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So I'm taking, we're live now. Yeah. Okay. Well, welcome everybody. Uh This is the breakout session for education too and we're delighted to have a brilliant set of talkers, speakers to uh speak to us today. Um My name Savan Paso Williams and I'm going to be the chair and I'll pass you over to Alison or co chair. Hi, my name's Alison Taylor. Uh one of the senior lectures at the University of Brighton, just co chairing today. Brilliant. So we've got uh we've got integrating climate and health in the nursing curriculum with Thibault and Maria. And then we're going to be hearing from Jenny Girl, er from health education England UK, talking about the implementation of sustainable quality improvement program for dental Corps trainees in Yorkshire. And then lastly, but not least we're going to be hearing from Sherry Scott from Nottingham Trent University UK. Talking about embedding sustainability into clinical laboratory practice and education using Suss Qy principles. So um Thibault and Maria, it's over to you. Okay. I'll share my presentation should be visible now. Correct? Yeah, I can see that. Ok, so you can start counting the seven minutes now. Um So, hello, Everybody. Good afternoon. My name is Thibault. I'm from health care without harm Europe. And I will be presenting today together with Doctor Maria Kassa from the University of Malta. She's a senior lecturer there and you will hear from her in the second part of this presentation. Um We will talk to you today about the nurses, climate challenge and the nursing school commitment that we have running at health care without harm Europe. So if you have not heard about health care without harm Europe yet, um we are basically a network of hospitals, healthcare professionals, healthcare leaders, but also health systems. Um And we have members across Europe and partners across the globe. So how it works is we are the Europe branch of health care without harm. But there's also, for example, the US and can ID A branch, Latin America branch, Southeast Asia branch, we have partner organization in South Africa and India, Brazil, etcetera. And together with this global network, we prove that it's possible to deliver the highest quality of care in a way that is sustainable, both environmentally and financially. So we decided in January 2021 that it was a high time to start an initiative for sustainability and nursing. And with that, we started the nurses climate challenge. Um You can see a QR code in the top right corner. Um If you're interested, feel free to scan it and go to the website. Um You're also very welcome. To become a member of the nurses climate challenge. Um It's free. Um And what is the aim of the network? Well, basically, we identified a couple of important points. So nurses, but this is not only nurses, it's health professionals in general need to learn, educate, advocate and practice. So first and foremost, learning is about informing yourself about climate change and health and the impacts of climate change on health educating is about teaching others. And obviously, nurses are in a very good position uh for doing that both towards patients' but also towards colleagues. Um Third is about advocating so it's key for nurses to advocate within healthcare institution, for example, towards management, but also in the community and in the country. Um And last but not least, obviously, if we want to work towards a more sustainable um and climates, more nursing practice, it has to happen from within both bottom up and top down. At the moment, we have about 500 nurses from 44 countries that are part of the nurses climate challenge. But what we noticed was that focusing only on nurses directly was great. But by focusing on nursing schools as well, we could really have a catalyst impact because obviously they are training nurses and sustainability leaders for the future. And this project which is called the Nursing School Commitment was launched in um in October 2021. So about nine months after the nurses climate challenge and at the moment we have 19 universities and nursing schools from 13 different European countries that are part of this network. And what is the special thing about this network is that it really makes the participants make a formal commitment to include climate change and planetary health into the nursing curriculum. And now I will give the word to Maria who is a representative from the University of Malta, who is actually a participant um of the nursing school commitment. So they are one of the um 19 universities and nursing schools at the moment. So Maria, I'll give the word to you and feel free to tell me when I need to go to the next slide. Okay. Thank you, Thibault. Yes. As, as Thibault very gently um introduced me as we, we when I say we'd University of Malta, which is the university, I, I am a nurse educator as was one of the first um to join the to sign the nursing school commitment. And moreover, we were the first in Europe to join the nurse climate champion challenge. So we wait, how did that happen? We were looking for help. We were as a, as a university as a department of Nursing. We were trying to address climate change and environmental issues and planetary health within our curriculum. But where do we start from? I recognize that we need, we are a very small, small country with limited resources and experience in this regard and therefore, it was, it was a wonderful opportunity to have the resources to turn to through the climate change, the the nurse, climate champion challenges and the nursing school commitment. I'll go through very brief in