Incorporating Health Policy and Advocacy Curricula Into Undergraduate Medical Education in the United States

Physicians serve as crucial advocates for their patients. Undergraduate medical education (UME) must move beyond the biomedical model, built upon the perception that health is defined purely in the absence of illness, to also incorporate population health through health policy, advocacy, and community engagement to account for structural and social determinants of health. Currently, the US guidelines for UME lack structured training in health policy or advocacy, leaving trainees ill-equipped to assume their role as physician-advocates or to engage with communities. There is an undeniable need to educate future physicians on legislative advocacy toward improving the social determinants of health through the creation of evidence-based health policy, in addition to training in effective techniques to engage in partnership with the communities in which physicians serve. The authors of this article also present curricular case studies around two programs at their institution that could be used to implement similar programs at other US medical schools.

What would you do (WWYD)? Thinking outside the virtual lecture box during COVID-19 and beyond

Background

The COVID-19 pandemic disrupted many aspects of personal and professional life for surgeons, with resulting suspension of many in-person educational opportunities in favor of virtual education programs. Adapting to these new challenges, we developed, implemented, and evaluated a novel approach to Department of Surgery Grand Rounds to meet the educational needs of residents.

Methods

At the outset of COVID-19-related restrictions, educational leadership performed a needs assessment of resident education, leading to a quick pivot to video-based programming. We developed "What Would You Do?" (WWYD), a virtual case-based educational session. Junior residents worked with senior residents, fellows, and faculty to develop disease-specific cases and questions, which were then presented to a panel of invited national subject experts. Feedback was collected from attendees after each grand rounds session via electronic survey, and the panel logistics and "flipped classroom" style of questioning iteratively adapted based on survey responses, verbal feedback, and educational principles. A department-wide survey was conducted at the end of the first year of virtual sessions to assess faculty and trainee perceptions of virtual vs. in-person didactics.

Results

While COVID-19 educational materials were widely available, needs assessment found that surgical educational programming for trainees was dramatically reduced. Over a period of 24 months, we hosted twelve WWYD sessions with 20 internal faculty and 22 national virtual guest panelists. WWYD covered core surgical topics, such as hernia, colorectal, trauma, endocrine, vascular, foregut, and transplant. Weekly attendance ranged from 40 to 100, including faculty, trainees, and students. Attendees at WWYD grand rounds reported more strong agreement that speakers communicated effectively (93.7% vs. 79.8%, p < 0.0001), and that topics were engaging (92.4% vs. 78.5%, p < 0.0001) and relevant (91.5% vs. 79.7%, p < 0.0001), when compared to didactic virtual grand rounds. Department-wide survey noted differences in faculty vs. trainee priorities for didactic sessions, with faculty both finding virtual didactics more convenient (92.1% vs. 71.4% strong agreement, p = 0.004) and more highly valuing convenience (89.7% vs. 69.1% highly value, p = 0.005).

Conclusions

During an isolating time, the WWYD format leveraged affordances of a virtual platform to bring diverse content experts together for disease-specific discussions, aligning with problem-based, active learning pedagogical approaches which have proven more effective than lectures. Attendees found the format more engaging than virtual didactic lectures, but department-wide survey revealed a dichotomy of didactic priorities between faculty and trainees, with faculty more strongly favoring attendance convenience. WWYD is well-positioned to deliver a didactic educational experience with both engagement and convenience.

[Development of first-class biotechnology major under new economic situation]

The rapid development of bioeconomy urgently needs the support of biotechnology talents. Establishing an innovative training mode of biotechnology talents can provide support for regional economic development and industrial upgrading. Closely revolved around the concepts of new engineering disciplines development, such as serving the national strategy, docking industry, leading the future development and student-centered, a new economy-oriented training system was developed in School of Bioengineering of Dalian University of Technology. These systems include interdisciplinary curriculum system reconstruction, project-based teaching mode reform, evaluation system implementation and other aspects. The reform and exploration of the first-class biotechnology major under the new economic situation, puts forward the theory of value guidance, deep foundation, strong sense of innovation, technical and non-technical core ability literacy. This reform meets the industry demand for talent diversification, personalization, and dynamic change, helps the merge of industry and education, which provides a way for fostering first-class biotechnology-majored undergraduates.

