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It's late for this breakout session uh on education in sustainability. So, welcome to all. We've got a number of fantastic speakers who we are going to present their work for us today. And um we've got all our presenters with us. I think we've got all our slides ready to go. Um All our speakers are here and remember that we'll be doing the presentations first and, and then we'll have questions and comments um as a roundtable discussion during the second half an hour of the session. So remember you can't be, be heard or seen. So you'll need to put your questions or comments in the chat, please. Um And presenters, we've got a very, very strict time limit of seven minutes. So we'll kick off, I think uh without further a do um so that we can get everybody's presentations in and field as many questions as we can. So, Emma is first up with her presentation on an innovative planetary health and sustainable healthcare curriculum, adaptable to all health professions. Great. Thank you very much. I'll just start sharing my sides. Um So, hi, everyone. My name's Emma o'neill. I'm a palliative care doctor and clinical commissioner and I teach Planetary Health in my spare time at Leeds Medical School. So I'm really pleased to be here today to present the work that we've done on developing the nationally endorsed document education for sustainable healthcare, a curriculum for the UK. As we know, humans are driving massive environmental change on a scale and timeframe never experienced before. As future doctors, medical students need to be made aware of these ecological determinants of health. Um And this quote says it, all health professionals need to have that knowledge in order to act in the best interests of their patient and the planet. In order to address calls for medical education to reflect the climate and ecological emergency. I'm here to present the work that we've done on developing what we believe to be the first curriculum for planetary health and sustainable healthcare that has been nationally endorsed. This curriculum is of high quality comprehensive and concise and is easily adaptable to different levels of training and health professions and different context, both nationally and internationally. So this slide shows the curriculum document and there's a QR code here that you can scan to be taken to that document of note. Here also is the general Medical Council outcomes for graduates. And in 2018, sustainability was incorporated into these. So the production of this curriculum followed the Medical Schools Council special conference for all UK medical schools held in October 21 on education for sustainable healthcare and planetary health. Dr Sania May Tonne, who's the lead author called for interest in developing and national curriculum, which led to the formation of a working group of six colleagues to develop this curriculum through a series of consultations, discussion's and review processes. The education leads advisory group of the MSC reviewed and endorsed the curriculum in April 22 published it prominently on their website and it's freely available to all the MSC then sent this out to every medical school education lead in the UK. The G M C has approved this curriculum is informing the implementation of its outcomes for graduates and we'll use it as a point of reference for future iterations of the outcomes for graduates and other related guidance. It's also really significant that the MSC and GMC have endorsed this curriculum document. It was also presented at COP 27 last year by the lead author Dr Sania Matan. So the curriculum document is intended to facilitate integration of planetary health and sustainable healthcare into each medical school through suggested items to cover suggested pedagogy assessments and competencies supported by a list of resources with hyperlinks within the document which will help to aid for faculty development. And we do feel that it pushes the boundaries of traditional medical teaching. An example of this is the acknowledgement, acknowledgement of the importance of recognizing and understanding indigenous knowledge and value systems as essential to the solutions to the climate and ecological crisis. In terms of content. Broadly speaking, the document ensures the health professionals are aware of the ecological determinants of health, the drivers of environmental change and how to practice sustainable healthcare. It does this through covering approaches to curriculum delivery and design including integration, faculty development and assessments, key foundations for sustainable healthcare including planetary health health inequalities and health co benefits of solutions. It covers health impacts of the climate and ecosystem crisis and this is further broken down into additional impacts by medical special is um in order to identify areas which can be easily and quickly integrated into existing teaching, it covers the impact of the crisis on healthcare systems and of healthcare on the environment and again, how we can practice sustainable healthcare. Finally, it covers items of professionalism, leadership and achieving structural change. Whilst the document contains itemized lists of learning outcomes. It's important to remember that these are often linked interlinked as systems thinking is a significant aspect of teaching planetary health and sustainable healthcare. So when developing the curriculum, many resources and frameworks were drawn on including the A Emmy consensus statement on Planetary health and education for sustainable healthcare and the Planetary Health Alliance's Planetary Health Education framework. We also reference the metrics of the Planetary Health report card to ensure that all aspects called for by the student initiative have been covered. Our curriculum document covers how they should be taught ideally, this should be mandatory within the medical curriculum. And we advocate for both a discreet and integrated approach. The discreet approach allows for teaching of overarching themes and concepts highlighting interlinking which is between systems and impacts on health. So a system sinking approach and we also advocate for embedding this teaching into existing teaching as it allows quick implementation and shows that this teaching is cross cutting and applies to all aspects of the curriculum. Longitudinal installation of this teaching throughout the course is an absolute priority as it should be seen as a theme running throughout medical education in a spiral format. With regards to modes of teaching. The curriculum document covers this and suggests lectures, small group teachings, virtual learning communication and clinical skills. We also acknowledge that there is likely to be an emotional impact of learning and of teaching this material and that pastoral care and should support should be a priority with a focus on solutions and benefits to acting on the climate