Empowering medical educators to teach planetary health: development and outcomes of a curriculum integration training

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For longitudinal integration across the curriculum, medical educators can serve as change agents and multipliers. A targeted training that conveys both PH knowledge and pedagogical skills can empower medical educators to incorporate PH topics into their teaching. Methods Following the curriculum development cycle by Kern, we developed a training for medical educators of Charité – Universitätsmedizin Berlin teaching in the medical curriculum. The learning objective was to enable medical educators to effectively integrate PH content into their courses. The program was delivered in a blended-learning format: input on the interconnectedness between human and planetary health was provided online via a learning platform prior to the in-person unit (1 teaching unit [TU]). The face-to-face workshop (6 TU) gave input on Planetary Health as well as didactic input and facilitated discussion of personal experiences with climate change and its relevance to teaching, thereby enhancing participants’ change agency. Further, participants developed teaching materials for their own courses and tested them via a micro-teaching exercise. As follow-up the participants revised their teaching materials-based feedback on their micro teaching (1 TU). The impact of the workshop was evaluated according to Kirkpatrick’s framework. Results Eighteen medical educators participated across three workshops, with 13 completing the follow-up questionnaire. Seventeen participants (94% response rate) completed the post-workshop evaluation. Participants reported satisfaction being satisfied with the content, structure, and practical relevance of the course and rated their knowledge gain as moderate to high. Fifteen participants intended to integrate the developed teaching materials into their courses, and 14 planned to share their materials with colleagues. One year later, nine participants (50%) responded to a follow-up survey; five had integrated the materials into their teaching, and three had shared them with colleagues. Conclusion A targeted training that actively prepares and supports the transfer of knowledge into teaching practice is well received by medical educators. PH content was integrated into courses by a subset of participants. Beyond the workshop, ongoing networking may further support sustainable PH content integration into the curriculum. Medical education Climate Change faculty training lecturer training Planetary Health Curriculum Change Agency Figures Figure 1 Figure 2 Introduction What is the problem? Climate change, biodiversity loss, and air pollution are increasingly affecting human health and healthcare systems. Health professionals must therefore engage with these impacts as part of their professional responsibilities (1,2). Planetary Health (PH) is a framework that interconnects human health with the integrity of Earth’s natural systems (3), encompassing multiple dimensions of health. There is broad consensus across academia and civil society actors that PH content should be integrated into the curricula of health professions education (4,5). However, actual implementation within medical curricula remains limited and insufficient (6). In Germany, specific learning objectives related to PH have been defined and incorporated into the National Competency-Based Learning Objectives Catalogue for Medicine (NKLM) (7). In addition, various educational projects have been described and implemented to promote curricular integration (7–9). Despite these efforts, a nationwide survey indicates that PH teaching is still frequently confined to elective courses, thus primarily reaching students with a strong intrinsic motivation for the topic (8,10). However, longitudinal integration into the core curriculum, is considered more effective and adequate to prepare physicians for the health impacts of climate change in clinical practice (11–13). While barriers to curricular integration include increasingly dense medical curricula, which limit the incorporation of additional teaching content (11), medical educators have been identified as key stakeholders as their subject-matter expertise, attitudes, and time availability significantly influence the success of PH implementation into the curriculum (12,14). Importance of change agency for PH in curricular transformation Sustainable curricular change in medical education depends not only on structural frameworks but also on individuals who actively drive implementation. Change agency, as defined by Fullan (2007) (15) and Priestley et al. (2015) (16), refers to the capacity to initiate and sustain change within complex systems by translating goals into practice. Within educational settings, change agents are essential for embedding new content into institutional culture and everyday teaching. Medical educators are well positioned to act as change agents for the integration of Planetary Health into curricula. Being educators and role models, they influence both formal curricula and students’ understanding of the clinical relevance of sustainability-related topics (17,18). Thus, medical educators engagement was identified as a key factor in the successful implementation of PH education (12,14). In order to strengthen PH related change agency among medical educators, it is necessary to consider factors beyond their knowledge on a topic. It involves fostering their awareness of the health relevance of climate change, enhancing their self-efficacy, and providing practical pedagogical tools that enable them to integrate PH within the existing curriculum. Trainings addressing these dimensions can empower medical educators to act as multipliers for the longitudinal integration of PH into curricula (15,18). The combined demands of clinical duties and research expectations severely limit medical educators’ availability to engage in extensive training, posing a significant barrier to participation. (19). (20–22)This study aimed to develop and evaluate a compact training for medical educators to enable them to act as change agents for integrating Planetary Health into their curses and thus into the medical curriculum. Methods Target group, program design, and project context The training targeted medical educators at Charité – Universitätsmedizin Berlin involved in teaching within the model medical curriculum. Since no institutional training on Planetary Health (PH) had been offered before, participants were assumed to have minimal formal knowledge of PH, aside from informal exposure. Given faculty’s limited time from clinical and research duties, we adopted a concise blended learning format. The training design drew inspiration from the “2slides4future” initiative (https://2slides4future.com/), which encourages academics to add two climate change-related slides to their presentations. Its online templates and examples serve as a useful resource for medical educators integrating Planetary Health content into their teaching. Guided by Kern’s six-step curriculum development framework (21), we designed a concise training to help medical educators embed Planetary Health content in their teaching and enhance their role as change agents in the medical curriculum. Following this approach, we introduced Planetary Health content, fostered didactic skills, and allowed time for participants to create their own teaching materials. Furthermore, we intentionally created space for exchange and networking, with the aim to establish and foster a community of practice (23). Through structured, collective reflection on their roles in the healthcare system, participants were encouraged to build a shared understanding of necessary change, strengthen self-efficacy, and engage in collective learning and support (e.g., shared goals, visible early wins, peer feedback, and ongoing adaptation). As part of the Climate Adaptation in Transformative Medical Education (CATMED) project, we developed and implemented the training. CATMED, a collaboration between Heidelberg University, Julius-Maximilians-Universität Würzburg, and Charité – Universitätsmedizin Berlin, aims to integrate Planetary Health into medical curricula and promote inter-university collaboration. The Berlin team focused on an intervention targeting medical educators as key stakeholders. The project was funded by the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection.All interventions and evaluations conducted within the project were reviewed and approved by the Ethics Committee of Charité – Universitätsmedizin Berlin (approval number: CTO 24-0459). Overall and specific learning objectives Our training aimed to equip medical educators to integrate Planetary Health into their teaching by combining didactic training in visualization and presentation with foundational Planetary Health knowledge. This objective reflects key recommendations from the AMEE Guide roadmap for faculty development in Planetary Health education(14). We defined the following overarching learning objectives. Discuss advantages and disadvantages of different visualization formats. Explain requirements for teaching materials in the context of cognitive load theory. Explain the concept of Planetary Health. Reflect on individual and societal health impacts of climate change. Integrate and present Planetary Health topics relevant to their own discipline in an engaging and comprehensible manner. Reflection on participants’ own attitudes and networking among participants were not explicitly formulated as learning objectives but were considered important implicit goals of the program by the facilitators. Teaching methods To accommodate participants' limited time, we designed a blended-learning