A finished thesis is a product of four years of intense labor. Therefore, one can easily forget that it is also, and…
Flipping the classroom to teach climate and health in medical education

In June 2021, a doctor diagnosed a woman in her 70s with “climate change” after she showed up at an emergency room in western Canada with breathing problems. She was dehydrated and suffering from asthma and diabetes. This was during a record heat wave in the region with temperatures around 40 °C and the woman lived in a trailer with no air conditioning.
In February 2013, a nine-year-old girl died after an acute asthma attack in south London after more than 25 emergency hospital admissions in the previous three years. In 2020, a landmark coroner’s report made the nine-year-old girl the first person in the world to have air pollution cited as a cause of death. The coroner said the failure to reduce pollution levels to legal limits possibly contributed to her death, as did the failure to provide her mother with information about the potential for air pollution to exacerbate asthma.
These are just two examples of real-world cases that can be used in the medical curriculum to describe the effects of climate change on human health. Climate change represents one of the biggest global health threats of the 21st century and is already adversely affecting human health and health systems.
For that reason, numerous medical professional societies, schools, and students have highlighted the need for a basic understanding of climate change and its impacts on health. Because of its complexity, basic science teaching may not be the optimal way to educate medical students in climate change and health if we want the knowledge to be applied to solve and explain problems instead of just passing examinations. An alternative to traditional learning is the flipped classroom approach which has become increasingly popular in health professions education. The essence of a flipped classroom is that the activities carried out during traditional class time and self-study time are reversed or ‘flipped’. This differs from a traditional, more passive approach where time in class is primarily devoted to the presentation of course content through lecturing with minimal application that instead occurs through homework and other assignments outside of class. Evidence suggests that the flipped classroom approach in health professions education yields a significant improvement in student learning compared with traditional teaching methods and student feedback has shown a significant improvement in satisfaction with flipped learning to standard lectures, both in scores and free-text feedback.
Combined with small group learning paradigms like team-based learning (TBL) in medical education, a flipped classroom approach also seems to be more suitable than traditional teaching to improve student engagement. One crucial aspect of TBL is that students prepare in advance of the lecture by reading for example a scientific paper, watching a video, or listening to a podcast. This procedure facilitates engaged active learning in the classroom when the instructor is present to guide and provide real-time feedback when the student can apply their knowledge through clinical problem-solving activities. Today, various health professionals have adopted flipped classrooms and TBL into their medical curriculum with an overwhelmingly positive response from students. Evidence also suggests that TBL provides positive contributions to healthcare education, helping to prepare students for increasingly complex healthcare systems. But how can these positive experiences be translated into a more complicated area like climate and health?
Climate change is often described as a “super wicked problem” lacking a single definition and solution, and thus a perfect candidate for smaller group discussions and TBL problem solving that can be suitable parts in skill building and knowledge production. This will further increase students’ ability to grasp the complexity between climate change and health outcomes and what this will mean for them as clinicians.
To do this, certain steps will need to be followed. First, didactics must be based on the latest climate research when developing novel curricula to educate medical students on the impacts of climate change as it is rapidly evolving. Second, clear educational objectives must be set up that will give students a basic understanding of climate change and health but also relational so that they can explain and analyze their role as healthcare professionals. Third, medical students in a TBL activity on climate and health will come prepared in advance for the lecture.
It is the future medics that will be at the frontline of climate change dealing with the fallout of a warmer planet. By flipping the classroom, we can hopefully prepare them for this challenge by engaging in climate resilience to protect their patients’ health and advocate for climate solutions. This kind of teaching will also be important for graduate and post-graduate studies that also will need to have some basic understanding of climate change and how it affects human and planetary health.
Featured image by Darwin Laganzon from Pixabay