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Climate Change and Sustainability in Health Professions Education: A Realist Review Protocol
Marah Elfghi1, Emer Galvin1, Deirdre Bennett1
1Medical Education Unit, University College Cork School of Medicine, Cork, County Cork, T12 AK54, Ireland.
HRB Open Research
|February 13, 2026
Summary
This realist review examines climate change and sustainability (CC&S) education in health professions education (HPE). It aims to identify effective strategies for integrating CC&S into curricula to equip future healthcare professionals for climate-related health challenges.
Area of Science:
- Environmental Health
- Medical Education
- Public Health Policy
Background:
- Climate change presents a significant global health threat, impacting public health systems and healthcare professions education (HPE).
- Current health professions education (HPE) lacks sufficient formal training in climate change and sustainability (CC&S), hindering the development of essential skills for healthcare professionals.
- Existing reviews offer limited insight into the specific mechanisms and contextual factors that determine the success or failure of CC&S education interventions.
Purpose of the Study:
- To conduct a realist review to understand the conditions, mechanisms, and contexts of effective climate change and sustainability (CC&S) education within health professions education (HPE).
- To identify how CC&S education interventions work, for whom, and under what circumstances to inform curriculum development and implementation.
- To provide practical, transferable, and context-sensitive insights for integrating CC&S education across diverse healthcare disciplines and educational settings.
Main Methods:
- A realist review methodology adhering to RAMESES standards will be employed.
- A comprehensive search of academic databases and grey literature will identify CC&S education interventions in undergraduate, postgraduate, and continuing professional education.
- Data extraction will utilize a Context-Mechanism-Outcome (CMO) framework to analyze intervention effectiveness, with iterative refinement of the programme theory through team consensus.
Main Results:
- This section is to be populated upon completion of the review; preliminary findings will focus on identifying key contextual factors, mechanisms, and outcomes influencing CC&S education interventions.
- Anticipated results will detail successful and unsuccessful intervention strategies, providing nuanced understanding beyond traditional systematic reviews.
- The review will synthesize evidence to explain the 'how' and 'why' of intervention effectiveness in diverse HPE settings.
Conclusions:
- This realist review will offer practical guidance for integrating CC&S education into HPE curricula, addressing current limitations in faculty expertise and curriculum constraints.
- Findings will inform evidence-based curriculum development, faculty training initiatives, and policy recommendations to prepare healthcare professionals for climate-related health challenges.
- The study aims to enhance the capacity of the healthcare workforce to promote sustainable practices and address the health impacts of climate change effectively.
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