ecological crisis. So the next steps for us are that we are aiming to develop a website of learning resources and a network of UK planetary health medical educators so that if a medical school needs support in this, they know how to ask for it. And the network can also act to promote integration of this into the curricula. The MSC will be a host in a disc platform for educators from each medical school. So if anyone here would like to be added to this to be part of the network, then you can email myself and we can ask for you to be added. So in summary, we've developed planetary health and sustainable healthcare curriculum that's been nationally endorsed in the UK. It's easily adaptable to all levels of training health professions and to all contexts. And they'll now be a development of a network of planetary health medical caters to support the rollout of this. So we hope that our work will allow timely integration of planetary health and sustainable healthcare into every medical curricula to reflect the escalating urgency of the converging planetary crises. Thank you. Thank you very much. Indeed, Emma kept beautifully to time. So that's the first win. Fantastic. So, any comments or questions for Emma and her team, please do put those in the chat and if you could, whenever you're putting comments or questions, if you could just tell us who your directing them to, that would be great. And then we'll pick them up at the end between myself and the only my co chair. Um So we'll move straight on to our next presentation, which is from Emily and she's joining us from New York very early in the morning. So, are you able to share your slides, Emily Emily's presentation is on the development and evaluation of a climate change curriculum in medical school education. A survey of student knowledge and attitudes over you going refu tude. Good morning. Thank you all so much. For having me. Um, I'm Emily, I'm a third year medical student at Albert Einstein College of Medicine. Um I'm also the curriculum co chair for the US check division of Medical students for a sustainable future. Um And as discussed, I'm going to be discussing a survey of student knowledge and attitudes about climate change curriculum. So as we all know, climate change represents a major threat to health and well being worldwide with 250,000 excess deaths projected by 2050 across the globe. Healthcare workers are seen as trusted sources of information about climate change, but many express a lack of confidence about the ability to communicate with patients about this. While accreditation standards in the United Kingdom have started incorporating Planetary Health US medical schools to date don't have such requirements and efforts to incorporate Planetary Health into us. Medical school curricula are largely student driven. So as part of a larger effort at our institution to integrate Planetary Health into the medical school curriculum, this survey intended to examine first year students attitudes beliefs and knowledge about climate and health before and after they received three mandatory sessions about it in their preclinical curriculum. So the design of the study was a pre post intervention of survey of first year medical students enrolled in the health system's health equity course at our school. All first year medical students are required to participate in this course. And then they were all sent the survey one week prior to the first of the three sessions related to climate change and health. You can see the sessions here and then they received it as well. Um after the sessions completed, and the survey design was based on another survey given at Stanford University School of Medicine for an elective. They gave on climate and health to all graduate students, including medical students, law students. And I believe there were even some undergrads and we adapted it to a class that was comprised only of medical students who were receiving required instruction on this topic. So it was a little more focused on clinical skill building and objective assessment of knowledge. So just to summarize the survey, it has 43 items. I'm not going to go through all of them individually because that's a bit much but broadly, it was divided into three sections and an optional demographic section. So first, a beliefs and attitudes about climate change in the role of healthcare professionals, a self assessed knowledge section about climate change and health and objective knowledge quiz about climate change and health. There were eight domains that we were asking about causes of climate change, impact of healthcare on climate change. Specific contributions of healthcare to climate change, impacts of climate change on health, climate justice and climate change, acting as a risk multiplier impacts of climate change on healthcare and systems. Bronx in New York City, specific climate issues and talking to patients about climate change. The self assessment questions and beliefs and attitudes questions were scored on a five point scale from strongly disagree to strongly agree and all of the multiple choice questions had one correct answer. So briefly, these are the demographics from our results. They're 100 and 83 students in the first year class and 100 and 16 of them took the pre course survey. I'm not going to go through these specific results just because I wanted them here so that people could see the slides. I'm going to focus on seven specific items from the attitudes and self assessment and just go through them their most related to student attitudes about weather, climate and health should be in a medical school curriculum and what they feel they're strong in and weaken. So first attitudes item 13 physicians should inform the public about climate change. You can see that on the far left here going from the bottom to the top. The darkest pink is strongly disagree and the darkest blue is strongly agree. So you can see just about half of students feel that physicians should be responsible for informing the public about climate change. Over half of students felt that a climate change curriculum should be included in medical education. Few students, you can see a lot of uncertainty here felt that our medical school's curriculum had already educated them about climate change. And again, this is the pre sessions that kind of makes sense. Self assessment item one confidence, explaining the impacts of climate change on health care. About a third of students agreed or strongly agreed that they could do this self assessment item too. I feel confident explaining how climate change exacerbates existing health disparities and generates additional and equity. Roughly half of students felt confident doing this self assessment item four, I can identify issues related to climate change that may affect patient's in my community. Again, about half of students felt they could do this. And then about a quarter of students felt that they could have a