the next couple of minutes. What our experience was as being part of this wonderful network which we are privileged to be members of which Tibo has, has kindly explained to us. But the main strengths of be of joining this network, these opportunities, these platforms call them whatever you want has been that we were able to efficiently and effectively address the needs, the learning needs which we had identified, which we know very well and humbly admit, I recognize that we would have struggled to be able to address them so efficiently and effectively had been not change, joined a bigger network uh consortium, a platform which these, which had, which which we managed to get the opportunity to join. Moreover, we had got the, had the opportunity to empower our learners to take a leadership role. They were part of a bigger, a bigger network, a bigger community, uh larger and perhaps uh empowered in the sense that even having more power to change things because they are belonging. We all were belonging to a bigger force, a bigger movement, a bigger sense of activism across, across Europe and even across the globe. Next, next slide, please, obviously, of course, as with anything in life, there were weaknesses and there are weaknesses with this, with this uh initiative, with these initiatives, I don't want to be picked up uh all flowery uh picture. There's we there's a lack of trans disciplinary. Um It is very nursing based so far and that is a disadvantage. And also learning opportunities were plenty, but they all had to be squeezed into nursing curriculum. A doc sometimes and that leads to some fragmentation of the learning opportunities. Next slide, please. What opportunities that we see as I described already alluded to the joining these, these networks have has provided the leverage to attract students attention. Somehow it wasn't Maria Cassar or another boring person that they're, they're the the students have enough of uh from the University of Malta, but they were uh they are now being uh active within a larger organization, a larger consortium of people, uh a larger network. And that gave provided leverage also with counteractive any skepticism we all know because I'm sure we've all experienced some skepticism as regarding eco activism and uh addressing climate change challenges and therefore being part of the bigger global network helped give us an opportunity to counteract that X skepticism more effectively. We would like to think the last slide. What are the threats? Obviously, there is lack of integration of different initiatives. Now we go eco activism and consciousness about efforts and initiatives uh regarding planetary heads are increasing, which is wonderful, but there's a risk that too many initiatives mail may lead to some disintegration because of lack of integration. And we, we fear that also. So we're trying to contain now our efforts and concentrate and focus. And one other threat is the lack of a limited engagement of policymakers and the stakeholders who we communicate with, who will work with on a daily basis. As a nursing department, we don't, we don't deliver our programs within a vacuum, but obviously, we're very dependent on, on the policy makers and the stakeholders, particularly those who provide student placements. So getting them onboard and engaging them into a similar mission or or are identical mission is a bit of a challenge judge maker and this and at times it threatens the effectiveness of our efforts. Looking forward. We are hoping to continue to find ways of overcoming the threats and weaknesses and we hope to improve our, the strength and overcome and kind of make, make, make the best out of all the opportunities by increasing the audit. And perhaps the the auditing, the impact will enable the developments to be more of these initiatives will be even more effective. So we're hopeful about the future was very conscious of the tele threats and risks um under weaknesses rather than x which prevailed. Thank you so much for your attention. I hope that's what gave you a good overview of what we're trying to do with health care without harm your mutants to gone. So I was just saying that's perfect time in the next step is Jenny Gertler. Um So over to you. Thank you very much. I hope you can all hear me. Okay. Um So I'm Jenny. I'm currently doing a leadership fellowship in Zero and Sustainable Dentistry with the Center for Sustainable Health Care and NHS England, which was hate health education England until the first of April. So it was changed over now. Um My background is I'm a dentist and I'm doing all the surgery specialty training. And I wanted to provide today, I wanted to talk to you to provide an overview of sustainable quality improvement program that we've implemented in Yorkshire and Humber for Dental Corps, Chinese. And I'm presenting on behalf of the NHS England, Yorkshire sous Q I P brilliant. So first of all, you might be thinking what is dental core training. So in my experience, allied health professionals are often unsure what we actually mean by dental core training. Uh it's quite a niche group and relatively small group of people compared to others in other specialties. So dental core training follows a year of dental foundation training and offers dentists the opportunity to enhance their clinical and professional skills in a setting. Very different from general dental practice. Most posts are based in hospital trust with a few aligned to salaried dental surgeries. And there are three standalone years in D C T. So DCT 12 and three, which are recruited annually after completion of D C T two trainees are then eligible to apply