{
  "abstract": "Introduction\n\nHealthcare is a significant contributor to global greenhouse gas emissions, with emergency departments being among the most resource-intensive settings. Despite increasing awareness of climate change and its health implications, structured sustainability education remains lacking in emergency medicine graduate medical education training. We evaluated the impact of a brief, educational intervention on emergency medicine (EM) residents' knowledge, attitudes, and self-reported behaviors related to sustainability.Methods\n\nWe conducted a prospective pre/post interventional study at two community-based EM residency programs. Emergency medicine residents completed a baseline survey assessing sustainability-related knowledge, attitudes, and self-reported behaviors, followed by a video on sustainable clinical practice and a peer-reviewed paper on the environmental impact of inhalers. Immediate postcourse and one-month follow-up surveys were administered to evaluate short- and intermediate-term changes. Our primary outcome measure was change in sustainability-related knowledge scores. Secondary outcomes included changes in attitudes toward sustainability and self-reported sustainability-related clinical behaviors. Survey responses were analyzed using descriptive statistics, paired t tests and repeated-measures analysis of variance, as appropriate.Results\n\nOf 41 eligible EM residents across two residency programs, 34 completed the baseline survey (82.9%), 28 completed the immediate post-intervention survey (68.3%), and 30 completed the one-month follow-up survey (73.2%). Knowledge scores at baseline were 55.0% and increased to 68.0% immediately after the intervention (P < .001). At one month, knowledge scores remained higher than baseline (65.0%) (P = .003). Attitudes improved significantly immediately post-intervention (P = .001), despite already neutral-to-positive baseline levels. Two self-reported behavior items improved at one month: preferential prescribing of dry-powder inhalers, which were described in the educational materials as having less of an environmental impact than aerosolized inhalers (12.0% to 37.0%, P < .050) and self-reported efforts to reduce unnecessary waste (56.0% to 87.0%, P < .050), with overall self-reported behavior change (P = .001). Nebulizer-related prescribing did not significantly change. The open-ended item showed similar thematic patterns at both baseline and after one month, with most residents describing simple waste-reduction actions (eg, minimizing disposables), and no significant shift in qualitative categories.Discussion and conclusion\n\nA brief, structured sustainability module delivered via a video format was feasible and well-received by EM residents. Preliminary data suggest improvements in knowledge, attitude, and self-reported behaviors, highlighting the potential for scalable sustainability education within graduate medical training. However, these findings should be interpreted in the context of a small sample size and self-reported outcomes.",
  "abstract_shown": true,
  "affiliations": [
    "New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, New York.",
    "New York Institute of Technology College of Engineering and Computing Sciences, Northern Boulevard, Old Westbury, New York."
  ],
  "article_type": "research article",
  "arxiv": null,
  "author_total": 4,
  "authors": [
    {
      "affs": [
        0
      ],
      "name": "Atieh D Ashkezari"
    },
    {
      "affs": [
        0
      ],
      "name": "Christina Bogdani"
    },
    {
      "affs": [
        1
      ],
      "name": "Xueqing Huang"
    },
    {
      "affs": [
        0
      ],
      "name": "Michael Gindi"
    }
  ],
  "bibtex": "https://research.draconitic.com/paper/3r7wchtvsk96c.bib",
  "cited_by": 0,
  "doi": "10.5811/westjem.56998",
  "fulltext_url": "https://europepmc.org/articles/PMC13660593",
  "id": "3r7wchtvsk96c",
  "issns": [
    "1936-900X",
    "1936-9018"
  ],
  "landing_url": "https://europepmc.org/article/MED/42900914",
  "language": "eng",
  "licence": "CC-BY",
  "licence_label": "CC BY",
  "licence_source": "article",
  "licence_url": "https://creativecommons.org/licenses/by/4.0/",
  "metadata_licence": null,
  "native_subjects": [
    [
      "openalex",
      "2739|Innovations in Medical Education"
    ]
  ],
  "openalex": "W7202122215",
  "pdf_url": "https://europepmc.org/articles/PMC13660593?pdf=render",
  "pmcid": "PMC13660593",
  "pmid": "42900914",
  "published": "2026-08-10",
  "publisher": null,
  "ris": "https://research.draconitic.com/paper/3r7wchtvsk96c.ris",
  "sources": [
    {
      "first_seen": "2026-10-30T12:19:41Z",
      "native_id": "MED:42900914",
      "source": "europepmc",
      "url": "https://europepmc.org/article/MED/42900914"
    }
  ],
  "subjects": [
    {
      "field": "medicine",
      "origin": "openalex:2739|Innovations in Medical Education",
      "subfield": "epidemiology-public-health"
    }
  ],
  "title": "Evaluating the Impact of a Sustainability Education Intervention on Emergency Medicine Residents.",
  "title_text": "Evaluating the Impact of a Sustainability Education Intervention on Emergency Medicine Residents.",
  "type": "peer-reviewed",
  "updated_at": "2026-10-30T12:19:41Z",
  "url": "https://research.draconitic.com/paper/3r7wchtvsk96c",
  "venue": "The western journal of emergency medicine",
  "versions": []
}