conversation with a patient about climate change related issues and how to mitigate their health impacts. So in terms of the objective knowledge quiz, the mean score was 74.4%. Most students in a multiple choice context could identify a conversation starter about climate change with patient's and a local climate impact on health. And the lowest scoring items were identifying the impacts of healthcare on climate change, identifying the impacts of climate change on healthcare and identifying which greenhouse gasses specifically contribute to climate change. So at baseline, a majority of first year medical students believe that it is important for physicians to be educated about climate change, that they do have a role in educating the public about climate change. And the medical school is the place where they should be developing the skills needed to do this. However, if you believe that they're prepared to manage the health impacts of climate change or that they have the tools needed to have conversations with patient's about managing the impacts of climate on health. And that includes conversation strategies as well as knowledge of local resources about climate and health. In a multiple choice context, most students can correctly identify information about climate and health, which is a good sign. So next steps, first year medical students feel this is important. So this information kind of helps us with clinical skill building. We hope to focus our clinical, our curriculum development on clinical skill building and providing information about local issues. And then in terms of our analysis, further analysis is planned to compare pre imposed session responses. So here are my references. Thank you so much for having me. Thank you very much. Indeed, Emily, again, beautifully timed. Thank you. Fantastic presentation there on, on more curriculum issues and we'll move straight on again. Um Any questions for Emily these um uh her name uh and your question in the chat. That will be fantastic. And we'll come back to those at the end and uh to continue with our next session, we have Amelia and Hi May I believe from Cambridge and you're already ready to go? Fantastic. Um Where you go. So, hello. So yeah, I'm high May and alongside Amelia, we're going to be presenting today. So um today we're going to be talking about student driven change and how we went about helping integrate Planetary Health into Cambridge's medical curriculum. So as we all know, um the climate crisis has I think been very intertwined with education and greater thumb. Berg really brought into the limelight. She was protesting by not going to school and we want to teach about it by going to school. Um So we really believe that education is really important in this. And um I think younger people tend to be very motivated about it because there's this concept of generational inequality. And um as a future doctors throughout our careers, we'll be dealing more and more with the effects of climate crisis. So we are really kind of pondering whether the medical curriculum nowadays is preparing doctors to face the effects of the climate crisis and really be kind of at the forefront of all this. And so we just thought it'd be good to kind of uh our story and how we went about this um Cambridge. So this is basically a timeline. So Amelia and I um we're third year graduates and we're part of this healthy planet group, which was founded in 2018, between 2018 and 2020. The main purpose was um of this society was to organize talks and kind of teaching primary schools. And then um alongside the help with uh Doctor James Smith, um we were able to make the clinical school declare a climate emergency, which then kind of brought about more changes because this allowed us to start having conversations with the Dean of the Medical School. And um these monthly conversations really allowed us to kind of pitch our perspective and push this agenda because as we all know, the medical school curriculum is already very jam packed. So it's very hard to get extra time. And um ultimately, uh most recently, we've been successful alongside the help of Doctor James Smith, of getting a funded teaching role that will hopefully start next year. And uh this uh that person's role will be to first map out the curriculum, which we've already done. But um kind of really find places where teaching about this can be included and integrated because what we're really trying to achieve is kind of um continuity um instead of quite blocked teaching. And um because the way the courses structured, it's very divided into preclinical and clinical. And as of this year, um in the preclinical, they have assessments where they're able to talk about the climate crisis. And uh this was due to the talks uh James gives and now I'm going to pass it on to Amelia who will talk about the resources and tools we used. Thank you. Um See Anderson talk briefly about how we managed to get ultimately to having this teaching well funded. Um I guess the first thing to say is we've had a lot of help along the way from really kind and motivated faculty members. Um Yeah, Doctor Jones Smith has been the biggest member in our team that's involved lots of others too. And we've been really lucky to meet with other organizations within Cambridge to get their help and their perspective on things. Uh We've been part of this group called Health Rule, which joins up with other organizations within the clinical school that focus on racism, sexism, other intersectional topics. Um And we've been able to work with them. Uh, we've used the Pantry health report card a lot in terms of pushing for change and auditing changes that we've made. Um We've also been really lucky and um we're invited to speak at the teaching forum to try and educate the educators in all different areas of the university and bring climate onto their own agenda in the work that they do outside of the medical school. Uh And also we've been lucky enough to meet with similar organizations, working other medical schools like in the scope gym program, for example. Uh And we've used resources made by the Eunice and um other centers which I'm sure a lot of people work who worked on those are here today. So thank you next slide, please. Um So I just quickly we've learned along the way. I'm sure, you know, it came, which is very old and sometimes very bureaucratic university and the way the medical school is set up, it's quite complicated and it's been difficult to navigate a very pre pre clinical versus clinical system. Um We've had some amazing support from faculty and we definitely couldn't have done without them. And I guess we just wish there were more faculty members, they were able to give their input into these kind of things. Um And that's kind of lead into one of our main focus is is we want to empower faculty members and educators to feel like they have the knowledge. Um And they know how to teach about these topics. I think a lot of