format. Self-directed preparatory and follow-up units for knowledge acquisition and material revision were delivered via an online learning platform, while the face-to-face sessions focused on hands-on PH and didactics practice to promote immediate transfer into teaching (24). Prior research shows such elements enhance practice transfer (25) The in-person session began with an interactive role-play exercise illustrating climate change's socially stratified impacts and emotional effects in everyday situations. This was followed by guided reflection on personal vulnerability, didactic input on visualization principles, and Planetary Health content linked directly to participants' teaching. After the break, participants developed their own teaching materials individually or in pairs. A detailed description of the training is described in table one. Phase Time (min) Learning objective (participant-centred) Educational approach Teaching and learning activities Key content/ Output Pre-course Preparation 45 Activate prior knowledge and establish a common baseline understanding of PH Flipped classroom Online, on demand, self-study Introduction to PH focused on interconnectedness of health and environment Orientation and learning engagement 10 Align expectations, learning goals and course structure Guided orientation Visualization on flipchart Welcome, agenda, learning objectives Experiential and reflexive engagement 45 Reflect on individual and societal health impacts of climate change through perspective-taking Experienced based learning, serious game Role-play “In the middle of society” with guided reflection Individual health effects of climate change, differential vulnerability and personal impact Conceptual grounding: design of teaching material 20 Understand requirements for teaching materials in the context of cognitive load theory Expert input, learning by example Interactive lecture with worked examples Slide design principles, cognitive load theory, visual examples Reflective application and quality criteria 40 Critically analyse teaching materials and derive quality criteria for effective design Activating reflection Headstand exercise in small group, plenary discussion Creation of “worst-practice” slides; development of feedback criteria 10 Break Conceptual grounding: Planetary Health 25 Build a shared conceptual understanding of PH relevant to medical education Expert input, interactive lecture Interactive lecture using PowerPoint Planetary Health framework, planetary boundaries, tipping points, areas of action Application: identifying entry points in own teaching 25 Identify and critically reflect on opportunities to integrate PH into one’s own courses Peer teaching, micro-teaching Tandem work, with on- and offline resources Identification of starting points and supplementary PH content 60 Lunch break Practical transfer to own teaching 45 Design PH teaching materials for immediate use Practical learning Individual or tandem work Development of 1-2 slides integrating PH content for upcoming course Micro-teaching and feedback 30 Present PH teaching materials in an engaging and comprehensive manner Formative assessment Short presentation, verbal feedback Presentation of slides,45+ feedback limited to key aspects Consolidation and evaluation 15 Reflect on learning outcomes and plan transfer into everyday teaching practice Reflection, formative evaluation 3-3-3 reflection method, plenary discussion Key takeaways after 3 hours, 3 days and 3 months, clarification of open questions Post-course follow-up 45 Revise and finalize teaching materials for sustainable integration Flipped classroom, individual work Submission via online learning platform Revised slides prepared for use in participants own courses Table 1: detailed description of the training Implementation The program was promoted through multiple channels and faculty networks, with sessions offered at all three university campuses to minimize commuting time. Evaluation We conducted a descriptive evaluation using Kirkpatrick's model (Kirkpatrick 1959, 1959a, 1960, 1960a), focusing on content/structure satisfaction (Level 1: reaction), self-reported knowledge gain (Level 2: learning) and transfer to teaching (Level 3: behavior). Pre-training assessments covered PH motivation, prior knowledge, and demographics (age, gender, teaching role, experience). Level 4 evaluation focusing on effects on students (results) was not feasible nor methodologically appropriate due to heterogeneous faculty-wide change across courses/cohorts. Post-workshop evaluation used self-developed 5-point Likert items (prior knowledge, motivation, satisfaction, knowledge gain, intended transfer), internally validated per learning objectives and two open-ended feedback questions. Transfer was assessed via documented PH teaching materials and a 12-month follow-up survey; quantitative data analyzed descriptively in Microsoft Excel (2024). The evaluation was conducted online using Microsoft Forms. Participants provided written informed consent prior to participation in the evaluation and data analysis. The questionnaire is provided in Appendix 1 Results Three trainings were conducted in February, August, and September 2024 (6, 8, and 4 participants, respectively). A planned October workshop at the smallest campus was cancelled due to low enrollment (two registrations). Implementation experiences The training was delivered via interdisciplinary team-teaching (2-3 facilitators, including medical/geography PH experts). The first implementation showed that strict time management—especially precise input timing—was essential for smooth transitions to application phases, which needed adequate time for contextual adaptation. Despite access to examples and materials, many participants struggled to develop 1-2 teaching slides during self-study. The presence of two facilitators in small groups provided individual guidance, actively utilized by participants and essential for workshop success Participants A total of 18 medical educators participated in three workshops. Seventeen (94%) completed the immediate post-workshop survey (10 females, 7 males, ages 28–57 years). Teaching experience varied: 7 had ≤3 years, 9 had >10 years. Participants represented diverse medical faculty disciplines with some educators responsible for up to 20 teaching sessions per semester; 9 (50%) completed the 12-month follow-up. All reported strong Planetary Health interest (agree: n=5; strongly agree: n=12) and climate role model self-perception (agree: n=10; strongly agree: n=6), with 8/17 (47%) already attempting to integrate PH content into their teaching beforehand. Satisfaction (Kirkpatrick Level 1: Reaction) Overall, participants reported high satisfaction with the workshop and with the balance between instructional input and practical exercises. The workshop increased interest in Planetary Health and was perceived as relevant to participants’ teaching activities (see Figure 1). Subjective learning outcomes (Kirkpatrick Level 2: Learning) Participants rated Planetary Health knowledge gain as moderate (n=9) to high (n=8). Knowledge gains relevant to their teaching were moderate (n=7) or high/very high (n=9). Post-training, 9 rated their integration ability as high/very high, 4 as moderate. Fifteen out of seventeen participants found the PH-didactics combination helpful for teaching integration. Transfer into teaching practice (Kirkpatrick Level 3: Behaviour) Immediately after the workshop, most participants completed the follow-up phase and reported intentions to integrate the developed teaching materials and additional Planetary Health content into their teaching, as well as to share the materials with colleagues. At the 12-month follow-up, 9/18 participants responded; 5 had integrated materials into their teaching and 3 had shared them with colleagues (Figure 2). Perceived contextual factors influencing transfer Perceived negative reactions from the surrounding environment appeared to play only a minor role in the transfer process. Only a small number of participants expected resistance from colleagues or students when integrating Planetary Health content into their teaching (n = 3 and n = 2, respectively). Eight of the nine respondents who participated in the 12-month follow-up reported having experienced predominantly positive reactions from colleagues and students. Perceived negative environmental reactions played only a minor role for transfer. Few participants expected resistance from colleagues (n=3) or students (n=2) when integrating Planetary Health into their teaching. Among 12-month follow-up respondents (n=9), 8 reported predominantly positive reactions from both groups. Discussion Project objectives Medical educators with diverse teaching experience and disciplines—all with pre-existing Planetary Health interest—attended the training. They reported high satisfaction with its structure, content, and everyday teaching relevance, rating overall PH knowledge gain as moderate to high and acquired integration competence as high. All but one lecturer completed follow-up and developed course-specific teaching materials. Most intended to integrate Planetary Health content and share with colleagues. At 12-month follow-up (n=9/18), half had implemented PH content, though few shared materials; negative reactions played minimal role. Low participation typical for Charité non-mandatory trainings. The one-day format didn't increase participation numbers but small groups enabled intensive transfer support, enabling team teaching and more resources for all sessions. Based on first-training experiences, team teaching (originally planned solely for that session) proved necessary and was implemented across all workshops, increasing personnel and resource requirements. Comparison with other