Quantitative metrics and psychometric scales in the visual art and medical education literature: a narrative review

The authors conduct a narrative review of the quantitative observation metrics and psychometric scales utilized in the visual arts and medical education literature in order to provide medical educators with a 'toolkit' of quantitative metrics with which to design and evaluate novel visual arts-based pedagogies. These efforts are intended to support the AAMC and National Academy of Sciences, Engineering, and Medicine's aims to formally evaluate and integrate arts and humanities curricula into traditional scientific educational programming. The scales reviewed examine a variety of domains including tolerance for ambiguity, bias, burnout, communication, empathy, grit, and mindfulness/reflection. Observation skill, given the heterogeneity of quantitative metrics, is reviewed separately.

Efficacy of Peer-to-Peer Education for Emergency Medicine Resident Financial Literacy: Curriculum Development Study

BACKGROUND

Early career physicians are under enormous stress from rigorous academic demands and financial insecurity due to increasingly large loan burdens and stagnant income. There are no institutionally required training programs to educate professionals on financial pitfalls or strategies for overcoming these burdens. Fiscal ignorance leaves them in a vulnerable position to be taken advantage of often, at great personal cost.

METHODS

Using a cross-sectional, convenience sample of emergency medicine residents at a single center, we evaluated the benefit of a six-month curriculum on financial education. Focusing on topics that were most pertinent early in medical careers, we assessed the utility of a six-lecture series totaling three hours of education on fundamental financial literacy. Lectures were given by a single educator with no formal financial background in the following areas: general principles, student loans, retirement accounts, basic taxes, real estate, and insurance.

RESULTS

Using pre-test and post-test information on 55 residents, financial literacy, as assessed by a 24-question multiple-choice survey, increased from 50% to 62% (p=<.001). Subgroup analysis was also performed within each financial category as well as by postgraduate year (PGY) of training. Raw data of individual percentages achieving specific financial milestones demonstrated an objective increase in the number of residents contributing to retirement accounts, creating an emergency fund, and establishing student loan repayment plans after the curriculum.

CONCLUSIONS

Programs can institute sufficient financial literacy education for trainees that covers financial foundations. These programs can be taught without financial professional expertise or long hours of didactics.

Enhancing interprofessional collaboration and interprofessional education in women's health

This article is from the 'To The Point' series from the Association of Professors of Gynecology and Obstetrics Undergraduate Medical Education Committee. The purpose of this review is to provide an understanding of the differing yet complementary nature of interprofessional collaboration and interprofessional education as well as their importance to the specialty of Obstetrics and Gynecology. We provide a historical perspective of how interprofessional collaboration and interprofessional education have become key aspects of clinical and educational programs, enhancing both patient care and learner development. Opportunities to incorporate interprofessional education within women's health educational programs across organizations are suggested. This is a resource for medical educators, learners, and practicing clinicians from any field of medicine or any health-care profession.

Development, implementation, and evaluation of Teach Back curriculum for community health workers

Teach Back is a commonly used communication method to improve patient understanding and retention of health information. The method has been shown to be effective in improving patient and healthcare system outcomes, including patient health literacy and hospital readmissions. Community health workers (CHWs) are frontline healthcare workers who can help address patient health and social needs associated with hospital readmissions. However, a gap exists in Teach Back curricula and training methods reflecting the scope of work for CHWs. The objective of this training was to provide CHWs with didactic information and skill building practice curriculum focused on the integration of Teach Back into clinical patient interactions, care coordination, and follow-up support. A multidisciplinary team of academic and clinical partners at a large academic health university developed, implemented, and evaluated a 3-week pilot Teach Back training with CHWs through a quality improvement approach. The CHWs reported overall satisfaction with the training and instructors. The academic clinical partnership allowed the training to be tailored to the daily clinical workflow as reflected in the CHWs agreement that the training was relevant and practical. With the repeated exposure to Teach Back each week, the CHWs also reported an increase in confidence and conviction in using Teach Back. Additional implementation and evaluation of the training curriculum for CHWs is needed to gain further insights into Teach Back and training best practices and translation into practice.