people are keen and realize the importance of it, but don't feel like they have the tools to talk about this stuff with the medical students. Um We found that sometimes hard to balance this work a long time alongside passing on medical school exams. Um But we have been lucky to have lots of help and draw on a lot of the graduate medical students who have had past careers working in the climate spaces and have really amazing perspectives and resources to help us. Um Yeah, next side, please. Uh So just quickly, what can we do as medical students guess our uh is to educate and advocate and be involved in research. Um We're running of time. So just kind of skim through these fact, you can see some of the things that we've been involved with um along the way. Uh And then next slide please. Um And then as medical schools, it was really great to hear. Um you talk about the G M C and the changes that happening to outcomes to graduates think our perspective is we found that the world in currently is a little bit vague and very open to interpretation when it comes to teaching about sustainability. Um And one thing that we've been involved with is um a wider open letter to the G M C um which is asking for more explicit wording about how they would like sustainability integrated into the outcomes. Um So, it's great to hear that works ongoing. Um And yeah, as medical schools, I think the message when you try to get across from meeting with faculty members, him if you answer um aware of the climate space is that, you know, things can start small and it can be discreet teaching or it can just be integration into already existing teaching sessions. It can be two minutes here and there. It doesn't have to be a whole new week of lectures. Um It doesn't have to be this overwhelming complete reform to the curriculum. Um And actually a lot of the tools that exist in the curriculum already uh perfect that we just need to kind of uh add additional bits in here and there. Um I think that's everything and yeah, just a big thank you to everyone who's helped us get where we are and excited to see where we go next. Thanks Angulus. Thank you very much. Indeed. High. Me and Amelia and I'm getting a very strong sense of how the power of student led changes, really making a difference in stamina uh initiatives break my alarm's going off for the time. OK. Our final presentation then for this breakout session is going to be from Jordan from the University of Oklahoma. Are you there, Jordan? Yes, there's your presentation. Uh University of Oklahoma who won our prize for the best poster. And we had a number of posters um submitted around 20 and we were really impressed. You're clear messaging and you're real sense of teamwork and collaboration on the project that you've been doing around the Planetary Health Report. So where you go to tell us, prevent it? Thank you. Thank you so much for having me. It is a distinct privilege to be here. And so, yes, I'm Jordan Zimmerman. I'm a first year medical student at the University of Oklahoma Health Sciences Center in Oklahoma City, Oklahoma. I'll be talking about some of the successes and some of the challenges that we found in the collaboration that we did in establishing overuse Frieri first planetary health report card. I just want to start off real quick introducing the team that I worked with to make this poster there on the call today and they'll be in the chat and able to help answer questions. I worked with Alice Moon and Marie Win and Sarah Powered were fellow medical students at the University of Oklahoma College of Medicine. I want to start out giving some background on our institution in Oklahoma as a whole. Uh since I think it's a rather unique structure and lend some insight into the report card that we did. Uh First of all, the College of Medicine. Oh You calm is located in Oklahoma City, Oklahoma. It's one of seven colleges at the Health Sciences Center campus uh in Oklahoma City. And there's also a campus in Tulsa, Oklahoma that's partnered with the University of Tulsa with more of an emphasis on community based medicine. With some of the course you can see they're below. Now in general, we were working with the backdrop of Oklahoma as a major player in the oil and gas industry with revenues in the billions each year. And so we went to the report card knowing this and trying to see where we fit as medical students among this backdrop. Given that background, this is where we store compared to a nationwide average that I took just from report card stores, from institutions in the States as you can see overall, oh you store below average and others below average in every category except for community outreach and advocacy. But across the board there is room to improve and we plan to do that. Going forward to talk about our approach. We had a multi pronged approach that looked at a few different spheres uh to really address uh the different issues that we were looking to. Um look at one of them was an online research work stream at O U S websites and beyond. And once we got that baseline, we looked at collaborating with different folks. One of them being just with university organizations as well as organizations in the community such as Oklahoma Gas and Electric, which is the largest provider, electricity in the state of Oklahoma unless works pretty closely with oil and gas that I had touched on earlier. We're not able to get in touch with them, but that's something to look for uh in the future as well. We worked with a Yukon faculty and staff. We work with people in the dean's office to really get a wide breath of knowledge about what the institution had to offer and again, what we as medical students could do in terms of enacting change. Now we noted a couple of successes and a couple of challenges um that throughout the process here, uh one of the successes being establishing some key relationships across campus by looking at different stakeholders that there were and really finding the people in charge that we could work with going forward and through these relationships that we established some people that we know we're really receptive to what we were doing. We got a really positive response from folks like associating a student affairs and E H S O at O U Environmental Health Safety and in those relationships, we learned that those people were willing to do what was in their power to make the changes in their uh specific spheres. And so looking forward, I think there are opportunities to look at other offices of the being other places and offices across. Oh you and beyond to really leverage these connections. And hopefully you have more people who are receptive and to enact power within their spheres. Looking at challenges that we found with the report card. Um Some of them we found and some of them, we foresee one of them that we found and foresee is maintaining student commitment, which has been talked about in this session a little bit. Um We