to enter dental specialty training. The dentistry makes up 3% of the carbon footprint of NHS in England. In order to deliver a net zero N H S, dental professionals must be trained with the knowledge and skills to embed um sustainability into their practice. And this can be achieved by integrating sustainability using established Q I methodology. So the aim of the program was to ensure that the Dental Corps trainees are able to understand the relationship between climate change and health. Be able to apply these principles of sustainable clinical practice to dentistry and contribute to a net zero health system. The program has been running annually for D C T since 2017 and is now a compulsory requirement to complete the training year. It's delivered across three sessions, what A six Q I teaching day to a project development workshop and three a presentation session where the presentations are assessed and then there are prizes for 1st, 2nd and 3rd. And the outcome is to support dental call trainees to develop implement and then present a SUBQ I project, the project's follow recognized center for sustainable healthcare askew I methodology and those project report templates that you may be familiar with. All trainees are provided with a list of pre reading material and asked to prepare a short presentation on one of the five principles of sustainable clinical practice prior to the first workshop. So they come in with a lot of knowledge before we actually do the workshop and what do we find? So each year between 20 to 30 D C T s, uh they present they're extremely high quality subq I projects empowering them all to up skilling's of Q I influenced clinical pathways and ultimately reduce the environmental impact of their clinical decisions. There are a wide range of topics that are covered as well. They come up with it themselves, but they're encouraged and guided by the facility just to think about the principles of sustainable practice. Examples include educating pediatric dentists on the adverse effects of nitrous oxide on the environment, which is usually news to all Kelly dentistry to reduce patient travel, focusing on reducing inappropriate antibiotic, prescribing, exploring PVC plastic recycling and of course reducing paper waste. There's always quite a few of those. Okay. I'll just go back to this slide. So this slide is just showing on the left hand side. A an example of one of the presentations delivered presentation day and the template report on the right is an example of anonymous project and it's just following the C S H askew I methodology which is available online free of charge for everyone. I'm going to give you a minute to read this slide. So this is why it's important. I don't need to say anything, it says it all. It's exactly what we would have, we wanted to hear. And yeah, we've got it written down. So we can share everyone and then we can persuade other people to take it on as well as an initiative. And I just wanted to note as well that by providing a project development workshop quite early in the program allows for trainees to discuss any worries, concerns and barriers in plenty of time which then empowers the trainees to overcome them or sometimes they even go a completely different directions. So I think that project development workshop is really important. So what next, the quality of the projects and the enthusiasm of the trainees to work towards a more sustainable healthcare system is a testament of what the dcps are willing and determined to do for their future in healthcare. It also shows what changes possible within a busy 12 months when you're given the tools and empowerment and now it's well established and well accepted. The program will continue to improve sustainability and trainee behaviors in the trainees themselves and their workplaces and beyond. And a body of projects has been created that act as a record of activity can be a resource for research and the project's subjects can be recycled to future cohorts because again, we want to be reducing um the duplication of effort. So why, why am I focusing on D C T S? Why, why did we um as a team decide to get to this group? So there are upcoming changes to the undergraduate dental curriculum and the dental specialty training curriculum. So this group seems to be in the no man's land in terms of curriculum change. We can't miss them out. They will be the specialist and consultants of the future or they'll be back in practice of dentists with special skills. Therefore, they'll be training those who've already had sustainability embedded into their education. I've adapted the program for the dental specialty trainees which is delivered in March. It's the pilot and there is research currently undergoing on the impact of the training on trainee behaviors. So to advance sustainable dentistry at the speed and scale required, this program could be looked at to be adapted or adopted nationally to suit the teaching needs at all levels of dentistry and then at all specialties, there's no reason why this should just be a DCT program and I love to end on a quote. Um So when it comes to sustainability, the time has either come to step up or to get out of the way. And John Elkington was actually the person who came up with the triple bottom line sustainability concepts of businesses in 1994. And then healthcare has adapted it through Francis Mortimer's work. We've done enough enough admiring of the bidirectional issue of climate change and oral health. The sustainability dentistry movement requires everyone to participate and we should be moving away from relying on a few members of the team with a special