Background
There is a pressing need for more sustainable healthcare. UK medical graduates are required to apply social, economic and environmental principles of sustainability to their practice. The Centre for Sustainable Healthcare has developed a sustainability in quality improvement (SusQI) framework and educator’s toolkit to address these challenges. We aimed to evaluate this toolkit at Bristol Medical School.
Methods
We facilitated a SusQI workshop for all third-year Bristol Medical School students. We used mixed methods including questionnaires, exit interviews and follow-up focus groups to evaluate the outcomes and processes of learning.
Results
Students reported: improvements in knowledge, confidence, and attitudes in both sustainable healthcare and quality improvement; increased self-rated likelihood to engage in SusQI projects; and willingness to change behaviour to reduce environmental impact in their healthcare roles. Factors for successful teaching included: interactivity; collaboration and participation; and real-life, relevant and tangible examples of projects delivered by credible role models.
Conclusions
SusQI education supported by the toolkit was effective at building knowledge and skills, and reframing thinking on sustainability in quality improvement. Combining the topics provided enhanced motivation for and engagement in both together, not only each individually. Further research is needed on translation of SusQI learning into practice.

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No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
Additional File 1.doc - Workshop slides and activities • Printout of the slides and activity worksheets used in the workshop.
Additional File 2.doc – Pre- and post-session questionnaires • The pre- and post-session questionnaires used for data collection
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Posted 02 Feb, 2021
On 04 May, 2021
Received 01 May, 2021
On 16 Apr, 2021
Received 16 Mar, 2021
On 05 Mar, 2021
Invitations sent on 14 Feb, 2021
On 08 Feb, 2021
On 29 Jan, 2021
On 29 Jan, 2021
On 22 Jan, 2021
Posted 02 Feb, 2021
On 04 May, 2021
Received 01 May, 2021
On 16 Apr, 2021
Received 16 Mar, 2021
On 05 Mar, 2021
Invitations sent on 14 Feb, 2021
On 08 Feb, 2021
On 29 Jan, 2021
On 29 Jan, 2021
On 22 Jan, 2021
Background
There is a pressing need for more sustainable healthcare. UK medical graduates are required to apply social, economic and environmental principles of sustainability to their practice. The Centre for Sustainable Healthcare has developed a sustainability in quality improvement (SusQI) framework and educator’s toolkit to address these challenges. We aimed to evaluate this toolkit at Bristol Medical School.
Methods
We facilitated a SusQI workshop for all third-year Bristol Medical School students. We used mixed methods including questionnaires, exit interviews and follow-up focus groups to evaluate the outcomes and processes of learning.
Results
Students reported: improvements in knowledge, confidence, and attitudes in both sustainable healthcare and quality improvement; increased self-rated likelihood to engage in SusQI projects; and willingness to change behaviour to reduce environmental impact in their healthcare roles. Factors for successful teaching included: interactivity; collaboration and participation; and real-life, relevant and tangible examples of projects delivered by credible role models.
Conclusions
SusQI education supported by the toolkit was effective at building knowledge and skills, and reframing thinking on sustainability in quality improvement. Combining the topics provided enhanced motivation for and engagement in both together, not only each individually. Further research is needed on translation of SusQI learning into practice.

Figure 1

Figure 2

Figure 3

Figure 4
No competing interests reported.
This is a list of supplementary files associated with this preprint. Click to download.
Additional File 1.doc - Workshop slides and activities • Printout of the slides and activity worksheets used in the workshop.
Additional File 2.doc – Pre- and post-session questionnaires • The pre- and post-session questionnaires used for data collection
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