find that students going from preclinical lecture courses to a clinical curriculum and being on wards and sometimes change the commitment they're able to dedicate. And so being very intentional with this going forward is key for maintaining a good student commitment. And we think faculty commitment will follow as long as the students are putting that foot forward and maintaining the system communication as well. We noted uh bureaucratic uh difficulties sometimes it was quite difficult and just convoluted to find who is in charge in certain spheres. And I think as we continue to do the Planetary Health Report card and continue to work on sustainability initiatives that old make itself easier. But certainly that's an issue that I think will continue to be um something we have to look at for long term projects. Like one that I mentioned here working on one currently as uh to prevent bird strikes on certain buildings and campus. Now looking forward, I think we identify three key next steps uh to really go forward and make sustainability changes on campus. I think this works is great framework, not only grow you but institutions trust globe to really address different facets of sustainability. First of the, is this curriculum change? University of Oklahoma is going under a huge curriculum reform currently and I think that is a great opportunity to integrate climate health objectives and courses. Additionally, though you Tulsa curriculum that I mentioned earlier with this community based focus can offer easier implementation for certain climate health objectives as it's quite relevant for the physicians of the future as well. We're looking at interdisciplinary efforts I mentioned earlier that uh the College of Medicine is under the umbrella of HSC. It's one of seven colleges and there are different institutions already with sustainability initiatives. I think we can leverage finally community engagement what we keep going forward not only with community gardens, which is closer to earth, but in partnerships with different activists, Oklahoma has a large indigenous population. And so working with activists and mass fear as well, environmental activists will be key in enacting change and making lasting change across the state of Oklahoma. So I think in general this is what we're looking at going forward. Before I conclude, I want to thank a few people, Doctor Caitlin Cialis is our faculty mentor, as well as the students and faculty members and deans with whom we work to make this report card. Finally, I wanted to thank the Planetary Health Report Card executive team for helping us get this off the ground and really get things going. These are my references there on the poster. You can check the recording if you'd like to take a look at them. And so thank you all for your attention. I'll now open the Florida questions. Thank you very much. Indeed, Jordan. And just remind everybody that the posters, all the posters can be viewed in the posters area um on the left hand side, hopefully of your screen. Okay. So we have just under half an hour for questions um and discussion and so if I could invite all the panelists to rejoin us, um Leonie, have you spotted a good question to kick off? If not? I have, yes, there were lots of questions and um the chat. So I'll start with the first one, um which was for Emma. Um And that was asking if um we can join the network if we are in another country. And that's the question from Brie Jones. Yes, absolutely. It's a great idea. Anyone's welcome. So, just email that email address, um, we can add you. That's great. Thank you. Very great. I've seen a really good question from just actually to follow on from that Kush is asking Emma if the in curriculum includes education on the role of healthcare professionals in becoming advocates policy change at local national or international level. Yeah, absolutely. Thank you. Push for that question. Um We do cover that in the curriculum. So under the section of professionalism um and achieving structural change, it's massively important that we have um that we teach the skills of advocacy um and how to create that structural change that's needed to transform all of society to try and benefit um planetary health. Um And as part of that, the planetary health education framework, one of their five domains is movement building as well. So it's drawing on that as well. Anyone else got any thoughts on, on that kind of um advocacy um angle from what you've done? Um uh We originally were when we were trying to kind of get this more on to the curriculum, um The university felt it was more of like a political stance initially and once they had they changed their stance to more uh this is just happening in the climate crisis is real. Um I think that was very empowering for them to allow teaching on the matter. Um And kind of to not push opinions but push, push facts, any other swords? Yeah, I think Einstein are curricular integration really started from a health systems, health equity course. So it was really kind of focused on an advocacy lens, both like advocating for your patience and then also like what are you going to do in a broader sense? I will say, I don't think we learned any specific skills to like lobby legislators or anything like that. So that's definitely a place where ideally we could improve in the future. Sure. And Jordan, it sounds like, you know, from your geographical area, you've got particular challenges around uh you know, political, political, um leanings or political um directions and, and maybe some extra resistance because of the industries that are in your area. So I guess that's a big issue for you guys. Yeah, that's certainly an element. And we organize both with the environmental and sustainable health group on campus as well as different legislative groups to try and lobby for things. But yes, there is that element of resistance as we're looking at curriculum integration and uh advocacy. Thank you. Uh There's been some, some good questions around um integration and that word kind of came up quite a lot. Um As we went through, uh I'll come back to the other questions were kind of jumping around a bit but some Andrews asked about the experience of implementing the curriculum, the UK medical schools and true integration rather than this kind of bolting on idea. Um Maybe with optional sessions is the real key to, to some of this, isn't it? So what's everyone's experience of really trying to integrate this topic or this series of topics and this really important area um into the curriculum. So it's a true thread and rather than a sort of add on, I'm happy to speak a little bit about our experiences. Um So one thing Hamid didn't mention because he's very modest is that this all kind of started when he lobbied the course to try and introduce a lecture into our ethics teaching that we receive in the first year. Um, and that was delivered alongside James. Um, and initially, um, he fought very hard