Environmental health education in the medical school curriculum

Objective.- To collect baseline data of environmental history-taking skills and clinical toxicology knowledge and examine the effects of a lecture on environment on students' history-taking skills. Methods.-An anonymous survey was distributed to third-year medical students prior to an asthma lecture that strongly emphasized environmental triggers. Fourteen questions assessed students' practices and attitudes toward environmental history taking. Six multiple-choice questions assessed clinical toxicology knowledge. Histories written by students were reviewed to determine the group's actual performance before and after a lecture on environmental health. Results.-Although students reported that an environmental history was important, few asked about environmental history topics other than smoking and pets. Occupational histories were included for adult patients, but few students asked about parental occupations for pediatric patients. Students recognized the correct antidotal therapy for iron and acetaminophen toxicity but were less proficient at identifying clinical features of lead and organophosphate poisoning. Student history performance, when students were considered as a group, was similar to reported performance, with the presence of pets being the only significant postlecture change in history-taking behavior (P = .01). Conclusions.-Students have a positive attitude toward the need for an environmental history, but in self-reported practice and in actual practice, they explore few major environmental history issues. Data were insufficient to prove that one lecture changed history-taking practices.