Preparing for tomorrow: Iranian medical students’ attitudes toward climate change and its integration into the medical curriculum

Climate change is widely recognized as one of the most significant threats to global health today. Medical doctors play a crucial role in climate change mitigation and adaptation by educating patients, advocating for sustainable healthcare practices, and incorporating climate-related health impacts into medical education and professional responsibilities. In this study, Iranian medical students were assessed on their attitudes regarding climate change and whether it should be included in the curriculum. A national online survey was conducted at Smart University of Medical Sciences from November 2021 to March 2022. The participant group comprised 553 medical students from Iran who were enrolled in the summer semester program at Smart University of Medical Sciences (SMUMS), representing 38 medical universities across the country. The research instrument included 22 items on a 5-point Likert scale, focusing on climate change in medical education, adapted from two earlier questionnaires. Content validity was established through expert review using Content Validity Ratio (CVR) and Content Validity Index (CVI) methods, leading to a refined 22-item questionnaire. Face validity was confirmed via pilot testing with students. Reliability analysis with 100 participants showed satisfactory internal consistency (Cronbach’s alpha). It addressed two categories, which include six key components: curriculum enrichment, teaching activities, attention to learning, concern for others, social responsibility, and individual accountability. Data analysis was performed using SPSS version 24. Out of 650 medical students who received the questionnaire, 553 completed and returned it, resulting in a response rate of 86%. The sample comprised 177 males (32%) and 376 females (68%). In the category of Integrated Education, the mean scores were as follows: Curriculum Enrichment (3.2), Teaching Activities (2.82), and Attention to Learning (3.01). For the Self-Responsibility category, the results included Concern for Others (3.63), Social Responsibility (3.52), and Individual Responsibility (3.78), with Individual Responsibility receiving the highest score. The independent t-test showed a statistical difference between gender and opinion toward climate change (p = 0.01). The analysis of variance showed that the differences between mean scores of academic years from various years of medical school were statistically significant (p = 0.03). According to the study, integrating climate change into medical curricula is essential to equip future physicians with the knowledge and responsibility to address climate-related health challenges.