interest to keep it going. Sustainability needs to be embedded into our conversations with our National Bodies, Regulators Professionals and patient's okay. Thank you very much for listening. And please do put your questions in the chat because I think we can have some useful discussion today. Thank you, spare moment and I shall share this lights. Mhm. I love what? Great Jenny. Yeah, I found it while doing an essay and I thought that could be, that could be more useful. Yeah. Right. Can I just confirm you can see the slides? Yeah, I can see them. Well, hi, everyone. So my name is Sherry Scott. So I am a biomedical scientist. So I work uh I currently work at National Trent University, but I am a practice based lecturer. So I've got over 20 years of experience working in their clinical laboratory. So in today's presentation, I'm going to give you a very quick introduction to my role and my professional activities and how that's fed into my current teaching and how I've embedded my principles within that teaching and also show you some examples of how I've put that together in a student workshop. So I was a drunk trainee, biomedical scientists way, way, way back before the millennium. Um I spent 20 plus years in clinical biochemistry, processing samples, working my way up to training lead before I moved to a national trend, full time in 2018. And as a practice based lecture were expected to not only teach but also retain our HCP see, registration and work with our professional body. Now in the academia and in across the profession, there's been quite a few changes with regards to education for sustainable development, advanced H E and QA A have produced guidance documents about introducing sustainability into teaching. We've got the Science Council that have embedded sustainability into the standards for professional registration. We've got COP 26 which further highlighted the impact of climate change. And more recently, we've seen the HCP see in the UK standards have been updated and the new benchmarks for biomedical sciences updated to include sustainability. So what is E S D? What E S D is education for sustainable development? It's about instilling skills into our students into our professionals and those skills go beyond the academic. They look at systems thinking, looking at future thinking, critical thinking. So thinking about ways of actually what is happening with our world. Um What we might need to do it about it, it fosters collaboration and problem solving. I'm moving on to self awareness and normative competency. So it's actually ways of being and such. Cleo I is a a way of embedding these principles into the student to start looking at quality improvement principles in terms of that sustainability. So I put together a task driven workshop for my biomedical science students where I introduce the topic of sustainability. I gave them an overview of what the university was doing in regards to its sustainable practices and also looked to and introduce them to these skill sets that they would be developing as part of this workshop. The students got to do with skills inventory on so they could assess how much they already know about the S D G s and sustainability. We looked at carbon footprint in principles and the circular economy and we related this back to their practice so they could have a look at sustainability in the NHS as a whole within their organization. But then break that down and look at it with regards to the laboratory where they work and what of stds were relevant to their, what they did in the workplace. They develop self awareness and values, they developed leadership styles and we looked at individual disciplines. So hematology, biochemistry and his to pathology and the differences between those different lab areas and sustainability. And then we looked at what changes they could do, looked at what knowledge and skills they developed as part of the session and then lead into looking at sustainability, quality improvement. So the initial targets the objectives for the students who is about understanding that concept of sustainability and the role of the stds play, looking about those developing those competences, relating it to the these sustainability concepts, too personal and laboratory practice. And then thinking about how they could then adopt best practices in relation to their own personal and uh professional practice. But also in terms of the patient pathway. It and, and one of the things we use is the fact that labs are 10 times more used, 10 times more energy than office spaces. Labs use 10 4 times more water than office spaces and 12 billion lbs or 5.4 metric tons of plastic. Now, there's lots of things to consider. With laboratory practice, we have to consider the quality of the results. We have to consider the safety of our colleagues. But with all that in mind, there are still small changes that we can make that can improve the carbon footprint of the laboratory. So we took into the these principles from centers for sustainable healthcare, these PSAs Q I principles and I've got the students to consider when they were thinking about their research projects, what was the outcome towards the patient's and populations of any quality improvement? They were thinking of their of introduce it and looking at the environmental, social and financial impacts of any of those changes. So the students explored the relationship between that climate emergency and public health. So we really delve down into what was going on and how the increase in uh illnesses can increase the workload and mental health. As a result of that, we looked at the system and the value