Are we teaching the health impacts of climate change in a clinically relevant way? A systematic narrative review of biomechanism-focused climate change learning outcomes in medical curricula

Figures & data

Table 1. PIO Framework for search term building “and” operator connected the three components.

Component of review topic	MeSH and/or keyword search terms
Population	(clinic* OR medic* OR anaesthetic* OR allergy OR “Cardiovascular Medicine” OR “Cardiology” OR genetics OR neurophysiology OR pharmacology OR therapeutics OR dermatology OR endocrinology OR diabetes OR gastroenterology OR genito-urinary OR geriatric* OR “Infectious Disease*” OR oncology OR toxicology OR neurology OR “Pain Medicine” OR palliative OR “Rehabilitation Medicine” OR nephrology OR respiratory OR pulmonology OR rheumatology OR “Sleep Medicine” OR “Sports Medicine” OR “exercise medicine” OR “Critical Care” OR “Emergency Medicine” OR “Forensic Medicine” OR haematology OR gynaecology OR obstetrics OR “Occupational Medicine” OR ophthalmology OR otolaryngology OR “ENT” OR paediatrics OR neonatology OR pathology OR immunology OR microbiology OR virology OR pharmacology OR “Complementary Medicine” OR “Alternative Medicine” OR “Primary Care” OR psychiatry OR “Addiction Medicine” OR “Learning Disabilities” OR “Public Health” OR epidemiology OR radiology OR oncology OR “Nuclear Medicine” OR “Reproductive Medicine” OR surgery OR “Peri-Operative” OR orthopaed* OR surgery OR urology
Intervention	“Climate change” OR “extreme weather”
Outcome	Teach* OR education OR undergraduate OR post-graduate OR curricul*

Table 2. Data extraction variables.

	Item type	Description
Descriptive analysis	Reference detail	Authors
	Paper type	Commentary paper, original research, perspective article
	Country/countries	Of all authors in paper. Excludes National Medical Student Associations*
	Year published
	Author qualifications	Named degrees
	Author departments	E.g. Paediatric, neurology, Global Health departments
Content analysis	Names of domains and relevant sub-domains	Sub-domains considered relevant if includes HICC in biomechanism context
	Number of learning outcomes in HICC
	Learning outcomes related to the HICC	If more general LOs, then whether LOs recognise HICC for different specialties
	Key biomedical discipline terms	Whether LOs had mentions of medical specialties (e.g. cardiology, respiratory) and if so, details of Los
	Climate change phenomena identified	E.g. Extreme weather events (heatwaves, storms, droughts) or meteorological events (rising temperatures and humidity)

Figure 1. Prisma flowchart outlining study screening process.

Figure 2. PRISMA flowchart outlining process for updated search, June 2023.

Table 3. Learning outcome count and proportion focused on biomechanisms.

First author	Total learning outcomes	Proportion of LOs related to biomechanisms
Thompson (2014)	13	.08
Maxwell (2016)	18	.17
Valois (2016)	24	.33
Walpole (2016)	18	.22
Teherani (2017)	15	.13
CFMS (2019)	71	.35
Incision UK (2020)	60	.08
GCCHE (2020)	47	.13
Rabin (2020)	49	.55
Goldman (2021)	15	.33
Gomez (2021)	5	.20
Kligler (2021)	15	.73
Kuczmarski(2021)	35	.57
Philipsborn (2021)	24	.50
Madden (2022)	31	.06
Navarette-Welton (2022)	11	.82
Wabnitz (2022)	31	.03
Dunne (2022)	8	.00
Aasheim (2023)	14	.00
Bevan (2023)	16	.13
Blom (2023)	9	.22
Hatfield (2023)	7	.29

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