Air Pollution Education: A Novel Curriculum for Pulmonary Fellows

Air pollution plays a significant role in human health, impacting respiratory outcomes. Despite decades of evidence detailing these health consequences as a result of both short and long-term air pollution exposure, the harms of air pollution exposure are infrequently taught at the graduate medical education level, particularly at the level of pulmonary fellowship. As the climate changes and air pollution increases, patients are becoming increasingly aware of how these changes affect their health, but do not routinely receive guidance from their pulmonologist, in part due to limited healthcare provider knowledge.

We developed an air pollution curriculum to increase fellow knowledge about air pollution and its health impacts by focusing on the question "what do pulmonologists need to know about air pollution?"

Using Kern's six steps for curriculum development, we developed an air pollution and health impact curriculum. Following identification of the five domains of focus (composition, health effects, monitoring, risk mitigation, and environmental justice) by a panel of content experts, a 20-item knowledge scale was developed via a modified Delphi process to deliver as both a pre- and post-curriculum assessment. By delivering it over the course of the year and infusing it with interactive components, the curriculum allowed for implementation of spaced repetition, active recall, and reinforcement of key air pollution topics to facilitate learning a novel topic within the constraints of an existing educational program's structure.

Fellows demonstrated an increase in knowledge in all five domains of the air pollution curriculum when comparing pre- and post-course assessments (p < 0.001). The curriculum was well-received with requests for both repetition of the curriculum and expansion to other climate-related topics.

This study demonstrates the feasibility and effective implementation of an air pollution curriculum for pulmonary and critical care trainees that increases knowledge of this critical environmental exposure.