educational projects Despite the short duration of the workshop, nearly all participants were able to develop teaching materials suitable for use in their own courses. Consistent with prior research, learning transfer to practice proved challenging, depending on competence, autonomy, perceived value, and supportive context (24). While most medical educators intended to implement the materials, only half had done so at follow-up. As Kirkpatrick Level 3 outcomes (actual behavior change) are rarely assessed, it's unclear if other formats achieve higher implementation rates. The "knowledge-to-action gap"—encompassing motivational, systemic, emotional, and social dimensions (24)—explains why intentions often diverge from implementation. According to the evaluation, participants felt sufficiently competent to implement PH into their teaching. To sustain implementation motivation, explicit action plans prove beneficial (25), which informed the workshop's didactic concept for transfer preparation. As fear of negative reactions hinders behavior change (24), a community of practice approach (26) was implemented to enhance social acceptability. Thus, the workshop promoted lecturer networking for collective rather than isolated action, with few negative reactions reported at follow-up. Potential factors that may have hindered implementation for some participants include systemic constraints, such as highly regulated curricula that offer limited encouragement for individual initiative, as well as a lack of institutional incentives or recognition for curricular innovation. A comparable integrative approach has previously been described by Flaegel et al. (20) in an elective course for medical students who are interested in teaching. It encompassed a whole semester and supported students to develop an online lesson with planetary health content. The impact on medical school curricula or teaching practice was not evaluated. Outlook and future development Although personnel-intensive, the time commitment required from both facilitators and participants was limited. Faculty development programs aiming to change teaching behavior are often associated with substantially higher resource demands (27). The community-of-practice approach has been discussed as a key success factor for sustainable faculty development. Networking among medical educators was therefore a central component of the program and a primary reason for implementing the training as an in-person format. To support networking beyond the individual workshops, a Planetary Health teaching working group was established within the project and successfully embedded under the umbrella of the Charité Climate Network. In the second quarter of 2025, an increasing number of medical educators requested training opportunities related to PH, underscoring both the need and interest for structural integration of such formats. However, following the end of project funding, additional workshops could not be offered. A long-term e-learning format was considered but abandoned due to the critical importance of personal interaction. Key success factors included peer exchange, individualized material development support, group feedback on teaching materials, and lecturer networking. Transferability and broader implications Beyond the local context, this study demonstrates that a compact, transfer-oriented training can successfully support medical educators in integrating PH content into their teaching. While the intervention was implemented within a single institution, its core design principles—low-threshold participation, explicit preparation for transfer, and a focus on change agency within a community-of-practice —are not institution-specific. Medical faculties that already offer training for faculty members may readily adapt this approach to their local contexts, integrating PH content into their existing training programs. Given the widespread time constraints and competing clinical/research demands across medical schools nationally and internationally, this model appears transferable to diverse educational contexts. Limitations This study has several limitations. First, the small sample size and voluntary participation likely introduced selection bias toward medical educators with pre-existing Planetary Health interest. Second, most outcomes relied on self-reported measures, which are susceptible to social desirability bias and may not reflect objective teaching behavior changes. Third, the moderate 12-month follow-up response rate (50%) limits conclusions about long-term implementation. However, a strength is our assessment of Kirkpatrick Level 3 outcomes (actual behavior change)— rarely evaluated in faculty development studies — which provides valuable insights into real-world transfer despite these limitations. Kirkpatrick Level 4 (student results/clinical outcomes) was not feasible due to heterogeneous curriculum-wide implementation. Future research could target Level 4 once Planetary Health content achieves more consistent curricular embedding. Conclusion This study demonstrates that medical educators are key stakeholders and potential change agents for the integration of Planetary Health content into medical curricula. Institutional faculty trainings customized to medical educators' concrete needs and limited time resources, with practical implementation support, could successfully facilitate Planetary Health curricular integration. To ensure sustainable impact beyond individual training sessions, ongoing networking among medical educators—such as through communities of practice—appears to be a promising strategy. Declarations Ethics approval and consent to participate All interventions and evaluations conducted within the framework of the CATMED project were reviewed and approved by the Ethics Committee of Charité – Universitätsmedizin Berlin (approval number: CTO 24-0459). The study was performed in accordance with the Declaration of Helsinki and its later amendments. Written informed consent was obtained from all participants prior to inclusion in the evaluation. All data were collected, processed, and stored in accordance with applicable data protection regulations, and participant confidentiality was strictly maintained throughout the study. Consent for publication Not applicable. Availability of data and materials The datasets generated and analyzed during the current study are not publicly available due to data protection and privacy considerations but are available from the corresponding author on reasonable request. Competing interests declaration The authors declare that they have no competing interests. Funding This work was funded by the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (Grant No. 67DAS264B) as part of the Climate Adaptation in Transformative Medical Education (CATMED) project. Authors’ contributions All authors contributed to the conception and design of the study. Funding was secured by A. Schuster and S. Gehrke-Beck. The shared first and last authorship reflects team-based role transitions due to maternity leave and parental leave during the project period. Specifically, H. Hauch assumed responsibilities originally held by N. Kutschke, and S. Gehrke-Beck assumed responsibilities originally held by A. Schuster. The training concept was primarily developed by S. Gehrke-Beck and N. Kutschke. The training was implemented by all four authors. A. Schuster additionally served as project coordinator. Data collection and analysis were performed by H. Hauch and S. Gehrke-Beck. All authors contributed to article writing, critically revised the manuscript, and approved the final version. Use of AI tools AI-based language tools were used to support the translation and linguistic refinement of the manuscript, including ChatGPT (OpenAI), Perplexity and DeepL (DeepL SE). These tools were used exclusively for language support. All content was reviewed, edited, and approved by the authors, who take full responsibility for the final manuscript. Acknowledgements We thank Oskar Masztalerz for his valuable input as a Planetary Health expert during the training sessions. We would also like to thank the staff at the Dieter Scheffner Center for their help in organizing the continuing education program for medical educators. References WHO. WHO factsheet on climate change and health. 2023 [cited 2025 Aug 1]. Climate change. 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Additional Declarations No competing interests reported. Supplementary Files Appendix1questionnaires.docx Cite Share Download PDF Status: Under Review Version 1 posted Reviews received at journal 29 Apr, 2026 Reviewers agreed at journal 16 Mar, 2026 Reviewers invited by journal 05 Mar, 2026 Editor assigned by journal 25 Feb, 2026 Submission checks completed at journal 23 Feb, 2026 First submitted to journal 23 Feb, 2026 You are reading this latest preprint version Research Square lets you share your work early, gain feedback from the community, and start making changes to your manuscript prior to peer review in a journal. As a division of Research Square Company, we’re committed to making research communication faster, fairer, and more useful. We do this by developing innovative software and high quality services for the global research community. 