Climate change education for environmental sustainability in health professional education: A modified Delphi

Background The escalating health impacts of climate change demand urgent integration of climate education into health professions curricula. Yet there is limited global consensus on the essential competencies, content, and pedagogy for such integration. This phase is part of a multi-pronged study. The first phase was an integrative review which identified 5 themes and 45 subthemes about climate change education in Health Professions Education (HPE). The second phase is presented here as a modified Delphi to refine and validate the themes through expert consensus. The third phase will be a feasibility study. Design A modified Delphi. Methods Forty experts (25 academics and 15 climate professionals) from Africa and Asia participated in two rounds of online surveys between October 2024 and January 2025. Themes and subthemes were shared for independent and blinded ratification. Consensus was set at 80%. Expert comments were used to refine and validate themes and subthemes. Results At the end of round one, with a 98% response rate, 45 subthemes were reviewed; 20 were revised or merged. At the end of the second round, there was a response rate 0f 50%, 16 subthemes were retained and 9 subthemes were removed. Final validated themes included models, resources, faculty development, regulatory engagement, and curriculum integration. Conclusion Health professionals, as frontline responders to climate crises, must be equipped with actionable, context-specific competencies. This study presents a consensus-driven framework to embed climate change education within HPE, fostering environmentally responsible health systems and a more resilient, sustainable future.