R.P. Philipsborn is assistant professor, Department of Pediatrics and Emory Global Health Institute, Emory University, Atlanta, Georgia; ORCID: https://orcid.org/0000-0002-2843-7509 .
P. Sheffield is assistant professor, Department of Pediatrics and Department of Environmental Medicine and Public Health, Icahn School of Medicine at Mt. Sinai, New York, New York; ORCID: http://orcid.org/0000-0001-9156-1193 .
Acad Med. 2021 Mar 1;96(3):355-367. doi: 10.1097/ACM.0000000000003719.
Despite calls for including content on climate change and its effect on health in curricula across the spectrum of medical education, no widely used resource exists to guide residency training programs in this effort. This lack of resources poses challenges for training program leaders seeking to incorporate evidence-based climate and health content into their curricula. Climate change increases risks of heat-related illness, infections, asthma, mental health disorders, poor perinatal outcomes, adverse experiences from trauma and displacement, and other harms. More numerous and increasingly dangerous natural disasters caused by climate change impair delivery of care by disrupting supply chains and compromising power supplies. Graduating trainees face a knowledge gap in understanding, managing, and mitigating these many-faceted consequences of climate change, which-expected to intensify in coming decades-will influence both the health of their patients and the health care they deliver. In this article, the authors propose a framework of climate change and health educational content for residents, including how climate change (1) harms health, (2) necessitates adaptation in clinical practice, and (3) undermines health care delivery. The authors propose not only learning objectives linked to the Accreditation Council for Graduate Medical Education core competencies for resident education but also learning formats and assessment strategies in each content area. They also present opportunities for implementation of climate and health education in residency training programs. Including this content in residency education will better prepare doctors to deliver anticipatory guidance to at-risk patients, manage those experiencing climate-related health effects, and reduce care disruptions during climate-driven extreme weather events.
尽管有人呼吁在医学教育的各个领域的课程中纳入有关气候变化及其对健康影响的内容,但目前还没有广泛使用的资源来指导住院医师培训计划在这方面的努力。这种资源的缺乏给那些试图将基于证据的气候和健康内容纳入其课程的培训项目负责人带来了挑战。气候变化增加了与热有关的疾病、感染、哮喘、心理健康障碍、不良围产期结局、创伤和流离失所带来的不利经历以及其他危害的风险。气候变化导致的更多和日益危险的自然灾害破坏了医疗服务的提供,扰乱了供应链并危及电力供应。即将毕业的受训人员在理解、管理和减轻气候变化的这些多方面后果方面存在知识差距,预计在未来几十年内,这些后果将影响他们的患者的健康和他们提供的医疗服务。在本文中,作者提出了一个针对住院医师的气候变化和健康教育内容框架,包括气候变化(1)如何危害健康,(2)如何在临床实践中需要适应,以及(3)如何破坏医疗服务的提供。作者不仅提出了与住院医师教育的研究生医学教育认证委员会核心能力相关的学习目标,而且还提出了每个内容领域的学习形式和评估策略。他们还介绍了在住院医师培训计划中实施气候和健康教育的机会。在住院医师教育中纳入这些内容将更好地使医生能够为有风险的患者提供预期指导,管理那些经历与气候相关的健康影响的患者,并减少在气候驱动的极端天气事件期间的护理中断。