Successfully integrating sustainability into medical science education with mixed-method iterative approaches

Students, accrediting bodies, and institutions are increasingly calling for educators to include planetary health (PH) in medical and health professions curricula. With the World Health Organization identifying climate change as the single biggest health threat facing humanity, health professionals must be prepared for the impacts of a changing climate, biodiversity loss, and pollution. There is an expectation that they will also need to practice sustainable and climate-resilient healthcare. Following limited beneficial outcomes in a first attempt to include PH content in an introductory Physiology subject for health sciences and medicine pathway students at an Australian university, we utilized an educational research design theory and design-based research methodology to develop, implement, and evaluate the integration of PH into a Physiology subject. Key stakeholders (students and tutors) provided ongoing feedback at regular points before, during, and at the end of the 12-week semester. Based on the findings, we offer evidence-based recommendations for integrating PH into an existing subject that avoids overloading an already busy curriculum. Recommendations include providing a clear definition of PH at the start of the semester, embedding a weekly "fact" in lecture slides, engaging learners in discussions during tutorials, linking PH concepts during hands-on practical laboratories, and establishing a dedicated PH learning objective for the subject.<b>NEW & NOTEWORTHY</b> Planetary health can be integrated into current medical and health professions subjects without the need to remove existing content or excessively impact staff and student time commitments. It is possible to meet student, faculty, employer, and accreditor expectations of preparing graduates to work in a changing healthcare system.