Wang Bangyun, Sheehy Louise, Frotjold Astrid, Power Tamara, Saravanos Gemma
Clinical Skills and Simulation Education, Operation Unit, Susan Wakil Health Building, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
Susan Wakil School of Nursing and Midwifery, Faculty of Medicine and Health, University of Sydney, Camperdown, NSW, Australia.
Nurse Educ Today. 2025 Oct;153:106805. doi: 10.1016/j.nedt.2025.106805. Epub 2025 Jun 10.
Climate change is among the greatest of threats to human health. Paradoxically the health system is a contributor to planetary degradation through emissions and waste. Climate change and sustainability are important issues for the nursing profession. We explored the impact of an education module with embedded sustainability principles in the context of clinical simulation. This mixed methods study used pre- and post-intervention waste audits and student surveys to explore attitudes, knowledge and practices relating to climate change and sustainability. The intervention, a digital clinical simulation education module, included three themes: 1) professional conduct, 2) work health and safety, 3) resource stewardship and sustainability. Quantitative data were analysed through descriptive statistics and comparison of pre- and post-intervention means and proportions. Qualitative data were analysed thematically to identify facilitators and barriers. We examined two weeks of simulation for the same cohort of 170 students preparing for clinical practice assessment. We found no significant difference in waste per student following the intervention. Most items targeted for re-use were actively diverted to the recycling station with proportional increases following the intervention. A total of 44 (30.3 %) and 80 (53.3 %) students completed the surveys and most agreed that climate change and sustainability are important issues for nurses. Students' perceived application of sustainability during clinical simulation increased following the intervention (mean 4.8 to 5.4, p ≤0.01). Perceived application of sustainability in clinical practice, and of the principles 'reduce' and 're-use' also increased. Barriers to sustainable practice included cognitive overload, knowledge deficit, time pressure, and desire for authentic practice. Clinical simulation generates substantial volumes of waste. Student nurses are motivated and capable of applying sustainability principles during simulation, however, often experience barriers. Embedding sustainability principles in simulation curriculum demonstrated positive impacts and ongoing efforts are needed to address barriers and increase opportunities for sustainable practice.
气候变化是对人类健康的最大威胁之一。矛盾的是，卫生系统通过排放和废物对地球退化也有一定影响。气候变化和可持续性是护理专业的重要问题。我们在临床模拟背景下探讨了一个嵌入可持续性原则的教育模块的影响。这项混合方法研究使用干预前后的废物审计和学生调查，以探究与气候变化和可持续性相关的态度、知识和实践。干预措施是一个数字临床模拟教育模块，包括三个主题：1）职业行为，2）工作健康与安全，3）资源管理与可持续性。通过描述性统计以及干预前后均值和比例的比较来分析定量数据。对定性数据进行主题分析以确定促进因素和障碍。我们对为临床实践评估做准备的同一组170名学生进行了为期两周的模拟研究。我们发现干预后每名学生产生的废物量没有显著差异。大多数旨在再利用的物品都被积极转移到回收站，干预后比例有所增加。共有44名（30.3%）和80名（53.3%）学生完成了调查，大多数人同意气候变化和可持续性是护士的重要问题。干预后，学生在临床模拟中对可持续性的感知应用有所增加（均值从4.8提高到5.4，p≤0.01）。在临床实践中对可持续性的感知应用以及“减少”和“再利用”原则的应用也有所增加。可持续实践的障碍包括认知过载、知识不足、时间压力以及对真实实践的渴望。临床模拟会产生大量废物。实习护士有动力且有能力在模拟过程中应用可持续性原则，然而，他们经常遇到障碍。将可持续性原则融入模拟课程显示出积极影响，需要持续努力解决障碍并增加可持续实践的机会。