process mapping. So actually breaking down the patient pathway regards to where the sample comes from and what happens to that sample. When it's within the laboratory, we looked at some real life. Uh ask you I cases inaction within the NHS. And we tried to get them to think about in terms of their reset project there improvement. Um What they could potentially impact on the sustainability of their laboratory. So we applied those principles of sous Q I to design that intervention and we then had to link about where we could then assess that these PSAs Q I principles. How we, how we could assess these sustainability com E S D competencies. So because they're apprentices, um they're actually working and studying at the same time. And as part of their assessment in their final year, they have to present on their projects. So we actually looked beyond what their project was just about and looked at the actual impact of their project. So as part of their research presentation, they looked at the impact of sustainability from their project, their service improvement. And so, and they also got them to incorporate the triple bottom line in their project right up and their conclusions. So very that was a very quicker introduction, but I'm happy to answer any questions. So please post them in the chat and thank you very much. Brilliant. Thank you. So, what we'll do now is we'll go to the roundtable questions. Um So I think there's some questions that have been put in the chat. Um So there's one uh from Jenny Gertler to Thibault and Maria, what has been the uptake of this initiative in the UK. Yeah, I responded in the chat at the moment. We have to nursing schools slash universities in the UK. That port. Thank you. That would be, um, so you've got the first one in the UK. Well, first two now going, so there's potentially, now they can use that as a model for other nursing areas to copy as well. So that's good. I wasn't sure if we had any at all. Yeah, there are some definitely it's growing, it's mostly going through snowball now. So people hear about it and then they decide to join. But since it's also a formal commitment, it takes quite some time often times to get it actually signed. Thank you. Thank you to the top. I would think uh um a comment rather than a question to my colleagues is that it would be interesting if other parallel initiatives to what happened to what is happening with the nursing school commitment of other schools of healthcare professionals would develop such commitment, such formal commitments because as as table explained, it is a formal current commitment. So it's it's actually director of the school. Mhm Signs that's monitored. Yeah, from the from the writing perspective, we obviously had to kind of, I don't know if lobby is the is the right word, but we had to convince our head of school at the time that this was a positive and a forward thinking measure. Unfortunately, our head of school at the time on our current dean were very, very positive and embracing of the uh principles of the nursing school commitment. And I guess um 11 thing we perhaps thought is that um when it's just including nursing schools, like you say, other types of healthcare education are perhaps uh unintentionally excluded in our school, for example, is the school of health, sport and health sciences. So we're quite broad, we're not just nursing. Um And we're free. So I guess some of the language sometimes is important around two who that who is included and who feels included. So I'm sure that could be developed for the future. Ok. Somebody just ask, how is it monitored? Thibault? Would you like me to explain that you ask for regular, how you go about monitoring the impact or activity? So I'll, I'll explain how I experience it, but Maria at least feel free to uh to jump in. So after each semester, we ask all the participants to report their education activities, which is basically um passing us the numbers of students that have been common touch with the subject of sustainability in nursing and also the way that it happened, whether it was through practical courses, whether it was theoretical course, whether it was a standalone elective subject or guest lecture or whether it was integrated in the curriculum somehow. So we do have two times a year that we get in touch with the nursing schools um to us that information, but also we have a platform on which they can submit this information at any time a day want to. So that's how we monitor it. So I would think the scope of the monitoring is more to enable mutual support rather than policing. Perhaps monitoring is not uh correct words to be using. Yeah, because if we don't, we're being policed. Yeah. Well, if I, if I can add to that, so it's a formal commitment to include planetary health and or climate change in the nursing education. But it doesn't mean that it has to be a full stand alone subject from the first year that you remember, it can be a guest lecture in the first year. Even one, our guest lecture done by an external person with expertise also counts. So it's more of a the willingness to create change and obviously it takes a lot of time to integrate things in uh health sciences curriculum. Um But yeah, it can start small and it can grow throughout the years. So indeed, it's not really policing or actually monitoring whether you follow all the steps, but it's rather to make sure that you're on the right track to see if there's any problems or if we can get uh certain nursing schools in touch with each other to exchange what they've done or to exchange knowledge. It's about enabling support. Mm There's another question to you. Um