Exploring environmental sustainability in dentistry among students and teachers in the United Arab Emirates: a cross-sectional study | BMC Medical Education

Following the publication of the consensus advice arising from discussions at the ADEE Sustainability Workshop at the Annual Conference in Berlin in 2019, there has been a significant increase in interest in ESD. The consensus aimed to inform educators about the core principles set out in the Sustainable Dental Clinical Practice Report and underlined the importance of integrating sustainability into the four educational domains and key competencies in general dental education (12). This study was conducted to investigate for the first time the existing awareness and motivations among dental students and teachers regarding ESD in the UAE. Furthermore, the study sought to identify the barriers and factors influencing the adoption of ESD within dental education in the region.

Despite poor ESD awareness among students and teachers in the UAE and the paucity of its official and clear inclusion in current dental curricula, as evidenced by the current survey, there was a positive attitude among most students and teachers to promote ESD in the adopt and integrate curricula. These findings are consistent with numerous previous studies in the medical (28,29,30) and dental education literature (20,21,22, 25). There is a clear awareness of practical environmental protection among the young student generation, such as cycling and public transport plans, switching off energy-consuming equipment and motion-detecting lights. However, significant barriers need to be addressed to integrate ESD into dental curricula, including the lack of knowledge about ESD among students and teachers, insufficient curriculum space and resources, lack of time to prepare necessary content, and the tendency not to prioritize to ESD learning outcomes. in the dental curriculum. To overcome these barriers, this study recommends offering capacity building and training courses for teachers and educational staff in the field of ESD “train the teachers”, integrating the subject both in the classroom and clinical environment and emphasizing is placed on establishing ESD-related program objectives and learning outcomes. This list of recommendations does not necessarily require a complete overhaul of the educational curriculum, but rather the incorporation of ESD content into existing dental curricula. The barriers and enablers identified in this study show significant similarities between sustainability-related barriers and enablers reported in previous studies. For example, the results of our study are also consistent with those of Joury et al. in 2021 examining ESD in US and UK dental schools (20). Furthermore, Gershberg et al. noted that there is little room for additional learning content. Nevertheless, their study results indicated the feasibility of integrating ESD into existing courses (21). A recent survey conducted by Durnall et al. revealed that there is notable interest and concern among undergraduate students in Great Britain regarding the topic of ESD. The aforementioned studies conducted in Great Britain served as a compelling catalyst for the inclusion of ESD into academic curricula by the General Dental Council (20, 22). In the US the situation mirrors that in Britain; Gershberg et al. emphasized the importance of assessing students’ interest and attitudes toward ESD to help teachers devise effective strategies for integrating it into the curriculum (21). It is imperative to emphasize that the primary focus should be on dental students as they will play a crucial role in promoting sustainable sustainability-related attitudes and beliefs among future dentists. The beginnings of this endeavor should come from their dental education, which should serve as the basis for instilling these values. Indeed, our research underlines the importance of students’ role as leaders and initiators for the promotion of environmental education. The enthusiasm among students for learning ESD, their recognition of its relevance to their future practice, and the innate sense of responsibility towards the environment among younger generations suggest that involving students in planning and initiating ESD activities and collaborations can pave the way for the successful implementation of ESD in both current curricula and future dental practice (20,21,22,25). It is essential that physicians and students develop a partnership in the learning process in this ever-evolving field (21). The various institutions in the UAE offering dental education can open the door for a shared collaboration between them to introduce ESD into their curricula. Such an agreement is a driver to accelerate the progress of ESD and the integration of the subject on a larger scope. Nevertheless, financing, organizational factors and intellectual property challenges hinder such innovative measures that need to take place across a broad spectrum, and therefore legislative authorities must address these challenges.

Similar to the findings of our study, Jamal et al. reported teachers’ desire to incorporate ESD into their teaching, despite their limited foundational knowledge on the subject (25). Efforts to incorporate ESD into UAE dental curricula can be facilitated by easing the way for teachers to become competent in delivering ESD material through teaching techniques that students value and benefit from, such as Socratic seminars, mutual education and interdisciplinary learning. Furthermore, laying the foundation to achieve this goal requires access to capacity building and training packages and the creation of a repository of resources. Most of the resources available are medically based and do not fully cover dentistry, or are outdated and therefore require modification, adaptation and updating of the content. Another innovative and practical method to educate dental faculties in the UAE about the importance of ESD is to encourage them to become part of associations and attend international conferences that seek to embed UNESCO’s SDGs in higher education ( 31, 32). A next step is to increase their awareness of the country’s recent efforts towards sustainable development, especially in the healthcare sector, such as Abu Dhabi’s sustainability goals announced in 2023, which aim to reduce carbon emissions with a focus on waste management (33).

Despite student and faculty interest in ESD, legitimately embedding ESD into UAE dental curricula requires regulatory bodies such as the Ministry of Education (MOE), the Commission for Academic Accreditation, deans of the UAE Colleges of Dentistry , the Ministry of Health and Prevention and MOE National Qualification Center agree to include sustainable dental practices in the learning outcomes, requiring dental education providers to embed sustainability in their dental curricula. A structured Delphi approach could be deployed to build a consensus among dental students, educators and other key allies on environmental sustainability learning outcomes in dental education and the opportunity to make this part of the professional competency standards in the UAE (34). Furthermore, to advance the environmental sustainability agenda in dental education and practice, more research is needed on various aspects including the availability of materials, tools and equipment within the dental industry that meet sustainability-related objectives.

Despite the intriguing findings of the current study, there are several limitations. The low response rate may make it difficult to generalize the current findings to all students and faculty at the various dental higher education institutions in the UAE. Thus, it is possible that the current study primarily included participants who were interested in and familiar with ESD. Nevertheless, participants’ limited exposure to ESD, as evidenced by their responses, actively works against this possibility. It is worth noting that previous studies on environmental sustainability in dental education have also reported low response rates, ranging between 37% and 5% (20,21,22,25). The lack of sufficient and in-depth qualitative data may be a further limitation. However, the current quantitative findings enabled the current study to achieve its aim in terms of exploring current ESD awareness and drivers among dental students and educators in the UAE and identifying barriers and opportunities to embrace it.