for it to not be optional or marketed as optional in any way. Uh I was initially told that it would uh the off, you know, and then right at the last minute, it was sent out an email. So all of the elevated us uh and made us realize just how important it is that this is truly integrated. Um So I think that gave us a bit of far in our bellies maybe. Uh And it's really nice to say now that actually this is not an optional lecture as part of the mandatory course for that module. Um But I think we, we definitely agree that we want things to not only be part of the core curriculum, but we also think we want them to be examine herbal. We found from our experience, there's just so much to learn in medical school and you have exams to pass at the end of it. And I think a lot of students do ignore content unless they know it's directly going to help them pass the exams. At least that's been my experience in Cambridge. Um, is that something we've been really fighting for? And initially, we did have quite a lot of pushback around that idea. Um, and fax senior faculty members kind of maybe not getting where it could fit into the exams. But now, yeah, again, alongside a lot of help from James, um we've managed to get some examinal content in the public health exams in the final year, which he helps delivers, which I'm sure he can comment about. Uh and he's involved in the new M L A. I think the, the Cambridge team are um the common place name. So he's the senior MLA pass and we're able to have some meetings with them about how that could be incorporated in there. So, yeah, I think, sorry, I'm waffling now. But yeah, we, yeah, we definitely think that things being not optional and examine Nable at the court and you would be great to hear other people's experiences and how they found pushing for that. Any other comments on, on integration into the curriculum. We've got another question for, for Emma around the academic health institutions, Declaration on Planetary Health. And Tim has asked that question and helpfully provided a link so asking if, if we're encouraging medical schools to sign up to that. Um So I saw that message and I hadn't been aware of that. I have to admit. So that is a fantastic idea and I've taken a link and definitely will suggest that. Fantastic. Thank you. Yeah, I wasn't aware of it either as we'll be doing the same. Um Fantastic. Thank you, Leonie. Have I missed any, any questions related to sort of the flow that we haven't covered yet, do you think? Um I think this one and there's a few coming up into the comments now about integrating into the curriculum in other professions. And so, for example, I think it's rem in rem in our uh um he said it's really helpful to have this as curriculum. I'm a doctor but work in multi professional education. I wonder what the panel's thoughts are on enabling multi professional learning environments for this important work. Often the focus is purely on medicine. Yeah, I think that that's just from to my mind as well. We, we've got lots of medical school representation here uh and doctors here, which is fantastic, Leonie and our nurses. So how can we, how can we uh join our professions together and get that collaborative work going? Do you think? Um So is it okay if I just start? Thank you. So for the curriculum that we've developed, it is adaptable to all health professions. And so it isn't just specific to medicine. Um Obviously, we're, it is all health professions because we're dealing with all the health impacts of that. Um So it's freely available on the website link. So please feel free to use that to develop it and make it um specific to what you need um in your profession. Um The other thing that I would say is that as part of planetary health, I think it's incredibly important that we think into disciplinary as well. Um And not just health professions. Um I know that the planetary health education framework is set out so that any profession, any discipline can use it. Um And when I've been doing the teaching at Leeds Medical School that do kind of just in my spare time, I've do this live Q and A every year and just ensure that we have representation from different disciplines. So even economics and you know, all the different disciplines that we need to have that transformation that's needed um so that we can try and develop those relationships ships so that we can go forward and work together in the future. Any other thoughts for many of our other panelists? Yes. Um I'd just like to share it. I think one of the key things that got us involved in really wanting to work on this in the sustainability space in the first place was learning about medical waste and the different ways we can improve sustainability in places like the operating room. And I think starting at the clinical side of things is a great way to go across different specialties and better listen and involve people from nurses to pas um and everyone in between. Um as I mentioned as well, our School of Public Health is already doing sustainability initiatives. And I think going forward, we're going to be really looking at leveraging different connections there and really trying to get a multi prone multifaceted approach so that we're looking at these problems in a lot of different ways and not just all working individually um as passionate as well. Uh Thank you and uh Sarah's made a comment um about the involvement and the work that Plymouth have been doing. And we, we know that Plymouth are a very big, bright shining beacon um in the nursing world around sustainability. And it looks like they've done some fantastic work um for many years now. So uh embedding sustainability into the nursing curriculum. Um and I was going to raise this point as well. That that's what struck me about the medical side of things is the governing body and the backing that you get from the GFC in the UK. I'm not sure about in other countries, but we are sincerely lacking in that backing. And um and uh you know, promotion of this as an important topic from our professional body, as nurses and midwives, the Nursing Midwifery Council. But that's, you know, lobbying is increasing. And Sarah says, uh there's increased support across faculty and embedding some of these topic into clinical skills management, global health and mental health is going on. Uh It's taken time and Yeah, really inspiring to hear what's going on in the medical world. And I think there was another comment we only did you see there's another comment around um the planetary health report card amongst other disciplines. I've lost it now, but the planetary health report card is being done across um several different disciplines and we've been um um running with that at Brighton and Leonie if you could mention a couple of lines about what, what, what you've done with that work. Yes. So last year, I was a nursing student at the University of Brighton and I was involved with a team of other students internationally to