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

Abstract

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 to explore the underlying mechanisms that led to the changes in knowledge and attitudes as identified in the survey. The transcripts were then thematically analysed. Results 145 students played the game, of which 59 (40.7%) students completed the pre- and post-intervention surveys. After the game, self-reported knowledge and the proportion of students who recognized the importance of climate change education, to inform patients and society about the health impacts of climate change, significantly 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 recognition of climate and health co-benefits as tools for action. 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 positively influenced medical students’ knowledge and attitudes towards climate change and health. The accompanying climate worry needs attention through the empowerment of students’ agency to foster change.