Best Practices in Medical Documentation: A Curricular Module

OBJECTIVE

To create and validate a checklist for high-quality documentation and pilot a multi-modal, immersive educational module across multiple institutions. We hypothesized that this module would improve knowledge, skills, and attitudes in medical documentation.

METHODS

Module design was grounded in an established curriculum design framework. We conducted the study across 12 pediatric critical care fellowship programs between September 2017 and January 2018. Workshops were allotted 90 minutes for completion. We utilized a pre-/post- study design to determine the workshop's impact. Changes in knowledge were assessed through pre and post testing. Changes in skills were evaluated with a validated checklist for inclusion of key documentation elements. Changes in attitudes were determined through learner self-assessment RESULTS: 83 of 138 eligible fellows (60%) started the module and 62 of 83 (75%) completed data sets for analysis. Immediate post-testing demonstrated modest statistically significant improvement in knowledge, skills, and attitudes. The workshop was easily disseminated and deployed CONCLUSIONS: This study demonstrates that a multi-modal educational intervention can lead to improvement in medical documentation knowledge, skills, and attitudes in a cohort of PCCM fellows and be easily disseminated for use by other specialties and types of clinicians.

Participation in a Longitudinal Seminar Series Increases Medical Student Engagement with the COVID-19 Pandemic

The coronavirus disease 2019 pandemic created unprecedented challenges to medical education for learners at all levels, particularly for learners who were not able to function in a clinical role. This article describes the development and evaluation of a new preclinical elective course for students at the Baylor College of Medicine covering the healthcare field’s multidisciplinary response to the pandemic. In addition, this study presents evidence that virtual elective seminars can be implemented successfully to increase student engagement with current events in medicine.

Objectives

The coronavirus disease 2019 (COVID-19) pandemic required a multifaceted response by healthcare professionals. Medical students played only a limited role in the early response, resulting in feelings of disengagement. The authors developed a discussion-based elective course reviewing the COVID-19 response to address this gap in medical student education.

Methods

Preclinical medical students enrolled in this elective participated in weekly virtual interactive seminars led by expert faculty members. Students completed a final survey quantifying their understanding of the overall COVID-19 response, knowledge of its individual facets, and their feelings of personal engagement on a Likert scale from 1 to 5, with 5 representing the most understanding or engagement. The differences in mean scores on “precourse” and “postcourse” surveys were compared.

Results

A total of 65 students enrolled in the elective. Students demonstrated significant improvement in perceived holistic understanding of the response of the medical field to the COVID-19 pandemic (P < 0.001) and in feelings of personal engagement with the pandemic (P < 0.001). In addition, students reported a significantly increased understanding of each facet of the pandemic response covered in the course (8 questions; all P < 0.001).

Conclusions

Preclinical medical student participation in a discussion-based seminar course reviewing the COVID-19 pandemic significantly increased feelings of engagement with and understanding of the response of the medical field to the pandemic.

The balint method online: Past, pandemic and future

The Balint Method has been used worldwide since Michael and Enid Balint developed it in the 1950s. Even with the proliferation of Balint groups there were still doctors and other clinicians who did not have local access. The online format was developed to provide Balint groups to those individuals. With the pandemic the majority of clinicians were unable to get together in person. The online format provided a lifeline for Balint work. This article provides a short history of the development of Balint online, how the pandemic affected further development, and a summary of what was learned from that experience.

Responding to the need of postgraduate education for Planetary Health: Development of an online Master's Degree

Planetary Health has emerged as a new approach to respond to the existential risks that the clime and global environmental crises pose to human societies. As stated by various stakeholders, the challenges involved in Planetary Health are of such magnitude that education must be at the forefront to obtain a meaningful response. Universities and higher education institutions have been specifically called to embed the concept of planetary stewardship in all curricula and train the next generation of researchers and change makers as a matter of urgency. As a response to this call, the Universitat Oberta de Catalunya (UOC), the Universitat Pompeu Fabra (UPF), and the Barcelona Institute for Global Health (ISGlobal) developed the first online and asynchronous Master in Science (MSc) in Planetary Health. The aim of the programme is to train a new generation of academics and professionals who understand the challenges of Planetary Health and have tools to tackle them. This article describes the development of the curriculum of this MSc, presents the main characteristics of the programme and discusses some of the challenges encountered in the development of the programme and its implementation. The design of this MSc was based on: the alignment of the programme with the principles for Planetary Health education with a focus on human health; a multi-, inter-, and trans-disciplinary approach; the urgency to respond to the Anthropocene challenges; and the commitment to the 2030 Agenda. The MSc was recognized as an official degree by the Agency for Quality of the Catalan University System, included in the European Quality Assurance Register for Higher Education, and the Spanish National Academic Coordination body in April 2021 and launched in October 2021. There are currently more than 50 students enrolled in the program coming from a broad range of disciplines and geographic locations. The information presented in this article and the discussion on challenges encountered in developing and implementing the programme can be useful for those working in the development of similar programs.

