[Systemic barriers prevent competence-based teaching in the field of planetary health : An online survey among students and descriptive analysis of the National Competence-based Catalogue of Learning Objectives for Medicine 2.0].

Abstract

Background: The current medical studentship will be a generation of doctors who will experience the effects of climate change on global health during their clinical practice. This interplay between the integrity of ecosystems and human health is being investigated in the multidisciplinary research field planetary health. To cope with these climate-related health effects, students must be given a profound knowledge of the impact of destabilized natural systems on human health; however, despite the actuality of this topic recent studies show that competence-based teaching on this topic is insufficient. Considering the relevance of this topic, this study aim to identify systemic barriers preventing competence-based teaching in the field of planetary health.

Methods: Systemic barriers were first analyzed by means of an anonymous online survey of students. Students who completed the compulsory internship in anesthesiology in the winter semester 2021/2022 were invited to take part in this survey. Obstacles preventing competence-based teaching in the field of planetary health were defined as systemic barriers. Secondly, the frequency of defined terms related to planetary health was determined. This analysis was carried out to investigate the integration of planetary health into the "National Competence-based Catalogue of Learning Objectives for Medicine 2.0" (NKLM 2.0).

Results: Out of 130 students who participated in the internship, 54% (n = 70) submitted a completed questionnaire. Of these students 96% (n = 67) agreed with the statement that climate change will have a negative impact on patients' health. For 53% (n = 37) of participants, planetary health had not previously been part of teaching courses. In accordance, terms that are thematically related to planetary health were rarely used in the NKLM 2.0.

Conclusion: The study identified two systemic barriers to competence-based teaching in the subject of planetary health. The first barrier is the low number of compulsory classes which represents the insufficient integration of planetary health into the curriculum. Secondly, the subject of planetary health has not yet been sufficiently integrated into the NKLM 2.0. The current reform of the NKLM 2.0 represents an opportunity to overcome these two barriers and to implement competence-based teaching through joint efforts.