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Also discoverable on Platform About Our Team In Review Editorial Policies Advisory Board Help Center Resources Author Services Accessibility API Access RSS feed Manage Cookie Preferences © Research Square 2026 | ISSN 2693-5015 (online) Privacy Policy Terms of Service Do Not Sell My Personal Information {"props":{"pageProps":{"initialData":{"identity":"rs-8911081","acceptedTermsAndConditions":true,"allowDirectSubmit":false,"archivedVersions":[],"articleType":"Research Article","associatedPublications":[],"authors":[{"id":604039946,"identity":"2aa36d34-e964-4f47-9ff7-db32073b3e0a","order_by":0,"name":"Hélène Furaha Hauch","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Hélène","middleName":"Furaha","lastName":"Hauch","suffix":""},{"id":604039947,"identity":"c143e8c4-cd3d-469e-9e5a-cab858ebae91","order_by":1,"name":"Nadja Kutschke","email":"data:image/png;base64,iVBORw0KGgoAAAANSUhEUgAAAZAAAAAyAQMAAABI0h/eAAAABlBMVEX///8AAABVwtN+AAAACXBIWXMAAA7EAAAOxAGVKw4bAAABH0lEQVRIie2RMWuDQBTHXwnYRciqUMlXeMeB6SD9LIpwXRwcHTI4JYvgar+FXQqd8oqQLrauQpa6OGXI2KGEnpEWCjnnDveDg3vc+/F/jwPQaP4hSIAI4A934yoFD2QFJI8sLnP7o5ijIkaFJhSPzj2/SnUuYVJ5rcr4E0SwnVd9VyTNYnn91lXHBJxcobi1iFkGUZBZYsnKes+es3skqoE/KGJcihBNSKRiGna33vtIAuhlDUFJlxXeHJB9Dcq8lsrp3ceml8oJgq1CYW2E3BwGg8iwH1PysR1SUpmi2IW1fcxvUPCsFa5d7EJWtjKl3lm8UKRgEz6xQxI6m7zq7Wx1t8BGzI7JynNyxfoSA8e/+Iul7JfMPqZeNRqNRgPf0aFp5jbAEwYAAAAASUVORK5CYII=","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":true,"prefix":"","firstName":"Nadja","middleName":"","lastName":"Kutschke","suffix":""},{"id":604039948,"identity":"bdfa0fdb-5f4e-4062-8a98-57a9de39345b","order_by":2,"name":"Angela Schuster","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Angela","middleName":"","lastName":"Schuster","suffix":""},{"id":604039949,"identity":"048e1f01-0567-4eed-af97-d69e7cdd2f94","order_by":3,"name":"Sabine Gehrke-Beck","email":"","orcid":"","institution":"Charité - University Medicine Berlin","correspondingAuthor":false,"prefix":"","firstName":"Sabine","middleName":"","lastName":"Gehrke-Beck","suffix":""}],"badges":[],"createdAt":"2026-02-18 16:54:27","currentVersionCode":1,"declarations":"","doi":"10.21203/rs.3.rs-8911081/v1","doiUrl":"https://doi.org/10.21203/rs.3.rs-8911081/v1","draftVersion":[],"editorialEvents":[],"editorialNote":"","failedWorkflow":false,"files":[{"id":104470331,"identity":"98259057-5cea-483c-8a8a-b530855ed406","added_by":"auto","created_at":"2026-03-12 07:19:21","extension":"png","order_by":1,"title":"Figure 1","display":"","copyAsset":false,"role":"figure","size":54786,"visible":true,"origin":"","legend":"\u003cp\u003e\u003cem\u003eSatisfaction with the workshop\u003c/em\u003e\u003c/p\u003e","description":"","filename":"1.png","url":"https://assets-eu.researchsquare.com/files/rs-8911081/v1/95af9094ad46738534c12e18.png"},{"id":104470334,"identity":"234606bd-4298-45c2-bc2d-498b585f1b5e","added_by":"auto","created_at":"2026-03-12 07:19:21","extension":"png","order_by":2,"title":"Figure 2","display":"","copyAsset":false,"role":"figure","size":43749,"visible":true,"origin":"","legend":"\u003cp\u003eTransfer into teaching practice\u003c/p\u003e","description":"","filename":"2.png","url":"https://assets-eu.researchsquare.com/files/rs-8911081/v1/2c8b52964b0dcb1c9563e4d8.png"},{"id":104785804,"identity":"b1d462c6-6487-416e-8fae-07595f8d9dbf","added_by":"auto","created_at":"2026-03-17 08:13:05","extension":"pdf","order_by":0,"title":"","display":"","copyAsset":false,"role":"manuscript-pdf","size":1061016,"visible":true,"origin":"","legend":"","description":"","filename":"manuscript.pdf","url":"https://assets-eu.researchsquare.com/files/rs-8911081/v1/cd75e6a8-8ddd-44be-9977-20fe15aba83a.pdf"},{"id":104780434,"identity":"e48b235d-d542-4047-a60b-4c63233f30aa","added_by":"auto","created_at":"2026-03-17 07:52:54","extension":"docx","order_by":0,"title":"","display":"","copyAsset":false,"role":"supplement","size":39361,"visible":true,"origin":"","legend":"","description":"","filename":"Appendix1questionnaires.docx","url":"https://assets-eu.researchsquare.com/files/rs-8911081/v1/1129dcf41b1bf5b9968f0ec2.docx"}],"financialInterests":"No competing interests reported.","formattedTitle":"Empowering medical educators to teach planetary health: development and outcomes of a curriculum integration training","fulltext":[{"header":"Introduction","content":"\u003ch4\u003eWhat is the problem?\u0026nbsp;\u003c/h4\u003e\n\u003cp\u003eClimate change, biodiversity loss, and air pollution are increasingly affecting human health and healthcare systems. Health professionals must therefore engage with these impacts as part of their professional responsibilities\u0026nbsp;(1,2). Planetary Health (PH) is a framework that interconnects human health with the integrity of Earth\u0026rsquo;s natural systems\u0026nbsp;(3), encompassing multiple dimensions of health. There is broad consensus across academia and civil society actors that PH content should be integrated into the curricula of health professions education\u0026nbsp;(4,5). However, actual implementation within medical curricula remains limited and insufficient\u0026nbsp;(6).\u003c/p\u003e\n\u003cp\u003eIn Germany, specific learning objectives related to PH have been defined and incorporated into the National Competency-Based Learning Objectives Catalogue for Medicine (NKLM)\u0026nbsp;(7). In addition, various educational projects have been described and implemented to promote curricular integration\u0026nbsp;(7\u0026ndash;9). Despite these efforts, a nationwide survey indicates that PH teaching is still frequently confined to elective courses, thus primarily reaching students with a strong intrinsic motivation for the topic\u0026nbsp;(8,10). However, longitudinal integration into the core curriculum, is considered more effective and adequate to prepare physicians for the health impacts of climate change in clinical practice\u0026nbsp;(11\u0026ndash;13).\u003c/p\u003e\n\u003cp\u003eWhile barriers to curricular integration include increasingly dense medical curricula, which limit the incorporation of additional teaching content (11), medical educators have been identified as key stakeholders as their subject-matter expertise, attitudes, and time availability significantly influence the success of PH implementation into the curriculum (12,14).\u003c/p\u003e\n\u003ch4\u003eImportance of change agency for PH in curricular transformation\u003c/h4\u003e\n\u003cp\u003eSustainable curricular change in medical education depends not only on structural frameworks but also on individuals who actively drive implementation. Change agency, as defined by Fullan (2007)\u0026nbsp;(15)\u0026nbsp;and Priestley et al. (2015)\u0026nbsp;(16), refers to the capacity to initiate and sustain change within complex systems by translating goals into practice. Within educational settings, change agents are essential for embedding new content into institutional culture and everyday teaching.\u003c/p\u003e\n\u003cp\u003eMedical educators are well positioned to act as change agents for the integration of Planetary Health into curricula. Being educators and role models, they influence both formal curricula and students\u0026rsquo; understanding of the clinical relevance of sustainability-related topics\u0026nbsp;(17,18). Thus, medical educators engagement was identified as a key factor in the successful implementation of PH education\u0026nbsp;(12,14).\u003c/p\u003e\n\u003cp\u003eIn order to strengthen PH related change agency among medical educators, it is necessary to consider factors beyond their knowledge on a topic. It involves fostering their awareness of the health relevance of climate change, enhancing their self-efficacy, and providing practical pedagogical tools that enable them to integrate PH within the existing curriculum. Trainings addressing these dimensions can empower medical educators to act as multipliers for the longitudinal integration of PH into curricula\u0026nbsp;(15,18).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eThe combined demands of clinical duties and research expectations severely limit medical educators\u0026rsquo; availability to engage in extensive training, posing a significant barrier to participation.\u0026nbsp;(19).\u003c/p\u003e\n\u003cp\u003e(20\u0026ndash;22)This study aimed to develop and evaluate a compact training for medical educators to enable them to act as change agents for integrating Planetary Health into their curses and thus into the medical curriculum.\u003c/p\u003e"},{"header":"Methods","content":"\u003ch4\u003eTarget group, program design, and project context\u003c/h4\u003e\n\u003cp\u003eThe training targeted medical educators at Charit\u0026eacute; \u0026ndash; Universit\u0026auml;tsmedizin Berlin involved in teaching within the model medical curriculum. Since no institutional training on Planetary Health (PH) had been offered before, participants were assumed to have minimal formal knowledge of PH, aside from informal exposure.\u0026nbsp;Given faculty\u0026rsquo;s limited time from clinical and research duties, we adopted a concise blended learning format.\u0026nbsp;The training design drew inspiration from the \u0026ldquo;2slides4future\u0026rdquo; initiative (https://2slides4future.com/), which encourages academics to add two climate change-related slides to their presentations. Its online templates and examples serve as a useful resource for medical educators integrating Planetary Health content into their teaching.\u003c/p\u003e\n\u003cp\u003eGuided by Kern\u0026rsquo;s six-step curriculum development framework\u0026nbsp;(21), we designed a concise training to help medical educators embed Planetary Health content in their teaching and enhance their role as change agents in the medical curriculum. Following this approach, we introduced Planetary Health content, fostered didactic skills, and allowed time for participants to create their own teaching materials.\u003c/p\u003e\n\u003cp\u003eFurthermore, we intentionally created space for exchange and networking, with the aim to establish and foster a \u003cem\u003ecommunity of practice\u0026nbsp;\u003c/em\u003e(23). Through structured, collective reflection on their roles in the healthcare system, participants were encouraged to build a shared understanding of necessary change, strengthen self-efficacy, and engage in collective learning and support (e.g., shared goals, visible early wins, peer feedback, and ongoing adaptation).