The Impact of Integrating Environmental Health into Medical School Curricula: A Survey-Based Study

Abstract

Background Inclusion of environmental health (EH) in medical education serves as a catalyst for preparing future physicians to address issues as complex as climate change and health, water pollution and lead contamination. However, previous research has found EH education to be largely lacking in U.S. medical education, putting future physicians at risk of not having the expertise necessary to address patients' environmental illnesses, nor speak to prevention. Environmental health disparities fit well under the larger umbrella of social determinants of health, which still remain largely omitted from medical school curricula. Methods Environmental health (EH) knowledge and skills were incorporated into the first-year medical school curriculum at Hackensack Meridian School of Medicine, via a thread of two-hour interactive large group learning sessions with follow up activities. In year 1, students took the Environmental Health in Med School (EHMS) survey before and after the EH thread. This survey was designed to evaluate medical students’ attitudes, awareness and professionalism regarding environmental health. Results suggested a dramatic ceiling effect on students’ responses to the EHMS survey, making it difficult to detect any change from before to after the intervention. Our conclusion was that the current generation of medical students at this school is already extremely aware of and concerned about the impact of environmental issues on health. Based on the outcomes of the EHMS survey, a new Environmental Health Survey II (EHS II) was created for Year 2, to measure students' perceptions of preparedness to discuss EH with future patients. The two surveys were both created by the research team and designed to help inform subsequent content revisions to ensure learning objectives were met. ResultsResults for the four questions on the EHS II pre-survey (84 respondents) and on the post-survey (79 respondents) showed a statistically significant positive change in students’ self-reported sense of preparedness to discuss environmental health with their patients following the curriculum intervention. ConclusionsA relatively brief six-week environmental health module combining didactic and experiential elements can significantly increase medical students’ self-reported sense of preparedness to discuss environmental health issues, including climate change, with their patients.