And it says, I wonder if that nursing school commitment has had any influence or decision with any nursing registration organizations in Europe, for example, the Nursing and Midwifery Council in the UK about including planetary health as a required component of the pre registration nursing. Um Yeah, so we decided to focus on the whole of Europe because we initially wanted to uh to make the platform to learn. So if we would focus on one country might be difficult to get enough schools in there to learn. So at the moment, we have 19. So there is a possibility for nursing schools to learn from each other. But as Maria also showed in her presentation, it makes it geographically very widespread. So we have a couple of nursing schools here, a couple of nursing schools there. So there's not a lot of alignment within a country. So if we would want to work into policy or to, to influence policy, we obviously need more nursing schools in certain countries before we can engage in that at the moment, how we are influencing the critical is really like bottom up through the nursing schools that are a participant because they obviously signed that they will do something around climate change and planetary health in the curriculum. But it's something for the future. And I know that many of the current participants are really looking forward to engaging in that as well. But it will take some more time for now. Brilliant Um So we've got, I've just seen a question from James. Um but I could answer that one or try to answer that one. That's all right. So, question for Jenny perhaps because Brighton doesn't have dentistry, but the undergrad med medicine course feels very disconnected from other healthcare training. Is there much collaboration between educators of different health courses and sustainability? And what are the barriers to this collaboration? That's a good question. So I think that's, that is the ultimate question. Um So yeah, really interesting and important point that's been raised. It's similar in dentistry, the undergraduate and postgraduate world of education are very disconnected. And I think the reason for that is the different stakeholders involved. So trying to get things into undergrad involved, the Dental Schools Council and the individual dean's um and in the academic world and then if you look to postgraduate. So f one training and dental core training, for example, that's all led by um the trust and then the Dina is in charge of the training. So I think it can feel a bit disjointed because of all the different people who are involved. Well, at this stage, I think it's still important to just try and embed it into every place that we can with a view to getting it more widespread. Eventually, we've just got to have a bit of hope that these things will just automatically start connecting, which they are already. And what was a little bit. Um So the barriers, there's a lot of red tape and bureaucracy, different stakeholders involved. But as more and more legislation guidance comes in and curriculum changes and there should be more merging. I think this is one of the reasons why the PHR see focuses on undergraduate only. Um correct me if I'm wrong Jane, because the different NHS trusts and get involved on the post grad side would just make things extra complicated at the moment. But I think there should be a view to doing perhaps the post grad version of it interested to hear thought. Mhm. Uh huh. We've got a couple down here. Uh has this one been answered? Uh Got Jenny at the moment. We have uh university of like economic as members of the commitment. Okay. And then this one from Kibuye, we only know the only know at the moment we have the first increase in the magnitude of the network to have more leverage. We are going to growing quite fast. But in many different countries, we feel we need more nursing schools in a particular country before we can engage in influencing education policies. At the moment, we're most mostly influential bottom up through our members. Education. That's a goal is to also create leverage to influence national education policies. I think we need to finish quite soon. There's one last question um from Rory for Sherry around experience in providing the talk and engage with your clinical spell do you want to? Uh Yes, sorry. So I do do CPD lunchtime talks at the MY NHS colleagues. So I go out to clinical labs, but I've also been working with other professional bodies. So I've um recently did a talk with the Manchester Medical Society. I'm working with the R C path and the A C B to try and do some educational events and some Panama events through centers for sustainable healthcare. So I'm more than happy for you to reach out if you want me to do something locally. And uh it's definitely worth getting into conversations with your local lab because it is a part of it. We're gonna see some real differences in, in reducing unnecessary tests, utilizing point of care and also just thinking about how much blood we really need to take. I think that covered all the questions. Yeah. So which lab are you Rory? Do you want to pop it in the chat and I can happy to reach out. Brilliant. I'll put my email in the chat and anyone that wants to reach out and connect, I'm more than happy to liaise and put you in contact with your local labs. Fantastic. What time is this lab closing? Uh I think four minutes ago, I think we need to close it now. Okay. Well, thank you very much. Everyone. Really good talks and answers and questions. So, are we going back to the main room now? Yeah, I believe So we've got our next keynote there. Thanks everybody. Thank you. Thank you. Bye.