\u003c/p\u003e\n\u003cp\u003eAs part of the Climate Adaptation in Transformative Medical Education (CATMED) project, we developed and implemented the training. CATMED, a collaboration between Heidelberg University, Julius-Maximilians-Universit\u0026auml;t W\u0026uuml;rzburg, and Charit\u0026eacute; \u0026ndash; Universit\u0026auml;tsmedizin Berlin, aims to integrate Planetary Health into medical curricula and promote inter-university collaboration. The Berlin team focused on an intervention targeting medical educators as key stakeholders. The project was funded by the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection.All interventions and evaluations conducted within the project were reviewed and approved by the Ethics Committee of Charit\u0026eacute; \u0026ndash; Universit\u0026auml;tsmedizin Berlin (approval number: CTO 24-0459).\u003c/p\u003e\n\u003ch4\u003eOverall and specific learning objectives\u003c/h4\u003e\n\u003cp\u003eOur training aimed to equip medical educators to integrate Planetary Health into their teaching by combining didactic training in visualization and presentation with foundational Planetary Health knowledge. This objective reflects key recommendations from the AMEE Guide roadmap for faculty development in Planetary Health education(14).\u003c/p\u003e\n\u003cp\u003eWe defined the following overarching learning objectives.\u0026nbsp;\u003c/p\u003e\n\u003col\u003e\n \u003cli\u003eDiscuss advantages and disadvantages of different visualization formats.\u003c/li\u003e\n \u003cli\u003eExplain requirements for teaching materials in the context of cognitive load theory.\u003c/li\u003e\n \u003cli\u003eExplain the concept of Planetary Health.\u003c/li\u003e\n \u003cli\u003eReflect on individual and societal health impacts of climate change.\u003c/li\u003e\n\u003c/ol\u003e\n\u003col start=\"5\"\u003e\n \u003cli\u003eIntegrate and present Planetary Health topics relevant to their own discipline in an engaging and comprehensible manner.\u003c/li\u003e\n\u003c/ol\u003e\n\u003cp\u003eReflection on participants\u0026rsquo; own attitudes and networking among participants were not explicitly formulated as learning objectives but were considered important implicit goals of the program by the facilitators.\u003c/p\u003e\n\u003ch4\u003eTeaching methods\u003c/h4\u003e\n\u003cp\u003eTo accommodate participants\u0026apos; limited time, we designed a blended-learning format. Self-directed preparatory and follow-up units for knowledge acquisition and material revision were delivered via an online learning platform, while the face-to-face sessions focused on hands-on PH and didactics practice to promote immediate transfer into teaching (24). Prior research shows such elements enhance practice transfer (25)\u003c/p\u003e\n\u003cp\u003eThe in-person session began with an interactive role-play exercise illustrating climate change\u0026apos;s socially stratified impacts and emotional effects in everyday situations. This was followed by guided reflection on personal vulnerability, didactic input on visualization principles, and Planetary Health content linked directly to participants\u0026apos; teaching. After the break, participants developed their own teaching materials individually or in pairs. A detailed description of the training is described in table one.\u003c/p\u003e\n\u003ctable border=\"1\" cellspacing=\"0\" cellpadding=\"0\"\u003e\n \u003ctbody\u003e\n \u003ctr\u003e\n \u003ctd valign=\"top\" style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePhase\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTime (min)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 25.2893%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLearning objective\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003e(participant-centred)\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 14.3802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eEducational approach\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 15.0413%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eTeaching and learning activities\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd valign=\"top\" style=\"width: 21.3223%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eKey content/\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003cp\u003e\u003cstrong\u003eOutput\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePre-course Preparation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e45\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eActivate prior knowledge and establish a common baseline understanding of PH\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eFlipped classroom\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eOnline, on demand, self-study\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eIntroduction to PH focused on interconnectedness of health and environment\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eOrientation and learning engagement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e10\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eAlign expectations, learning goals and course structure\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eGuided orientation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eVisualization on flipchart\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eWelcome, agenda, learning objectives\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eExperiential and reflexive engagement\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e45\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eReflect on individual and societal health impacts of climate change through perspective-taking\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eExperienced based learning, serious game\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eRole-play \u0026ldquo;In the middle of society\u0026rdquo; with guided reflection\u003c/p\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eIndividual health effects of climate change, differential vulnerability and personal impact\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConceptual grounding: design of teaching material\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e20\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eUnderstand\u0026nbsp;requirements for teaching materials in the context of cognitive load theory\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eExpert input, learning by example\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eInteractive lecture with worked examples\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eSlide design principles, cognitive load theory, visual examples\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eReflective application and quality criteria\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e40\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eCritically analyse teaching materials and derive quality criteria for effective design\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eActivating reflection\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eHeadstand exercise in small group, plenary discussion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eCreation of \u0026ldquo;worst-practice\u0026rdquo; slides; development of feedback criteria\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e10\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eBreak\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConceptual grounding: Planetary Health\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e25\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eBuild a shared conceptual understanding of PH relevant to medical education\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eExpert input, interactive lecture\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eInteractive lecture using PowerPoint\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003ePlanetary Health framework, planetary boundaries, tipping points, areas of action\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eApplication: identifying entry points in own teaching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e25\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eIdentify and critically reflect on opportunities to integrate PH into one\u0026rsquo;s own courses\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003ePeer teaching, micro-teaching\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eTandem work, with on- and offline resources\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eIdentification of starting points and supplementary PH content\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e60\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eLunch break\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003e\u003cstrong\u003e\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003e\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePractical transfer to own teaching\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eDesign PH teaching materials for immediate use\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003ePractical learning\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eIndividual or tandem work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eDevelopment of 1-2 slides integrating PH content for upcoming course\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eMicro-teaching and feedback\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e30\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003ePresent PH teaching materials in an engaging and comprehensive manner\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003e\u0026nbsp;Formative