Piloting web-based structural competency modules among internal medicine residents and graduate students in public health

Introduction

Fewer than half of internal medicine program directors report any health disparities curriculum. We piloted a web-based healthcare disparities module among internal medicine (IM) residents to test effectiveness and feasibility, compared to a convenient sample of graduate students enrolled in a public health equity course.

Methods

IM residents participated in an in-person session (module 1: introduction to racial and ethnic health disparities), but first, they completed a pre-module knowledge quiz. Two weeks later, they completed module 2: "unconscious associations" and a post-module knowledge quiz. For the control arm Yale School of Public Health (YSPH) students enrolled in a course on health disparities completed the pre-module knowledge quiz, module 1, and 2 as required by their course instructor.

Results

Forty-nine IM residents and 22 YSPH students completed the pre-module quiz and Module 1. The mean (SD) score out of 25 possible points for the IM residents on the pre-module quiz was 16.1/25 (2.8), and 16.6/25 (3.2) for YSPH students, with no statistically significant difference. Nineteen residents (38.8%) completed the post-module quiz with a mean score of 16.7/25 (2.2), Hedge's g =0.23, compared to 18 (81.8%) YSPH students, whose mean (SD) score was 19.5/25 (2.1), Hedge's g=1.05. YSPH students' post-module quiz average was statistically significantly higher than their pre-module test score, as well as the residents' post-module test (P < 0.001). In examining participants' responses to specific questions, we found that 51% (n = 25) of residents wrongly defined discrimination with an emphasis on attitudes and intent as opposed to actions and impact, compared to 22.7% (n = 5) YSPH students before the module, vs. 63.2% (n = 12) and 88.9% (n = 16) respectively after.

Conclusion

After completing a healthcare disparities course, graduate students in public health saw greater gains in knowledge compared to IM residents. Residents' responses showed knowledge gaps such as understanding discrimination, and highlight growth opportunity in terms of health equity education. Furthermore, embedding health equity education in required curricular activities may be a more effective approach.

Training needs and curriculum of continuing medical education among general practitioners in Tibet, China: A cross-sectional survey

Background

Uneven distribution of health resources is higher in Tibet than in other regions. The development of core professional capability for general practitioners (GPs) is the main goal of continuing medical education (CME) training programs.

Aim

This study aimed to explore the needs of CME for GPs and provide advice for the development of policy, practice, and CME curriculums.

Methods

We conducted a cross-sectional online survey among GPs in Tibet Autonomous Region, China. We designed an online questionnaire including the demographic section, training contents, and training formats about CME.

Results

A total of 108 questionnaires were included in this study. Notably, 79 (73.15%) were women and 56 participants (51.85%) were working in primary care settings. We developed a curriculum priority: first-choice, major alternatives, and secondary considerations. The topics identified as first-choice for CME were related to "cardiovascular disease" (85.19%), "respiratory disease" (81.48%), and "digestive disease" (80.56%). Major alternatives included two essential knowledge and eight clinical skill items. We rated 10 items as secondary considerations. Only 39.81% ranked mental health as an essential priority; bedside teaching (51.85%) was the first choice.

Conclusion

We presented priority areas identified in this study to focus on CME for GPs in Tibet. The 23 topics may reflect the features of general practice, which increasingly require common disease management skills, while a demand-oriented curriculum and staged training plans should be adopted. CME programs should be adapted dynamically to respond to evolving needs.

