Exploring the Barriers and Facilitators to the Integration of Planetary Health into the Undergraduate Medical Curriculum: A Mixed-Methods Study of the Perceptions and Attitudes Among Students and Educators at the Royal College of Surgeons in Ireland

Background: Planetary health is a burgeoning field that advocates for evidence-based policies to promote human health, wellbeing and equity globally - while acknowledging the political, economic, social and environmental systems that dictate the efficacy of these policies. The overall aim of this project was to investigate the barriers and facilitators that exist to the integration of planetary health into the undergraduate medical curriculum at the Royal College of Surgeons in Ireland (RCSI). The objectives were: to appraise the existing literature regarding the integration of planetary health issues into medical curricula; to identify and explain the current level of knowledge that undergraduate medical students and medical educators have towards planetary health issues; to assess whether and how planetary health topics should be integrated into the curriculum from an undergraduate medical student and medical educator perspective; and, to make recommendations for implementing planetary health as part of a future undergraduate medical curriculum. Methods: A comprehensive, narrative review of the literature was completed. Qualitative semi-structured interviews were conducted with medical educators involved in the active teaching of undergraduate medical students. Consecutively, a quantitative survey was distributed to undergraduate medical students. Findings from both the qualitative and quantitative arms of the study were integrated. Results: Both educators and medical students, in the majority, believe that planetary health should be integrated into undergraduate medical education (77% of students agreed with the statement “It is important to make environmental change and its health-effects a part of medical curriculum”), in the context of a current perceived deficit. Educators and students endorsed a wide array of teaching methodologies and the notion of an integrated, spiral curriculum. Conclusions: This study makes recommendations for the implementation of planetary health in medical curriculum. Further research is needed to set priorities for future undergraduate medical curriculum content development and delivery.