assessment\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eShort presentation, verbal feedback\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003ePresentation of slides,45+ feedback limited to key aspects\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003eConsolidation and evaluation\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e15\u0026nbsp;\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eReflect on learning outcomes and plan transfer into everyday teaching practice\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eReflection, formative evaluation\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003e3-3-3 reflection method, plenary discussion\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eKey takeaways after 3 hours, 3 days and 3 months, clarification of open questions\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003ctr\u003e\n \u003ctd style=\"width: 17.1901%;\"\u003e\n \u003cp\u003e\u003cstrong\u003ePost-course follow-up\u0026nbsp;\u003c/strong\u003e\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 6.77686%;\"\u003e\n \u003cp\u003e45\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 25.2893%;\"\u003e\n \u003cp\u003eRevise and finalize teaching materials for sustainable integration\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 14.3802%;\"\u003e\n \u003cp\u003eFlipped classroom, individual work\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 15.0413%;\"\u003e\n \u003cp\u003eSubmission via online learning platform\u003c/p\u003e\n \u003c/td\u003e\n \u003ctd style=\"width: 21.3223%;\"\u003e\n \u003cp\u003eRevised slides prepared for use in participants own courses\u003c/p\u003e\n \u003c/td\u003e\n \u003c/tr\u003e\n \u003c/tbody\u003e\n\u003c/table\u003e\n\u003cp\u003eTable 1: detailed description of the training\u003c/p\u003e\n\u003ch4\u003eImplementation\u003c/h4\u003e\n\u003cp\u003eThe program was promoted through multiple channels and faculty networks, with sessions offered at all three university campuses to minimize commuting time.\u003c/p\u003e\n\u003ch4\u003eEvaluation\u003c/h4\u003e\n\u003cp\u003eWe conducted a descriptive evaluation using Kirkpatrick\u0026apos;s model (Kirkpatrick 1959, 1959a, 1960, 1960a), focusing on content/structure satisfaction (Level 1: reaction), self-reported knowledge gain (Level 2: learning) and transfer to teaching (Level 3: behavior). Pre-training assessments covered PH motivation, prior knowledge, and demographics (age, gender, teaching role, experience). Level 4 evaluation focusing on effects on students (results) was not feasible nor methodologically appropriate due to heterogeneous faculty-wide change across courses/cohorts. Post-workshop evaluation used self-developed 5-point Likert items (prior knowledge, motivation, satisfaction, knowledge gain, intended transfer), internally validated per learning objectives and two open-ended feedback questions.\u003c/p\u003e\n\u003cp\u003eTransfer was assessed via documented PH teaching materials and a 12-month follow-up survey; quantitative data analyzed descriptively in Microsoft Excel (2024). The evaluation was conducted online using Microsoft Forms. Participants provided written informed consent prior to participation in the evaluation and data analysis. The questionnaire is provided in \u003cem\u003eAppendix 1\u003c/em\u003e\u003c/p\u003e"},{"header":"Results","content":"\u003cp\u003eThree trainings were conducted in February, August, and September 2024 (6, 8, and 4 participants, respectively). A planned October workshop at the smallest campus was cancelled due to low enrollment (two registrations).\u003c/p\u003e\n\u003ch4\u003eImplementation experiences\u003c/h4\u003e\n\u003cp\u003eThe training was delivered via interdisciplinary team-teaching (2-3 facilitators, including medical/geography PH experts). The first implementation showed that strict time management\u0026mdash;especially precise input timing\u0026mdash;was essential for smooth transitions to application phases, which needed adequate time for contextual adaptation. Despite access to examples and materials, many participants struggled to develop 1-2 teaching slides during self-study. The presence of two facilitators in small groups provided individual guidance, actively utilized by participants and essential for workshop success\u003c/p\u003e\n\u003ch4\u003eParticipants\u003c/h4\u003e\n\u003cp\u003eA total of 18 medical educators participated in three workshops. Seventeen (94%) completed the immediate post-workshop survey (10 females, 7 males, ages 28\u0026ndash;57 years). Teaching experience varied: 7 had \u0026le;3 years, 9 had \u0026gt;10 years. Participants represented diverse medical faculty disciplines with some educators responsible for up to 20 teaching sessions per semester; 9 (50%) completed the 12-month follow-up. All reported strong Planetary Health interest (agree: n=5; strongly agree: n=12) and climate role model self-perception (agree: n=10; strongly agree: n=6), with 8/17 (47%) already attempting to integrate PH content into their teaching beforehand.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eSatisfaction (Kirkpatrick Level 1: Reaction)\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003eOverall, participants reported high satisfaction with the workshop and with the balance between instructional input and practical exercises. The workshop increased interest in Planetary Health and was perceived as relevant to participants\u0026rsquo; teaching activities (see Figure 1).\u003c/p\u003e\n\u003cp\u003eSubjective learning outcomes (Kirkpatrick Level 2: Learning)\u003c/p\u003e\n\u003cp\u003eParticipants rated Planetary Health knowledge gain as moderate (n=9) to high (n=8). Knowledge gains relevant to their teaching were moderate (n=7) or high/very high (n=9). Post-training, 9 rated their integration ability as high/very high, 4 as moderate. Fifteen out of seventeen participants found the PH-didactics combination helpful for teaching integration.\u003c/p\u003e\n\u003ch4\u003eTransfer into teaching practice (Kirkpatrick Level 3: Behaviour)\u003c/h4\u003e\n\u003cp\u003eImmediately after the workshop, most participants completed the follow-up phase and reported intentions to integrate the developed teaching materials and additional Planetary Health content into their teaching, as well as to share the materials with colleagues.\u003c/p\u003e\n\u003cp\u003eAt the 12-month follow-up, 9/18 participants responded; 5 had integrated materials into their teaching and 3 had shared them with colleagues (Figure 2).\u0026nbsp;\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003ePerceived contextual factors influencing transfer\u003c/strong\u003e\u003c/p\u003e\n\u003cp\u003ePerceived negative reactions from the surrounding environment appeared to play only a minor role in the transfer process. Only a small number of participants expected resistance from colleagues or students when integrating Planetary Health content into their teaching (n = 3 and n = 2, respectively). Eight of the nine respondents who participated in the 12-month follow-up reported having experienced predominantly positive reactions from colleagues and students.\u003c/p\u003e\n\u003cp\u003ePerceived negative environmental reactions played only a minor role for transfer. Few participants expected resistance from colleagues (n=3) or students (n=2) when integrating Planetary Health into their teaching. Among 12-month follow-up respondents (n=9), 8 reported predominantly positive reactions from both groups.\u003c/p\u003e"},{"header":"Discussion","content":"\u003ch4\u003eProject objectives\u003c/h4\u003e\n\u003cp\u003eMedical educators with diverse teaching experience and disciplines\u0026mdash;all with pre-existing Planetary Health interest\u0026mdash;attended the training. They reported high satisfaction with its structure, content, and everyday teaching relevance, rating overall PH knowledge gain as moderate to high and acquired integration competence as high.\u003c/p\u003e\n\u003cp\u003eAll but one lecturer completed follow-up and developed course-specific teaching materials. Most intended to integrate Planetary Health content and share with colleagues. At 12-month follow-up (n=9/18), half had implemented PH content, though few shared materials; negative reactions played minimal role. Low participation typical for Charit\u0026eacute; non-mandatory trainings. The one-day format didn\u0026apos;t increase participation numbers but small groups enabled intensive transfer support, enabling team teaching and more resources for all sessions. Based on first-training experiences, team teaching (originally planned solely for that session) proved necessary and was implemented across all workshops, increasing personnel and resource requirements.\u003c/p\u003e\n\u003ch4\u003eComparison with other educational projects\u003c/h4\u003e\n\u003cp\u003eDespite the short duration of the workshop, nearly all participants were able to develop teaching materials suitable for use in their own courses.\u0026nbsp;\u003c/p\u003e\n\u003cp\u003eConsistent with prior research, learning transfer to practice proved challenging, depending on competence, autonomy, perceived value, and supportive context (24). While most medical educators intended to implement the materials, only half had done so at follow-up. As Kirkpatrick Level 3 outcomes (actual behavior change) are rarely assessed, it\u0026apos;s unclear if other formats achieve higher implementation rates.