Evaluating the Impact of a Sustainability Education Intervention on Emergency Medicine Residents.
- 1New York Institute of Technology College of Osteopathic Medicine, Northern Boulevard, Old Westbury, New York.
- 2New York Institute of Technology College of Engineering and Computing Sciences, Northern Boulevard, Old Westbury, New York.
Abstract
Introduction
Healthcare 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
We 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
Of 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
A 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.
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BibTeX
@article{ashkezari2026evaluating,
title = {{Evaluating the Impact of a Sustainability Education Intervention on Emergency Medicine Residents.}},
author = {Atieh D Ashkezari and Christina Bogdani and Xueqing Huang and Michael Gindi},
journal = {The western journal of emergency medicine},
year = {2026},
month = aug,
doi = {10.5811/westjem.56998},
url = {https://europepmc.org/article/MED/42900914},
note = {CC BY},
}
RIS
TY - JOUR
TI - Evaluating the Impact of a Sustainability Education Intervention on Emergency Medicine Residents.
AU - Atieh D Ashkezari
AU - Christina Bogdani
AU - Xueqing Huang
AU - Michael Gindi
PY - 2026
DA - 2026/08/10
JO - The western journal of emergency medicine
DO - 10.5811/westjem.56998
UR - https://europepmc.org/article/MED/42900914
AB - Introduction Healthcare 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 We 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 Of 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 A 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.
SN - 1936-900X
SN - 1936-9018
ER -