develop the first version of the nursing Planetary Health report card. Um and just listening to Amelia and Homey um speak, it was really interesting to hear them talk about having keen students and having the support from faculty. Um And I think that brings me to a question from Andrew Dallas um for Amelia, which was um what was the uptake of your teaching, the teachers sessions? What has that been like? So the kind of initial session that I was referring to is that the Cambridge University teaching from which is like an annual event. We were lucky enough to kind of get a slot um to push our climate agenda. Uh And yeah, it was kind of an optional thing where people go to different sessions as they wish. So, yeah, in that session, we had quite a good turnout and people were really engaged and really keen to go back to their own areas, um their own disciplines, whether it was like music, physics, um the university librarians um and kind of um implement um some of the ideas we were talking about. Um since then, I think this teaching, the teachers um role is maybe going to fall more, more under the role of the day teaching fellow that is hopefully going to be starting work in all. This is a full time job as they will be in contact with all of the individual curriculum leads. Um And the people who deliver various different sessions we have here um to kind of get them up speed and help them deliver those sessions. I think that's the ongoing plan. Um But hopefully we'll get another session of teaching for them again. Um uh We've also kind of arranged them other talks um which we've invited all members of the clinical school to attend um as well and that's had some good reception. Um Yeah, I hope that answers your question. Great. I found the question that I lost earlier back to the PHR see in, in using it in other specialties. Jenny said, does anyone have any top tips on how to improve, take up in other specialties? Because obviously the numbers of medical students quite large compared to some of the other professions. Um And then Emily provided a helpful link um for something that could, could help with that for an interdisciplinary approach. How many did you want to say something about that? Oh, yeah, so sorry, I did not realize I was going to speak. Um So the climate Rx badges something I don't know if it exists outside of the United States, but it's a little scannable QR code badge um for healthcare professionals of all disciplines who are patient facing. Um And the idea is that it's intended to be a conversation starter for patient's but not necessarily something that they're like squeezing into an already crowd ID visit. Um So the idea is it's meant to like start a more of longitudinal conversation with patient's about climate and health. Um And you can order them again. I'm not sure if they ship outside of the United States. Thank you. So it's sort of a more patient facing uh tool there. Um Any others that we've got that we've missed, the only James has answered Jenny's question around uh specialties working together on a combined Planetary Health report card report. Um Yeah, we found some challenges around. The different approach is required lots of comments and um from people around how to how to get flammatory health into what is already a very, very packed curriculum. Um And um just trying to look for streamlined ways of doing that. So Anna's mentioned the works that's been going on with the clinical skills, um facilitators and, and um teaching areas where they've integrated teaching on managing waste and have always avoiding overuse of gloves into the clinical skills training sessions. And we've been doing very similar things in our nursing, clinical skills sessions here at Brighton. Um Just to add on quickly to what Amelia said um in the teaching for um um what was really being driven. Um We were there alongside and swift who is also teaches on kind of our more uh sorry, I can't remember what it's called. Uh the teaching about uh basically all the different aspects about medicine outside of medicine. So the personal side um and it was really much about a co production. Um And uh they're very keen and I think going forward um alongside this health for all, which is kind of the intersection of medicine um is about co production and kind of finding students that are very keen to and very knowledgeable about certain subject areas. So why not get them to help teach these sessions? Um And I think we found that quite helpful way on kind of engaging faculty and allowing these sessions to be taught. So, for example, we told a lecture at um for the graduates um here in Cambridge and that faculty were very happy for us to teach it and they, they're very willing. Um often it's more if we have the time and resources to do it. But we found that staff have been very receptive. Fantastic, Jessie's also added uh something that looks really interesting uh national piece of work around integrating sustainability within 14 Allied Health Professional curricula. This sounds like a real significant step forward and will help with some of these inter professional groups um trying to move things forward published by the Council Genes of Health and her emails there if people want to find out more. Um uh They're asking a specific question on sustainability uh during the consultation on reviewing their standards of conduct, performance and ethics. So it sounds like you can, you can submit your comments around that. I have to say if only the NMC, we're doing the same, we'll see if that that follows a bit later. Um Okay, and son, you may turn has provided a useful link. Um Look at that to an article around um integrating teaching learning of sustainable healthcare in curricula. So thank you very much for that. Okay. Any other comments or questions around areas? I haven't picked up one. The only is there anything else we haven't spotted? Um I'm not sure. Did did we cover the questions about uh like Teresa Martin said, I'm not surprised that most students did not feel they could advise patient's on mitigation for climate related health problems. As I think most experienced clinicians would struggle to do this. How do we encourage doctors to address this as a priority in an already overstretched system? Yeah, I think that links nicely to the resource that you just told us about Emily. Um Does anyone have any other thoughts on that around, um you know, direct involvement with patient's and, and getting those conversations going around climate related health problems. One thing I want to say that I think is kind of important to underscore I think no one feels good about this because medicine, most medicine is really an all, like all healthcare professionals is really steeped in a lot of like longstanding evidence. And with climate change, there was just so much looking the other way for a long time that there's not an equivalently well rounded body of evidence that we can lean on and look to. Um And I