The purpose of this Consensus Statement is to provide a global, collaborative, representative and inclusive vision for educating an interprofessional healthcare workforce that can deliver sustainable healthcare and promote planetary health. It is intended to inform national and global accreditation standards, planning and action at the institutional level as well as highlight the role of individuals in transforming health professions education. Many countries have agreed to 'rapid, far-reaching and unprecedented changes' to reduce greenhouse gas emissions by 45% within 10 years and achieve carbon neutrality by 2050, including in healthcare. Currently, however, health professions graduates are not prepared for their roles in achieving these changes. Thus, to reduce emissions and meet the 2030 Sustainable Development Goals (SDGs), health professions education must equip undergraduates, and those already qualified, with the knowledge, skills, values, competence and confidence they need to sustainably promote the health, human rights and well-being of current and future generations, while protecting the health of the planet. The current imperative for action on environmental issues such as climate change requires health professionals to mobilize politically as they have before, becoming strong advocates for major environmental, social and economic change. A truly ethical relationship with people and the planet that we inhabit so precariously, and to guarantee a future for the generations which follow, demands nothing less of all health professionals. This Consensus Statement outlines the changes required in health professions education, approaches to achieve these changes and a timeline for action linked to the internationally agreed SDGs. It represents the collective vision of health professionals, educators and students from various health professions, geographic locations and cultures. 'Consensus' implies broad agreement amongst all individuals engaged in discussion on a specific issue, which in this instance, is agreement by all signatories of this Statement developed under the auspices of the Association for Medical Education in Europe (AMEE). To ensure a shared understanding and to accurately convey information, we outline key terms in a glossary which accompanies this Consensus Statement (Supplementary Appendix 1). We acknowledge, however, that terms evolve and that different terms resonate variably depending on factors such as setting and audience. We define education for sustainable healthcare as the process of equipping current and
Strengths and limitations of this study ► Our review consolidates the full continuum of factors affecting equitable participation in clinical academia at all stages of the pipeline and across a range of protected characteristics. ► Our findings will have limited relevance to nursing, midwifery, allied health professions or other geographies where there may be divergent issues in relation to gender, sexuality and ethnicity or the nature of clinical academia. ► The majority of papers identified in the scoping review focused on gender, therefore the factors identified within each theme may not fully represent issues related to ethnicity and sexual orientation. No studies related to disability were identified. ► Policy is in constant transition and it will need to be studied and addressed locally. This paper focused on current UK policy as an illustrative case. AbStrACtObjectives To examine and synthesise current evidence on the factors that affect recruitment, retention, participation and progression within the clinical academic pathway, focusing on equitable participation across protected characteristics including gender, ethnicity and sexual orientation. Design Scoping review and meta-thematic synthesis. Data sources Web of Science, Google Scholar. Article selection We conducted a scoping review of English language articles on factors affecting recruitment, retention, progression and equitable participation in clinical academic careers published in North America, Australasia and Western Europe between January 2005 and April 2019. The most recent and relevant 39 articles were selected for meta-thematic synthesis using detailed inclusion/exclusion criteria. Data extraction The articles were purposively sampled to cover protected characteristics and career stages and coded for factors related to equitable participation. 17 articles were fully coded. No new themes arose after nine papers. Themes and higher level categories were derived through an iterative consensual process. results 13 discrete themes of factors impacting on equitable participation were identified including societal attitudes and expectations; national and organisational policies, priorities and resourcing; academic and clinical workplace cultures; supportive, discriminatory and compensatory interpersonal behaviours and personal factors related to social capital, finances, competing priorities, confidence and ambition, and orientation to clinical, academic and leadership roles.Conclusions The broad and often interconnected nature of these factors suggests that interventions will need to address structural and cultural factors as well as individual needs. In addition to standard good practice on equality and diversity, we suggest that organisations provide equitable support towards early publication success and targeted mentoring; address financial and role insecurity; address the clinical workplace culture; mitigate clinical-academic-personal role conflicts and overload; ensure that promotional structures and processes encourage diverse applicants an...
Enabling tomorrow's doctors to address obesity in a GP consultation: an action research project Obesity is a leading risk factor for morbidity and mortality, however guidelines for prevention and management are relatively recently established, and little is known about what needs to be in place to put these into practice.This research provides an insight into how senior medical students consult with obese patients in general practice, the range of their learning needs, and the impact of various educational strategies that aim to bring their practice closer to current evidence-based guidelines.It centres on a series of compulsory but formative reflective case studies written by final year students at one large medical school on their GP rotation as they consult independently with obese patients with 'next room' GP tutor support.Analysis of these case studies was used to inform a three-year educational action research project. By systematically identifying and addressing learning needs, including barriers and enablers to best practice, we have demonstrated how senior medical students, and their GP tutors, can acquire the role legitimacy and role competency required for effective practice.Keywords: obesity, medical education, behaviour change, health promotion, primary care, general practice Status Box What is already knownOur clinical and educational response to obesity is less well developed than our response to other risk factors for morbidity such as smoking. There are difficulties translating behavioural change and obesity guidelines into practice, and teaching tends to be inconsistent and vicarious with little understanding of the learning needs of students or how teaching translates into clinical practice. What this work addsThis paper gives insights into real-life encounters with obese patients providing a rich understanding of the learning needs of senior medical students. An action research methodology has been used to test approaches to addressing these needs, which have been tested in the clinical context. Suggestions for future work and researchA follow-up study looking at patient experiences and outcomes of consultations led by healthcare professionals trained using these approaches is needed.
International collaboration can bring together diverse perspectives and provide critical insights for the inclusion of environmental health into basic education for medical practitioners.
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