Accepted for/Published in: JMIR Formative Research
Date Submitted: Jul 1, 2024
Date Accepted: May 12, 2025
Environmental Impact of Online vs In-Person Critical Care Training: A Carbon Footprint Analysis of the CERTAIN Program (2016-2022)
ABSTRACT
Background:
Climate change is a pressing public health issue, with the U.S. healthcare sector contributing about 479 million tons of carbon dioxide (CO2) annually. Online continuing medical education (CME) offers an alternative solution to increase global education delivery while reducing CO2 emissions associated with traditional teaching methods.
Objective:
The objective of this study was to evaluate the carbon dioxide equivalent (CO2e) emissions associated with different delivery methods of the CERTAIN (Checklist for Early Recognition and Treatment of Acute Illness and Injury) critical care education program. Specifically, we aimed to compare the climate impact of local in-person courses in Rochester, MN, international in-person courses, and online courses, to determine the potential environmental benefits of transitioning to digital education platforms.
Methods:
A cross-sectional analysis of CO2e emissions linked to the global CERTAIN critical care education program was performed from 2016 to 2022. We compared the climate impact of three different course offerings: local in-person Rochester, MN, and international in-person courses and online courses. CO2e emissions were calculated using the “My Climate Flight Calculator” and “Environmental Protection Agency Emission Factors” formulas for travel, conference venues, and online course-related emissions.
Results:
The local in-person course in Rochester, MN had the largest carbon footprint (2.5 tons CO2e per person, 52.7 tons CO2e per Course). International in-person courses produced lower emissions per person (0.4 tons CO2e) but still a considerable total volume (20.2 tons CO2e per course). Online course delivery was associated with a significant reduction in emissions (0.1 tons CO2e per person, 5.6 tons CO2e per course), primarily due to eliminating learner and faculty travel. Learner satisfaction for online courses was comparable to that of in-person formats, suggesting no compromise in learner experience.
Conclusions:
The transition to online delivery of our CERTAIN global education program has led to a substantial reduction in CO2 emissions, mainly by eliminating travel, with similar levels of learner satisfaction. These findings support a strategic shift towards digital medical education platforms to promote environmental responsibility and broaden global educational access.
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