure that students would:
1. Have a deep understanding of the 17 UNSDGs and an awareness of the 169 targets
2. Relate sustainability to healthcare needs and the climate crisis as a health crisis in a multiplicity of global contexts
3. Understand the impact of climate change on healthcare needs of populations
4. Describe the role of health professionals in achieving many of the UNSDGs
5. Understand the intersectionality of the UNSDGs across environmental, social and economic areas of the social world inhabited by our patients and clients
6. Be proactive and well-informed health professionals who relate their practices to the UNSDGs as committed climate champions
7. Promote the use of the UNSDGs as a measure of quality practices and research

Significance: This was the first time that issues of sustainability had been explicitly included in the undergraduate nursing and midwifery programmes in UCC. The module coordinator (AF) had undertaken sabbatical research in the area and worked with colleagues in Germany with experience of teaching sustainable healthcare. Their work developing the NurSus Toolkit, an Erasmus funded project to create materials for sustainability literacy and competency in nurse education, helped inform our module content and design.
We mapped our lecture titles against the UNSDGs to indicate the goals being addressed in each lecture. The module was delivered over a series of 10 x 2-hour weekly sessions in semester 1. Guest lecturers contributed to the module including the Lead for sustainability in the HSE region, experts on green healthcare, and local council initiatives for a healthy city.
Assessment: The module was assessed through an innovative and interactive ‘Elevator Pitch’ presentation. Using the ‘Groups’ functionality in Canvas, students were randomly allocated to one of five specific challenges in health care. The students were encouraged to meet up to research their topic together and to plan their oral presentations at a showcase event scheduled on the last week of the module. All College of Medicine and Health staff and students were invited to attend this open showcase event, as were clinical partners and external collaborators.
The real-world sustainability challenges:
1. Waste management in clinical settings
2. Aprons and gloves: usage and overuse
3. Food waste in hospitals
4. Energy and water usage in healthcare
5. Single use plastics in healthcare


Based on their experiences in clinical practices, and evidence from the literature, students pitched to their audience information on each of these sustainability in healthcare issues and their proposed solutions. Two assessors graded each group’s presentation using a rubric adapted from García Ros (2011) [See: https://repositorio.ual.es/bitstream/handle/10835/683/Art_25_639.pdf?sequence=1 ]

Students were awarded grades based on the following criterion:
1. Proficiency and comprehension of the sustainability issue presented
2. Planning and organisation of the presentation content
3. Integration of important elements and with other students’ contributions
4. Visual aids or props used to illustrate issue of concern
5. Connection of information to the UNSDGs
Marks were awarded to all students in each of the groups.

Finally, students had one week to submit a written reflection (800-1000 words) on
their experience of
• researching their sustainability issue
• working collectively in a group and preparing for the elevator pitch
• imparting information they researched to attendees at the elevator pitch
• reactions of attendees and what they interpreted from comments/responses
• how they see their role in influencing colleagues' practices
• conclude with their views on the UNSDGs as they apply to healthcare

This module has resulted in very positive real-world impact in terms of equipping students to become ‘climate champions’ in their areas of clinical practice. Module evaluations over the last three years illustrated the positive experience of students with comments such as:
“Brilliant elective module, that offers unique learning that is not being offered in any other module in nursing. It is a very prominent area of concern for healthcare workers and is not highlighted enough”
“This module offered an abundance of learning and insight and has empowered us healthcare workers of the future to be aware of our impact on the climate and how we can make positive changes.”

Furthermore, the collaborations we have made with external experts working in the field have already resulted in a major joint research funding application (HRB ILP).

https://www.ucc.ie/en/nursingmidwifery/theschool/news/archive2024/sustainability-focus-for-fourth-year-student.html

To summarise, we have produced three cohorts of informed climate champions for healthcare.