think this is an area where we just kind of have to lean into our discomfort a little bit and say this is what we know, this is what we are able to tell you. One of the reasons I think why healthcare professionals are so trusted is because they typically come with a lot of information. And I think when we don't have information, just being transparent about that, with patience is important. And then in terms of educating individual patient's, I don't think it necessarily has to be like a whole education session. I think something as easy as I'm an extreme heat person. So when it's extremely hot out ground ozone levels are higher, so you should be really focused on your asthma action plan today. It's that like simple. Um And it's something to get people interested in learning more. Absolutely. And I think a number of you mentioned the idea of just taking small steps because this can feel so overwhelming and so hard to tackle that is just getting those opportunistic um times and it's talk to people uh in nursing were talking about, we talk about making every contact counts. So just using those, those opportunities to talk to people about key key messages. Um And you said, I think used to can start the conversation with patients before they enter the consulting room. This can help. Um And you know, it's in our minds all the time and use lots and lots of different media, lots of different forums to start that conversation. Can I just add that? I think that things that are happening in the in the media as well such as the, the case of the really sad case of L A Kitty Deborah, who is the first person to get air pollution on her death certificate that that's kind of raised in the public arena. And that's a way in for us to talk about these things, you know. So air pollution obviously affects asthma rates and it has other huge number of detrimental impacts. And so it's kind of ensuring that the students are aware of how these um environmental changes are impacting on health to then be able to link that and develop those communication skills to bring that up with that have the confidence really to bring that up with the patient's when they have them there in front of them. Fantastic. Thank you. Were running out of time, but there's a couple more things. Um Williams just added some um comments around a new initiative, a staff student partnership grant to pay students to appropriate learning resources to get that partnership working going with educators across the institution to med these topics into the curriculum, which is a really great example of that teamwork and collaboration. That was the theme uh for the conference release. So that sounds fantastic. Um And what email address has been posted? Another question for Emily and the MSC Quicken team. Any update of inclusion of E S H in assessment I E the medical licensing exam? Yeah. So I can only speak to the United States. Um I don't know of any current discussion of the US Emily step 123 exams including this. Um There has been a lot of interest recently from the A M C which is the collection of college medical schools in the United States. Um So maybe that's something they'll be receptive to in the future. Um but it has not come up to my knowledge yet, right? Okay, a few more comments on ways people are um incorporating um leadership and um other ways of of talking around this topic and involving um integrating these issues into their work and their education. Um Williams mentioned the Center for sustainable Healthcare, who's one of the, the organization's co uh running the conference um and a talk of a separate student education network. That sounds quite exciting. And the Center for sustainable Healthcare is a really, really useful resources, tons of useful links and networks on their websites. They do have a look um at that. Okay. We've got three minutes left. Is there anything any one of the presenters would like to add as a sort of closing comments or thoughts to share before we close the session? Um I think James question was meant for Emma and the new license uh that will be coming into, into place. Uh Sorry, two years from now. Uh similar Emily, sorry Emma question around the exam. Yeah, sorry. So around uh the M L A. Yeah. Okay. The inclusion of the E S H in assessment I E V M medical licensing exam. So that would be the next step. That would be fantastic. I know Dr Sania Matan um may know more about this and myself. So I might just defer to her to answer that in the chat if she has any other comments on that. But yeah, that would be a fantastic next step. Thanks. Sorry about the confusion there. Okay. Well, we've got two minutes left. So I think I'll just remind everybody to um use the pad lits and there's, it's been posted in the chat a little bit further up if you want to um share some of your, your links there, there's lots of emails being shared. So do get in touch for people to um ask advice, chair resources, networked together. Um And for all of those doing planetary health report cards, keep going. You're doing a fantastic job, were growing this network year by year. Um And it's becoming really powerful and the power of students to, to take this action forward is really, really evidence. Uh You just ask, is there a way to save all the useful comments in the chat? I'll find out, I'm not sure myself. So that would be useful if they could be captured and posted elsewhere. Thank you ever so much to everybody who's joined us. Um I think we have the most people in our, in our session. It's not a competition, but, you know, education seems to be a really important topic for everybody. So, thank you very much for joining us. We've got a break now until 12 30 you can check the schedule for the next step, breakout sessions that I'm going to start at 12 30. So, thank you very much. Indeed. Thank you everyone. Thanks. I just have a quick question. Um I'm struggling to access the paddle it, the link is giving me an error message, an error message. Oh, I wonder why that is. Oh, let me try. Hold on. Uh hang on. I wonder why that is then. Um Are you getting to the page where it asks you to log in and then getting an error or just as you land on the page first I get an error and then it redirects me to the paddle it, but it asked me to log in and I don't have a log into my. Okay. So, the password, have you popped in a password? It's just a password. Yes. It's just shared 23 share is all capital letters. Um, it asked me for a user name as well. Okay. Well, I wonder why it's doing that. Um, okay, let me see if I can go back to the main site. I'll get that for you. Oh, gosh. Where was it? Um, hang on. Sorry, I'll just get it up from my emails and it should, uh, let's go back. Yeah. Okay. I'm going to post the link again into the chat. Oh, yeah, that's working. Now, is that working? And then the password is share or capital letters? 23. Yes, that worked. Yanks. Okay. All right. Thank you so much. Thank you. Nice to meet you. Bye bye.