Wilderness Medicine Curricula in United States EMS Fellowship, Emergency Medicine Residency, and Wilderness Medicine Programs

OBJECTIVE

Wilderness Medicine (WM) focuses on care delivered in austere or resource-scarce environments. The Accreditation Council for Graduate Medical Education (ACGME) requirements and core content for Emergency Medicine (EM) residency and Emergency Medical Services (EMS) fellowship in the United States (US) include some WM topics that are covered to varying degrees in these programs. Furthermore, there are no ACGME-approved WM fellowships or specific curricula. Different training programs may develop WM content and curricula that differ significantly, leading to variations in WM competencies and training. In 2009, the American College of Emergency Physicians (ACEP) Wilderness Medicine Section created a Fellowship Subcommittee and Taskforce to develop a standardized curriculum and core content for EM-based WM fellowships. However, to date, EMS fellowship and EM residency WM curricula in the US content have not been analyzed for consistency with the ACEP WM fellowship curriculum.

METHODS

In this study, the WM curricula components of EM residency and EMS fellowship were evaluated using the ACEP WM fellowship curriculum as a control. Potential curriculum gaps for each program type were identified.

RESULTS

Of the 19 WM competencies developed by the ACEP Wilderness Medicine Section Fellowship Subcommittee and Taskforce, EMS fellowship covers more WM topics (16 topics, or 84%) than EM residency (12 topics, or 63%), and combined, they cover 89% of these topics.

CONCLUSIONS

By expanding to cover two additional WM topics, all WM curricula topics recommended by the ACEP WM fellowship curriculum could potentially be covered in EM residency + EMS fellowship; however, the depth of education in each topic may vary. It may be beneficial for Graduate Medical Education (GME)-level learners for programs to implement hands-on educational experiences in WM topics.

Conceptualization, development, and evaluation of 'pharmaceutical product development' graduate program within pharmacy discipline

Objective

Designing a region's need-based programs can be an exceptional complement boosting the knowledge economy of the country. United Arab Emirates (UAE) is increasingly focusing on the pharma and biotech sectors. As a result, there have been increasing demands for qualifications in pharmacy education to fit into higher roles in pharmaceutical industries and multinational companies (MNCs) in the region.

Method

This study is a case demonstration that details the design processes authors used for the graduate program 'Pharmaceutical Product Development'.

Results

The three stages in program positioning; identifying the need for the new program, program design, and development, and program effectiveness are illustrated in this manuscript.

Conclusion

The authors believe that this manuscript serves as a valuable resource for novice curriculum developers in the development of new educational programs.

Walking Between the Raindrops: Evelyn's Birth Story

The author describes her 3-day birth process that results in a healthy delivery. Initial concerns such as the tension of an induction and the 20th anniversary of 9/11 dissipate as a baby girl is welcomed as the second child to a Boston-area family.

Progress and challenges in the harmonisation of European undergraduate dental education: A systematic literature review with narrative synthesis

INTRODUCTION

Harmonising education to support workforce mobility has been a policy objective for the European Union. However, alignment across varied national contexts presents challenges in dental education.

METHODS

A systematic literature review with narrative synthesis. Searches of the electronic databases Embase [Ovid]; MEDLINE [Ovid]; Scopus; CINAHL; AMED and PsycINFO were conducted for relevant material published between 2000 and 2019 on undergraduate curricula, quality standards and learning outcomes in dentistry.

RESULTS

Seventy-six papers met the inclusion criteria. Fifty-three papers were commentaries or editorials, twenty-one were research studies, and two were literature reviews on specific dental subfields. Eighteen of the research studies reported surveys. The literature contains extensive proposals for undergraduate curricula or learning outcomes, either broadly or for subfields of dentistry. Included papers demonstrated the importance of EU policy and educator-led initiatives as drivers for harmonisation. There is limited evidence on the extent to which proposed pan-European curricula or learning outcomes have been implemented. The nature and extent of dental students' clinical experience with patients is an area of variance across European Union member states. Arrangements for the quality assurance of dental education differ between countries.

DISCUSSION

Harmonisation of European dental education has engaged educators, as seen in the publication of proposed curricula and learning outcomes. However, differences remain in key areas such as clinical experience with patients, which has serious implications if graduate dentists migrate to countries where different expectations exist. Mutual recognition of professional qualifications between countries relies on education which meets certain standards, but institutional autonomy makes drawing national comparisons problematic.

