https://orcid.org/0009-0009-6503-5777
Setting and Problem
Leading medical organizations recognize climate change as the greatest public health crisis of the 21st century and recommend that medical training include climate change education.1,2 However, no standardized approaches exist to incorporate climate change topics into graduate medical education.2 To address this challenge, we created a multipronged intervention focusing on climate-specific improvements to clinical care, advocacy, research, and education (CARE).
Intervention
Resident leaders designed the intervention with support from residency program directors and faculty mentors with the goals of improving (1) clinical practice through climate change–related resources and training; (2) opportunities for advocacy; (3) opportunities for research; and (4) resident education on climate change and environmental justice. Monthly meetings open to all residents and faculty were held to design the following:
Clinical Practice: Created climate-focused, patient-centered talking points for patients and families using electronic health record (EHR) tools.
Advocacy: Organized quarterly ecological restoration events for residents, faculty, and their families in partnership with a local park organization. Collaborated with statewide organizations for legislative policy advocacy.
Research: Created research opportunities open to residents (solicitations via educational conferences and emails), including a national survey regarding incorporating climate change into residency training and a study investigating wildfire smoke effects on pediatric health care utilization.
Education: Developed a resident curriculum with quarterly noon conference lectures on topics related to pediatric medicine and climate change, including wildfire smoke and respiratory health, atopic dermatitis, climate injustice and environmental racism, hospital sustainability, and climate and health resources for primary care. Formed a national educational partnership with other pediatric educators and residents.
Following design of our intervention, recurring time commitment responsibilities were divided among residents to be feasibly achieved within a resident schedule and included contacting lecture speakers, coordinating restoration events, and participating in the annual statewide American Academy of Pediatrics (AAP) Advocacy Day.
Outcomes to Date
Clinical Practice: Two EHR smart phrases focusing on wildfire smoke education were incorporated into pulmonary clinic after visit summaries and 8 smart phrases were distributed to residents for use in primary care outpatient clinics.
Advocacy: Seven restoration events have led to the planting of hundreds of native species in local parks. Residents have presented and testified in the statewide AAP Advocacy Day annually since 2021 to promote climate-friendly policies. Three supported state bills have been signed into laws to decrease greenhouse gas emissions, increase clean energy projects, and improve the state’s response to climate change events.
Research: Our national survey study and 3 other scholarly manuscripts from our team have been accepted for publication.3 We have presented our scholarly work at one local and one national academic conference.
Education: Our curriculum has been incorporated as an ongoing resident lecture series since 2021. Preliminary data demonstrate that 100% of respondents (N=76) felt that lectures increased their knowledge of how climate change impacts children. The national educational collaborative has resulted in 2 workshops at national meetings.
This resident-driven initiative has had lasting effects; the above interventions have persisted since project implementation in 2021. Furthermore, because of this initiative’s success, efforts have expanded into a department-sponsored Climate Change CARE Committee with administrative and financial support. Multiple residents and faculty have focused their scholarly efforts and developed national networks to address climate change. Prospective residency applicants have also expressed interest in joining our efforts.
Compelled by the urgent need for resident skills in climate health, this intervention integrates resident-led innovations with faculty interest, to grow institutional awareness. Resident and faculty efforts have produced system-wide changes and propelled institutional investment to promote and sustain curricula, projects, and advocacy. Resident and faculty dedication has resulted in system-wide changes and propelled further investments necessary for sustainability of these efforts.
