Evaluation of the knowledge and behaviors of Family Medicine residents on planetary health and environment-health relationship
Aim: This study aims to evaluate the knowledge and attitudes of family medicine residents regarding planetary health and the environment-health relationship, thereby contributing to the enhancement of their environmental awareness. In parallel with WONCA’s vision of sustainability and Planetary Health, it also seeks to offer recommendations for the development and integration of a curriculum into medical education.
Materials and Methods: This cross-sectional study was conducted at the Family Medicine Clinic of Adana City Training and Research Hospital between 01.03.2024 and 30.04.2024, involving 94 family medicine residents. Participants completed a sociodemographic form, the Ecocentric and Anthropocentric Attitudes Toward the Environment scale (EAATE), and A Three-Tier Diagnostic Test to Assess Misconceptions on Atmosphere-Related Environmental Problems (AREPDiT).
Results: Examination of the participants’ EAATE scale scores revealed a mean ecocentric attitude score of 62.76 ± 12.34, a mean anthropocentric attitude score of 41.06 ± 10.11, and a mean antipathetic attitude score of 15.45 ± 9.02. When responses to the AREPDiT questions were evaluated, the proportion of scientifically accurate answers was 30.6% for global warming, 22.4% for the greenhouse effect, 31.7% for the ozone layer, and 13.5% for acid rain.
Conclusion: The study showed that family medicine residents predominantly hold ecocentric ethical views, yet they have substantial misconceptions and knowledge gaps regarding environmental and atmospheric phenomena. Strengthening the residency training with content on both the impact of the environment on human health and human impact on the environment is essential to address these deficiencies.
References
- Mwangi W, de Figueiredo P, Criscitiello MF. One Health: Addressing global challenges at the nexus of human, animal, and anvironmental health. PLoS Pathog 2016 Sep 15;12(9):e1005731.
- Zinsstag J, Schelling E, Waltner-Toews D, Tanner M. From “one medicine” to “one health” and systemic approaches to health and well-being. Prev Vet Med 2011 Sep;101(3–4):148–56.
- Spínola ACF, Arman IH, Bentounsi Z, Cordovil C, Gökdemir Ö. WONCA Europe’s new Family Medicine definition and sustainable healthcare knowledge. The Anatolian Journal of Family Medicine 2024;7(1):44–5.
- Gagnon Thompson SC, Barton MA. Ecocentric and anthropocentric attitudes toward the environment. J Environ Psychol 1994 Jun;14(2):149–57.
- Erten S. Ekosentrik, antroposentrik ve çevreye yönelik antipatik tutum ölçeğinin Türkçeye uyarlama çalışması. Eurasian Journal Of Educational Research 2007;28:67–74.
- Arslan HO, Cigdemoglu C, Moseley C. A Three-Tier Diagnostic Test to Assess Pre-Service Teachers’ Misconceptions about global warming, greenhouse effect, ozone layer depletion, and acid rain. Int J Sci Educ 2012 Jul;34(11):1667–86.
- Arslan HÖ, Çiğdemoğlu C. Atmosfer ile ilgili çevre problemleri konularında kavram yanılgılarını tespit eden Üç Aşamalı Tanı Testinin Türkçeye uyarlanması. Yüzüncü Yıl Eğitim Fakültesi Dergisi. 2017 Jun 15;14(1):671–99.
- Karakuş G, Çimen O. Öğretmen adaylarının çevre sorunlarına yönelik etik yaklaşımlarının incelenmesi. Gazi Üniversitesi Gazi Eğitim Fakültesi Dergisi 2020;40(2):411–35.
- Erten S, Aydoğdu C. Türkiyeli ve Azerbaycanlı öğrencilerde, ekosentrik, antroposentrik ve çevreye karşı antipatik tutum anlayışları. Hacettepe Üniversitesi Eğitim Fakültesi Dergisi 2011;41:158–69.
- Bozdemir H, Faiz M. Öğretmen adaylarının çevreye yönelik ekosentrik, antroposentrik ve antipatik tutumları. Sakarya University Journal of Education 2018 Apr 15;8(1):61–75
- Karahan G. Hemşirelik öğrencilerinin ekosentrik, antroposentrik ve çevreye yönelik antipatik tutumları. Yüksek Lisans Tezi. İstanbul Üniversitesi Sağlık Bilimleri Enstitüsü; 2009.
- Xie E. Challenges And Opportunities İn Planetary Health For Primary Care Providers. Lancet Planet Health 2018 May;2(5):e185-7.
- Tennison I, Roschnik S, Ashby B, Boyd R, Hamilton I, Oreszczyn T, et al. Health care’s response to climate change: a carbon footprint assessment of the NHS in England. Lancet Planet Health 2021 Feb;5(2):e84–92.
- Merchant C. Radical Ecology. 1st ed. Vol. 1. London, Routledge. 1992.
- Romanello M, Walawender M, Hsu SC, Moskeland A, Palmeiro-Silva Y, Scamman D, et al. The 2025 report of the Lancet Countdown on health and climate change: climate change action offers a lifeline. The Lancet 2025 Dec;406(10521):2804–57.
- Sarcone A, Angelillo S, Di Gennaro G, Belfiore MG, Pileggi C, Costa D, et al. The ecological footprint of healthcare: awareness, knowledge, and attitudes of medical students and medical residents. Front Public Health 2025 Nov 5;13:1711363.
- Redvers N, Wright K, Hartmann-Boyce J, Tonkin-Crine S. Physicians’ views of patient–planetary health co-benefit prescribing: a mixed methods systematic review. Lancet Planet Health 2023 May;7(5):e407–17.
- Sergeant M, Zahid D, Zvereva E, Douglass R, Kroeker L, Tieu M, et al. The low-carbon fruit tree for primary care. Healthc Manage Forum 2025 Jul 14;38(4):331–8.
- Blau E, Asrar FM, Arya N, Schabort I, Abelsohn A, Price D. Greener medical homes: Environmental responsibility in family medicine. Can Fam Physician 2016 May;62(5):381–4.