\u003c/p\u003e\n\u003cp\u003eThe \u0026quot;knowledge-to-action gap\u0026quot;\u0026mdash;encompassing motivational, systemic, emotional, and social dimensions (24)\u0026mdash;explains why intentions often diverge from implementation. According to the evaluation, participants felt sufficiently competent to implement PH into their teaching. To sustain implementation motivation, explicit action plans prove beneficial (25), which informed the workshop\u0026apos;s didactic concept for transfer preparation. As fear of negative reactions hinders behavior change (24), a community of practice approach (26) was implemented to enhance social acceptability. Thus, the workshop promoted lecturer networking for collective rather than isolated action, with few negative reactions reported at follow-up.\u003c/p\u003e\n\u003cp\u003ePotential factors that may have hindered implementation for some participants include systemic constraints, such as highly regulated curricula that offer limited encouragement for individual initiative, as well as a lack of institutional incentives or recognition for curricular innovation.\u0026nbsp;A comparable integrative approach has previously been described by Flaegel et al.\u0026nbsp;(20)\u0026nbsp;in an elective course for medical students who are interested in teaching. It encompassed a whole semester and supported students to develop an online lesson with planetary health content. The impact on medical school curricula or teaching practice was not evaluated.\u0026nbsp;\u003c/p\u003e\n\u003ch4\u003eOutlook and future development\u003c/h4\u003e\n\u003cp\u003eAlthough personnel-intensive, the time commitment required from both facilitators and participants was limited. Faculty development programs aiming to change teaching behavior are often associated with substantially higher resource demands (27). The community-of-practice approach has been discussed as a key success factor for sustainable faculty development. Networking among medical educators was therefore a central component of the program and a primary reason for implementing the training as an in-person format. To support networking beyond the individual workshops, a Planetary Health teaching working group was established within the project and successfully embedded under the umbrella of the Charit\u0026eacute; Climate Network.\u003c/p\u003e\n\u003cp\u003eIn the second quarter of 2025, an increasing number of medical educators requested training opportunities related to PH, underscoring both the need and interest for structural integration of such formats. However, following the end of project funding, additional workshops could not be offered. A long-term e-learning format was considered but abandoned due to the critical importance of personal interaction. Key success factors included peer exchange, individualized material development support, group feedback on teaching materials, and lecturer networking.\u003c/p\u003e\n\u003ch4\u003eTransferability and broader implications\u003c/h4\u003e\n\u003cp\u003eBeyond the local context, this study demonstrates that a compact, transfer-oriented training can successfully support medical educators in integrating PH content into their teaching. While the intervention was implemented within a single institution, its core design principles\u0026mdash;low-threshold participation, explicit preparation for transfer, and a focus on change agency within a community-of-practice \u0026mdash;are not institution-specific.\u003c/p\u003e\n\u003cp\u003eMedical faculties that already offer training for faculty members may readily adapt this approach to their local contexts, integrating PH content into their existing training programs. Given the widespread time constraints and competing clinical/research demands across medical schools nationally and internationally, this model appears transferable to diverse educational contexts.\u003c/p\u003e\n\u003ch4\u003eLimitations\u003c/h4\u003e\n\u003cp\u003eThis study has several limitations. First, the small sample size and voluntary participation likely introduced selection bias toward medical educators with pre-existing Planetary Health interest. Second, most outcomes relied on self-reported measures, which are susceptible to social desirability bias and may not reflect objective teaching behavior changes. Third, the moderate 12-month follow-up response rate (50%) limits conclusions about long-term implementation.\u003c/p\u003e\n\u003cp\u003eHowever, a strength is our assessment of Kirkpatrick Level 3 outcomes (actual behavior change)\u0026mdash; rarely evaluated in faculty development studies \u0026mdash; which provides valuable insights into real-world transfer despite these limitations. Kirkpatrick Level 4 (student results/clinical outcomes) was not feasible due to heterogeneous curriculum-wide implementation. Future research could target Level 4 once Planetary Health content achieves more consistent curricular embedding.\u003c/p\u003e"},{"header":"Conclusion","content":"\u003cp\u003eThis study demonstrates that medical educators are key stakeholders and potential change agents for the integration of Planetary Health content into medical curricula. Institutional faculty trainings customized to medical educators' concrete needs and limited time resources, with practical implementation support, could successfully facilitate Planetary Health curricular integration. To ensure sustainable impact beyond individual training sessions, ongoing networking among medical educators\u0026mdash;such as through communities of practice\u0026mdash;appears to be a promising strategy.\u003c/p\u003e"},{"header":"Declarations","content":"\u003ch4\u003eEthics approval and consent to participate\u003c/h4\u003e\n\u003cp\u003eAll interventions and evaluations conducted within the framework of the CATMED project were reviewed and approved by the Ethics Committee of Charit\u0026eacute; \u0026ndash; Universit\u0026auml;tsmedizin Berlin (approval number: CTO 24-0459). The study was performed in accordance with the Declaration of Helsinki and its later amendments. Written informed consent was obtained from all participants prior to inclusion in the evaluation. All data were collected, processed, and stored in accordance with applicable data protection regulations, and participant confidentiality was strictly maintained throughout the study.\u003c/p\u003e\n\u003ch4\u003eConsent for publication\u003c/h4\u003e\n\u003cp\u003eNot applicable.\u003c/p\u003e\n\u003ch4\u003eAvailability of data and materials\u003c/h4\u003e\n\u003cp\u003eThe datasets generated and analyzed during the current study are not publicly available due to data protection and privacy considerations but are available from the corresponding author on reasonable request.\u003c/p\u003e\n\u003ch4\u003eCompeting interests declaration\u003c/h4\u003e\n\u003cp\u003eThe authors declare that they have no competing interests.\u003c/p\u003e\n\u003ch4\u003eFunding\u003c/h4\u003e\n\u003cp\u003eThis work was funded by the Federal Ministry for the Environment, Nature Conservation, Nuclear Safety and Consumer Protection (Grant No. 67DAS264B) as part of the \u003cem\u003eClimate Adaptation in Transformative Medical Education\u003c/em\u003e (CATMED) project.\u0026nbsp;\u003c/p\u003e\n\u003ch4\u003eAuthors\u0026rsquo; contributions\u003c/h4\u003e\n\u003cp\u003eAll authors contributed to the conception and design of the study. Funding was secured by A. Schuster and S. Gehrke-Beck. The shared first and last authorship reflects team-based role transitions due to maternity leave and parental leave during the project period. Specifically, H. Hauch assumed responsibilities originally held by N. Kutschke, and S. Gehrke-Beck assumed responsibilities originally held by A. Schuster.\u003c/p\u003e\n\u003cp\u003eThe training concept was primarily developed by S. Gehrke-Beck and N. Kutschke. The training was implemented by all four authors. A. Schuster additionally served as project coordinator. Data collection and analysis were performed by H. Hauch and S. Gehrke-Beck. All authors contributed to article writing, critically revised the manuscript, and approved the final version.\u003c/p\u003e\n\u003ch4\u003eUse of AI tools\u003c/h4\u003e\n\u003cp\u003eAI-based language tools were used to support the translation and linguistic refinement of the manuscript, including ChatGPT (OpenAI), Perplexity and DeepL (DeepL SE). These tools were used exclusively for language support. All content was reviewed, edited, and approved by the authors, who take full responsibility for the final manuscript.\u003c/p\u003e\n\u003ch4\u003eAcknowledgements\u003c/h4\u003e\n\u003cp\u003eWe thank Oskar Masztalerz for his valuable input as a Planetary Health expert during the training sessions.\u003c/p\u003e\n\u003cp\u003eWe would also like to thank the staff at the Dieter Scheffner Center for their help in organizing the continuing education program for medical educators.\u003c/p\u003e"},{"header":"References","content":"\u003col\u003e\n\u003cli\u003eWHO. WHO factsheet on climate change and health. 2023 [cited 2025 Aug 1]. Climate change. Available from: https://www.who.int/news-room/fact-sheets/detail/climate-change-and-health\u003c/li\u003e\n\u003cli\u003eRomanello M, Di Napoli C, Drummond P, Green C, Kennard H, Lampard P, et al. The 2022 report of the Lancet Countdown on health and climate change: health at the mercy of fossil fuels. Lancet. 2022 Nov 5;400(10363):1619\u0026ndash;54. \u003c/li\u003e\n\u003cli\u003ePrescott SL, Logan AC, Albrecht G, Campbell DE, Crane J, Cunsolo A, et al. The Canmore Declaration: Statement of Principles for Planetary Health. Challenges. 2018 Dec;9(2):31. \u003c/li\u003e\n\u003cli\u003eMlinarić M, Moebus S, Betsch C, Hertig E, Schr\u0026ouml;der J, Loss J, et al. Climate change and public health in Germany - A synthesis of options for action from the German status report on climate change and health 2023. J Health Monit. 2023 Nov;8(Suppl 6):57\u0026ndash;85. \u003c/li\u003e\n\u003cli\u003eChase H, Hampshire K, Tun S. Improving the medical curriculum on planetary health and sustainable healthcare. 