Approaches to integrating online videos into health professions curricula: educators' perspectives from multiple institutions

Background: The COVID-19 pandemic has accelerated a transition from lecture-based classes to blended and online learning, increasing the need to integrate publicly available online educational videos. Although online videos are widely available, it is challenging for educators to effectively integrate them into a curriculum. Years before the pandemic, educators from different institutions integrated videos from a library of microbiology and immunology resources into different curricula. Their experiences may inform current educators on the approach to incorporating external resources into their unique curricula. Methods: We interviewed US health professions instructors or course directors who had previously requested access to online microbiology and immunology videos. Using thematic analysis, we organized prominent themes into an existing framework for curriculum development. We then reflected on the meaning of the themes using the same conceptual framework. Results: We found that educators from different schools were able to integrate the same publicly available videos into varying contexts. Most used them as preparation for interactive sessions. For integrating videos, educators felt success when the following actions occurred. 1) Educators integrated videos as a tool to enhance active-learning activities. 2) Educators created activities that focused on clinical applications of knowledge, taught critical thinking, and developed enthusiasm for the subject. 3) They tested students on knowledge application and major concepts rather than solely on content for high-stakes exams. 4) Educators worked with administrators who understood the goals of integrating external videos and supported educators with time and resources to develop effective blended learning. Conclusion: Our study suggests that educators integrating external resources into their curricula may benefit from first establishing their goals and aspirations for their students. These goals then become the anchor for other curricular elements, including external videos, in-class activities, and assessments. Our study highlights the need for dedicated time to develop experienced and enthusiastic educators.

Leadership Experiences of Internal Medicine Residents: A Needs Assessment for Leadership Curricula

Purpose

Leadership development during medical training is critical. Accrediting bodies strongly recommend and residents desire leadership training. However, limited needs assessment data exist regarding trainee perceptions of and experiences with leadership training. Our objective is to describe residents' perceptions of leadership and desires for leadership training with the goal of informing effective curricular development.

Patients and Methods

In 2019 a trained qualitative interviewer conducted semi-structured interviews with volunteer second-year categorical internal medicine residents recruited via email across four institutions. Interviews were audio-recorded, transcribed, and inductively coded by two independent coders. After adjudicating discrepancies, coders synthesized codes into broader themes. Final thematic analysis was triangulated with the entire author group.

Results

Fourteen residents were interviewed (50% female). Few reported prior leadership training. Thematic analysis yielded six main themes. First, residents perceive "leadership" to be related to formal, assigned, hierarchical roles. Second, residents identify their own leadership primarily in the inpatient clinical setting. Third, residents identify clinical competence, emotional intelligence, and communication as important skills for effective leadership. Fourth, residents struggle to identify where leadership is currently being taught. Fifth, residents desire additional leadership development. Finally, residents prefer well-labeled, interactive methods for leadership development.

Conclusion

Although residents desire leadership development, these skills are not often explicitly taught, labeled, or assessed. Curriculum developers may consider explicitly contextualizing leadership training within an "everyday leadership" framework, dovetailing leadership coaching with daily teaching workflow and feedback structures, and implementing faculty development initiatives to allow for appropriate feedback and assessment of these skills.

A grassroots approach for greener education: An example of a medical student-driven planetary health curriculum

Given the widespread impacts of climate change and environmental degradation on human health, medical schools have been under increasing pressure to provide comprehensive planetary health education to their students. However, the logistics of integrating such a wide-ranging and multi-faceted topic into existing medical curricula can be daunting. In this article, we present the Warren Alpert Medical School of Brown University as an example of a student-driven, bottom-up approach to the development of a planetary health education program. In 2020, student advocacy led to the creation of a Planetary Health Task Force composed of medical students, faculty, and administrators as well as Brown Environmental Sciences faculty. Since that time, the task force has orchestrated a wide range of planetary health initiatives, including interventions targeted to the entire student body as well as opportunities catering to a subset of highly interested students who wish to engage more deeply with planetary health. The success of the task force stems from several factors, including the framing of planetary health learning objectives as concordant with the established educational priorities of the Medical School's competency-based curriculum known as the Nine Abilities, respecting limitations on curricular space, and making planetary health education relevant to local environmental and hospital issues.

