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一项纵向的儿科住院医师气候正义课程。

A Longitudinal Pediatric Residency Climate Justice Curriculum.

作者信息

Marwah Harleen, Thapar Isha, McShane Mark, Silva Genevieve S, Goodall Harrison, Lewis Noreena, Bottone Paul Devine, Hussain Farah

机构信息

at the time of the study, was a PGY-3 Resident, Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, and is now an Editorial Fellow, New England Journal of Medicine, Waltham, Massachusetts, USA.

is a Medical Student, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA.

出版信息

J Grad Med Educ. 2024 Dec;16(6 Suppl):115-119. doi: 10.4300/JGME-D-24-00058.1. Epub 2024 Dec 13.

Abstract

Graduate medical education programs must prepare physicians to adapt their care for patients whose health equity and outcomes are being threatened by climate change. This article presents the implementation of a longitudinal climate justice curriculum within a pediatrics residency program. To measure the self-reported changes in attitudes and intentions for change in behavior after implementation of a climate justice curriculum. A longitudinal, 4-part, climate justice and health equity (CJHE) curriculum was implemented from 2023 to 2024 into the broader advocacy training of a pediatrics residency program. Resident participants completed pre- and post-session surveys that assessed their attitudes toward climate change and health, as well as their intentions to engage in climate advocacy. Paired deidentified responses were analyzed via Wilcoxon signed-rank test. Thus far, facilitators have conducted 4 introduction sessions, 4 narrative medicine sessions, and 3 health system sustainability sessions. Sixty-eight of 100 residents (68%) completed both pre- and post-session surveys. The curriculum was associated with increased self-reported understanding of how climate change impacts human health (CJHE 1: median of pairwise averages of pair-differences [MPA]=1.00, <.001; CJHE 3-4: MPA=1.00, <.001), increased agreement that health care providers can be effective climate advocates (CJHE 1: MPA=2.00, <.001; CJHE 3-4: MPA=1.50, <.001), and increased intention to discuss the health impacts of climate change in future patient encounters (CJHE 1: MPA=1.00, <.001; CJHE 3-4: MPA=1.00, <.001). This longitudinal CJHE curriculum demonstrated acceptability and increased participants' self-reported understanding of how climate change impacts human health and the ways in which physicians can act as advocates.

摘要

毕业后医学教育项目必须培养医生,使其能够调整对患者的护理方式,这些患者的健康公平性和治疗结果正受到气候变化的威胁。本文介绍了在一个儿科住院医师培训项目中实施纵向气候正义课程的情况。以衡量气候正义课程实施后自我报告的态度变化和行为改变意图。从2023年到2024年,一个由四部分组成的纵向气候正义与健康公平(CJHE)课程被纳入一个儿科住院医师培训项目更广泛的宣传培训中。住院医师参与者完成了课前和课后调查,评估他们对气候变化与健康的态度,以及他们参与气候宣传的意图。通过Wilcoxon符号秩检验分析配对的匿名回复。到目前为止,主持人已经举办了4次介绍会、4次叙事医学会议和3次卫生系统可持续性会议。100名居民中有68名(68%)完成了课前和课后调查。该课程与自我报告的对气候变化如何影响人类健康的理解增加相关(CJHE 1:配对差异的成对平均值中位数[MPA]=1.00,<.001;CJHE 3 - 4:MPA = 1.00,<.001),对医疗保健提供者可以成为有效的气候倡导者的认同增加(CJHE 1:MPA = 2.00,<.001;CJHE 3 - 4:MPA = 1.50,<.001),以及在未来患者诊疗中讨论气候变化对健康影响的意图增加(CJHE 1:MPA = 1.00,<.001;CJHE 3 - 4:MPA = 1.00,<.001)。这一纵向CJHE课程显示出可接受性,并增加了参与者自我报告的对气候变化如何影响人类健康以及医生可以如何成为倡导者的理解。

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