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Using Visual and Narrative Methods to Achieve Fair Process in Clinical Care
Published on: February 16, 2011
A Longitudinal Pediatric Residency Climate Justice Curriculum
Harleen Marwah1, Isha Thapar2, Mark McShane3
1at the time of the study, was a PGY-3 Resident, Department of General Pediatrics, Children's Hospital of Philadelphia, Philadelphia, Pennsylvania, USA, and is now an Editorial Fellow, New England Journal of Medicine, Waltham, Massachusetts, USA.
Abstract:
Background Graduate medical education programs must prepare physicians to adapt their care for patients whose health equity and outcomes are being threatened by climate change. This article presents the implementation of a longitudinal climate justice curriculum within a pediatrics residency program. Objective To measure the self-reported changes in attitudes and intentions for change in behavior after implementation of a climate justice curriculum. Methods A longitudinal, 4-part, climate justice and health equity (CJHE) curriculum was implemented from 2023 to 2024 into the broader advocacy training of a pediatrics residency program. Resident participants completed pre- and post-session surveys that assessed their attitudes toward climate change and health, as well as their intentions to engage in climate advocacy. Paired deidentified responses were analyzed via Wilcoxon signed-rank test. Results Thus far, facilitators have conducted 4 introduction sessions, 4 narrative medicine sessions, and 3 health system sustainability sessions. Sixty-eight of 100 residents (68%) completed both pre- and post-session surveys. The curriculum was associated with increased self-reported understanding of how climate change impacts human health (CJHE 1: median of pairwise averages of pair-differences [MPA]=1.00, P<.001; CJHE 3-4: MPA=1.00, P<.001), increased agreement that health care providers can be effective climate advocates (CJHE 1: MPA=2.00, P<.001; CJHE 3-4: MPA=1.50, P<.001), and increased intention to discuss the health impacts of climate change in future patient encounters (CJHE 1: MPA=1.00, P<.001; CJHE 3-4: MPA=1.00, P<.001). Conclusions This longitudinal CJHE curriculum demonstrated acceptability and increased participants' self-reported understanding of how climate change impacts human health and the ways in which physicians can act as advocates.
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