Planetary Health Education and Capacity Building for Healthcare Professionals in a Global Context: Current Opportunities, Gaps and Future Directions

The emerging concept of planetary health needs to be discussed in a more organized and sustainable way within the global public health and healthcare disciplines. Therefore, planetary health should be considered a cardinal component of the global academic framework for healthcare professionals. The availability of related curricula and courses is crucial to equip health professionals in this relatively new discipline of planetary health. In this review article, we aimed to explore published articles and online databases of courses to summarize the available planetary health education opportunities and discussions for health professionals, to identify the gaps in resource allocation and to suggest future recommendations. We observed a visible resource inequity in the global south with the lack of a universal planetary health module for healthcare professionals. Additionally, there is minimal inclusion of allied health disciplines in this learning process. We therefore recommend a dedicated network of motivated healthcare professionals and regional hubs with an agenda to ensure a comprehensive, uniform, and inclusive planetary health education curriculum and practice.

Designing a programme to train social workers on how to promote physical activity for disabled people: A Delphi study in the UK

Recently, social workers have been identified as a key messenger group for promoting physical activity (PA) to disabled people. Also identified is the need to train social workers in PA promotion. In response, the purpose of this article is to inform the design of a training programme prototype aiming to support social workers to become active PA messengers. We conducted a three-round Delphi study to identify the essential contents and teaching methods for the programme, as well as the challenges that may jeopardise its success. Qualified experts on physical activity and health, social work, and/or disability working in the UK were invited to partake in the study. The response rates were 55% (33/60) in the first round, 79% (26/33) in the second and 77% (20/26) in the third rounds. Following the last questionnaire round, the experts reached consensus on 8 contents, 7 teaching methods and 10 challenges to success. The top three most important contents were: benefits of PA (1.05 ± 0.22), what PA means to disabled people (1.15 ± 0.36) and person-centred PA planning (1.35 ± 0.57). The most relevant teaching methods were interactive activities and discussions (1.20 ± 0.51) and case studies (1.25 ± 0.43). Blended learning (1.85 ± 0.57) was preferred to e-learning (2.20 ± 0.60) and face-to-face learning (2.10 ± 0.70). Lack of time (1.30 ± 0.46) and confidence (1.45 ± 0.59) were deemed vital challenges. However, consensus around other potential barriers such as lack of interest and commitment (1.30 ± 0.46), lack of buy in from employers (1.75 ± 0.70) and professional inertia (2.05 ± 0.67) suggest that a major challenge for long-term impact is to convince key people that social work and PA promotion make a good match. The results of this study provide a valuable starting point evidence base for PA curriculum development. Future research will delve into expert opinions using in-depth qualitative interviews. Participatory approaches including knowledge cafés will also be used to add more views of stakeholders with experiential knowledge.

LGBTQ+ and dental education: Analyzing the present and recommendations for the future

LGBTQ+ populations constitute increasing proportions of children, adolescents, and adults in the United States. Compared to their heterosexual counterparts, this group suffers from health inequities, including oral health. The report "Oral Health: Advances and Challenges" identified the LGBTQ+ community as an underserved population which faces significant barriers in accessing oral health care. Coverage of LGBTQ+ topics in formal education settings in both dental schools and dental hygiene programs is scarce, which contributes to inequities within this group. Increasing curriculum content related to LGBTQ+ populations is of utmost importance to promote optimal patient-provider interactions while improving oral health outcomes. Ensuring equity in oral health care provision will require deliberate, consistent efforts on the part of all stakeholders. Dental and allied dental education programs have made important strides in enhancing equity and inclusion in their institutions by engaging campus groups that support LGBTQ+ populations, creating mentorship programs, and collaborating with non-profit advocacy groups. Such efforts have successfully empowered LGBTQ+ patients, providers, and allies who are committed to further closing the knowledge gap. Most of the research regarding LGBTQ+ inclusion efforts have been done in the medical arena and there is a void in the data available from the dental profession. To fill this void, recommendations are offered that institutions can easily implement to expand LGBTQ+ diversity and inclusion visibility.