2022 Jan 25 [cited 2025 Aug 1]; Available from: https://www.bmj.com/content/376/bmj.o209.long\u003c/li\u003e\n\u003cli\u003eVisser EH, Oosterveld B, Slootweg IA, Vos HMM, Adriaanse MA, Schoones JW, et al. The Development and Characteristics of Planetary Health in Medical Education: A Scoping Review. Academic Medicine. 2024 Oct;99(10):1155. \u003c/li\u003e\n\u003cli\u003eWabnitz K, Schwienhorst-Stich EM, Asbeck F, Fellmann CS, Gepp S, Leberl J, et al. National Planetary Health learning objectives for Germany: A steppingstone for medical education to promote transformative change. Front Public Health. 2023 Feb 16;10:1093720. \u003c/li\u003e\n\u003cli\u003eSchwienhorst-Stich EM, Kropff D, Kersken K, K\u0026ouml;nig S, Leutritz T, Parisi S, et al. Das Wahlpflichtfach \u003cem\u003ePlanetare Gesundheit: Klima.Umwelt.Gesundheit\u003c/em\u003e an der Medizinischen Fakult\u0026auml;t W\u0026uuml;rzburg \u0026ndash; Konzeption, didaktische Methoden und Evaluationsergebnisse. Zeitschrift f\u0026uuml;r Evidenz, Fortbildung und Qualit\u0026auml;t im Gesundheitswesen. 2024 May 1;186:92\u0026ndash;103. \u003c/li\u003e\n\u003cli\u003eLemke D, Holtz S, Gerber M, Amberger O, Sch\u0026uuml;tze D, M\u0026uuml;ller B, et al. From niche topic to inclusion in the curriculum \u0026ndash; design and evaluation of the elective course \u0026ldquo;climate change and health\u0026rdquo;. GMS J Med Educ. 2023 May 15;40(3):Doc31. \u003c/li\u003e\n\u003cli\u003eGrieco F, Parisi S, Simmenroth A, Eichinger M, Zirkel J, K\u0026ouml;nig S, et al. Planetary health education in undergraduate medical education in Germany: results from structured interviews and an online survey within the national PlanetMedEd Project. 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AMEE Consensus Statement: Planetary health and education for sustainable healthcare. Med Teach. 2021 Mar;43(3):272\u0026ndash;86. \u003c/li\u003e\n\u003cli\u003eFullan M, editor. The NEW meaning of educational change. New York, NY: Teachers College Press; 2016. 1 p. \u003c/li\u003e\n\u003cli\u003eBiesta G, Priestley M, Robinson S. The role of beliefs in teacher agency. Teachers and Teaching. 2015 Aug 18;21(6):624\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eFrenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. The Lancet. 2010 Dec;376(9756):1923\u0026ndash;58. \u003c/li\u003e\n\u003cli\u003eSteinert Y, Mann K, Anderson B, Barnett BM, Centeno A, Naismith L, et al. A systematic review of faculty development initiatives designed to enhance teaching effectiveness: A 10-year update: BEME Guide No. 40. 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Available from: https://muse.jhu.edu/book/44600\u003c/li\u003e\n\u003cli\u003eWenger-Trayner B. a brief overview of the concept and its uses. Communities of practice. 2015; \u003c/li\u003e\n\u003cli\u003eKahlke RM, McConnell MM, Wisener KM, Eva KW. The disconnect between knowing and doing in health professions education and practice. Adv Health Sci Educ Theory Pract. 2020 Mar;25(1):227\u0026ndash;40. \u003c/li\u003e\n\u003cli\u003eBoekaerts M, Maes S, Karoly P. Self-Regulation Across Domains of Applied Psychology: Is there an Emerging Consensus? Applied Psychology: An International Review. 2005;54(2):149\u0026ndash;54. \u003c/li\u003e\n\u003cli\u003eLave J, Wenger E. Situated Learning: Legitimate Peripheral Participation [Internet]. 1st edn. Cambridge University Press; 1991 [cited 2026 Jan 20]. Available from: https://www.cambridge.org/core/product/identifier/9780511815355/type/book\u003c/li\u003e\n\u003cli\u003eHaas M, Triemstra J, Tam M, Neuendorf K, Reckelhoff K, Gottlieb-Smith R, et al. A decade of faculty development for health professions educators: lessons learned from the Macy Faculty Scholars Program. BMC Medical Education. 2023 Mar 27;23(1):185. \u003c/li\u003e\n\u003c/ol\u003e"}],"fulltextSource":"","fullText":"","funders":[],"hasAdminPriorityOnWorkflow":false,"hasManuscriptDocX":true,"hasOptedInToPreprint":true,"hasPassedJournalQc":"","hasAnyPriority":false,"hideJournal":false,"highlight":"","institution":"","isAcceptedByJournal":false,"isAuthorSuppliedPdf":false,"isDeskRejected":"","isHiddenFromSearch":false,"isInQc":false,"isInWorkflow":false,"isPdf":false,"isPdfUpToDate":true,"isWithdrawnOrRetracted":false,"journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true},"keywords":"Medical education, Climate Change, faculty training, lecturer training, Planetary Health, Curriculum, Change Agency","lastPublishedDoi":"10.21203/rs.3.rs-8911081/v1","lastPublishedDoiUrl":"https://doi.org/10.21203/rs.3.rs-8911081/v1","license":{"name":"CC BY 4.0","url":"https://creativecommons.org/licenses/by/4.0/"},"manuscriptAbstract":"\u003cp\u003e\u003cstrong\u003eBackground\u003c/strong\u003e\u003cbr\u003e\nPlanetary Health (PH) content is increasingly recognized as essential for medical education. For longitudinal integration across the curriculum, medical educators can serve as change agents and multipliers. A targeted training that conveys both PH knowledge and pedagogical skills can empower medical educators to incorporate PH topics into their teaching.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eMethods\u003c/strong\u003e\u003cbr\u003e\nFollowing the curriculum development cycle by Kern, we developed a training for medical educators of Charité – Universitätsmedizin Berlin teaching in the medical curriculum. The learning objective was to enable medical educators to effectively integrate PH content into their courses.\u003c/p\u003e\n\u003cp\u003eThe program was delivered in a blended-learning format: input on the interconnectedness between human and planetary health was provided online via a learning platform prior to the in-person unit (1 teaching unit [TU]). The face-to-face workshop (6 TU) gave input on Planetary Health as well as didactic input and facilitated discussion of personal experiences with climate change and its relevance to teaching, thereby enhancing participants’ change agency. Further, participants developed teaching materials for their own courses and tested them via a micro-teaching exercise. As follow-up the participants revised their teaching materials-based feedback on their micro teaching (1 TU). The impact of the workshop was evaluated according to Kirkpatrick’s framework.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eResults\u003c/strong\u003e\u003cbr\u003e\nEighteen medical educators participated across three workshops, with 13 completing the follow-up questionnaire. Seventeen participants (94% response rate) completed the post-workshop evaluation. Participants reported satisfaction being satisfied with the content, structure, and practical relevance of the course and rated their knowledge gain as moderate to high. Fifteen participants intended to integrate the developed teaching materials into their courses, and 14 planned to share their materials with colleagues. One year later, nine participants (50%) responded to a follow-up survey; five had integrated the materials into their teaching, and three had shared them with colleagues.\u003c/p\u003e\n\u003cp\u003e\u003cstrong\u003eConclusion\u003c/strong\u003e\u003cbr\u003e\nA targeted training that actively prepares and supports the transfer of knowledge into teaching practice is well received by medical educators. PH content was integrated into courses by a subset of participants. Beyond the workshop, ongoing networking may further support sustainable PH content integration into the curriculum.\u003c/p\u003e","manuscriptTitle":"Empowering medical educators to teach planetary health: development and outcomes of a curriculum integration training","msid":"","msnumber":"","nonDraftVersions":[{"code":1,"date":"2026-03-12 07:19:11","doi":"10.21203/rs.3.rs-8911081/v1","editorialEvents":[{"type":"communityComments","content":0},{"type":"editorInvitedReview","content":"","date":"2026-04-29T15:18:07+00:00","index":"hide","fulltext":""},{"type":"reviewerAgreed","content":"309529334136224902407297132598452510051","date":"2026-03-16T15:50:49+00:00","index":"hide","fulltext":""},{"type":"reviewersInvited","content":"","date":"2026-03-05T14:42:07+00:00","index":"","fulltext":""},{"type":"editorAssigned","content":"","date":"2026-02-25T12:45:33+00:00","index":"","fulltext":""},{"type":"checksComplete","content":"","date":"2026-02-23T17:36:11+00:00","index":"","fulltext":""},{"type":"submitted","content":"BMC Medical Education","date":"2026-02-23T17:32:05+00:00","index":"","fulltext":""}],"status":"published","journal":{"display":true,"email":"[email protected]","identity":"bmc-medical-education","isNatureJournal":false,"hasQc":true,"allowDirectSubmit":false,"externalIdentity":"meed","sideBox":"Learn more about [BMC Medical Education](http://bmcmededuc.biomedcentral.com/)","snPcode":"","submissionUrl":"https://www.editorialmanager.com/meed/default.aspx","title":"BMC Medical Education","twitterHandle":"BMC_series","acdcEnabled":true,"dfaEnabled":false,"editorialSystem":"em","reportingPortfolio":"BMC Series","inReviewEnabled":true,"inReviewRevisionsEnabled":true}}],"origin":"","ownerIdentity":"ad19a9c6-3653-4caf-8f96-49cc8e72f595","owner":[],"postedDate":"March 12th, 2026","published":true,"recentEditorialEvents":[{"type":"editorInvitedReview","content":"","date":"2026-04-29T15:18:07+00:00","index":87,"fulltext":""}],"rejectedJournal":[],"revision":"","amendment":"","status":"under-review","subjectAreas":[],"tags":[],"updatedAt":"2026-03-12T07:19:11+00:00","versionOfRecord":[],"versionCreatedAt":"2026-03-12 07:19:11","video":"","vorDoi":"","vorDoiUrl":"","workflowStages":[]},"version":"v1","identity":"rs-8911081","journalConfig":"researchsquare"},"__N_SSP":true},"page":"/article/[identity]/[[...version]]","query":{"redirect":"/article/rs-8911081","identity":"rs-8911081","version":["v1"]},"buildId":"XKTyCvWXoU3ODBz1xrDgd","isFallback":false,"isExperimentalCompile":false,"dynamicIds":[84888],"gssp":true,"scriptLoader":[]}