
Summer research projects: fertile ground to integrate planetary health, environmental, and sustainability topics into undergraduate education
Introduction
Many funding agencies offer financial or other support for undergraduate students to engage in research outside of their curriculum, often during the summer months. Such opportunities are highly competitive and often benefit career prospects as well as developing skills in research, evidence-based practice, critical thinking and other attributes which are relevant to education in sustainable development. This work highlights the process of involving a student in a summer research with a focus on planetary health, which was co-designed by academic and clinical physiotherapists.
Student Engagement and Educational Experience
This project aimed to provide a student with deep insights into the views of key stakeholders in integrating planetary health into phase three cardiac rehabilitation (CR) services. Climate change poses a significant threat to human health (WHO, 2023), and physiotherapists are beginning to address this issue in clinical settings (Francis et al., 2019; Jones, 2009; Maric & Nicholls, 2022; Palstam et al., 2022). However, despite widespread positive attitudes towards sustainability (Chi et al., 2024), research has reported a lack of knowledge and a trepidation around the implementation of changes to Physiotherapy practice to benefit planetary health (Lister et al., 2022).
Project overview
The student participated in a research project over 8 weeks during the summer months. As part of this project, the potential role of Phase Three CR in promoting planetary health and sustainable living was explored. Phase three of CR encourages positive lifestyle changes to reduce cardiovascular disease risk factors, which often align with planetary health goals, but are not designed specifically to tackle the current planetary health crisis. As a widespread service with high patient turnover incorporating a “teachable moment” (Stange, 2018), Phase Three CR could theoretically represent favourable conditions for the introduction of planetary health education or the adaptation of sustainable health practices.
Methods
The student conducted semi-structured interviews with patients and service providers at a hospital in Dublin, Ireland. Using Clarke and Braun’s 6-step framework, the student performed thematic analysis to identify and define themes within the data.

Cuisle Forde (PT, PhD)
Associate Professor in Physiotherapy, School of Medicine, Trinity College Dublin, Ireland and Education for Sustainable Development Fellow of Trinity College Dublin, Ireland
Cuisle helped develop and coordinates the MSc in Clinical Exercise and teaches on the BSc in Physiotherapy at Trinity College Dublin. Her research centres around exercise prescription and promotion. She recently established a transdisciplinary team to examine the intersection of health and modern transport.
Results
The study involved 13 patients and 8 service providers. The analysis revealed mixed feelings about incorporating planetary health into CR. While some participants were skeptical and concerned about the impact of such efforts on infection control, others saw potential for advocacy and small sustainable changes, such as digital resources and online educational sessions. The student gained valuable insights into the diverse perspectives on sustainability in healthcare. Conducting research on this topic also raised awareness among students, academic and clinical staff working in CR and was a topic most had never before considered relevant to their work. An abstract on the research findings of the study conducted will be presented at the World Congress of Physical Therapists in Japan in May 2025. This represents another valuable educational experience for the student who will present their work to a global audience, and it also serves to contribute to the growing body of evidence in physiotherapy and planetary health.
Conclusion
The project demonstrated that integrating planetary health into CR services is complex and met with varied opinions. However, the educational experience for the student was profoundly formative. The student developed proficiency in data collection and analysis and engaged in meaningful discussions with stakeholders, enhancing their own and their participant’s understanding of sustainability in physiotherapy, specifically as it relates to phase three CR.
Implications
For cardiac rehabilitation services, there is a need to address concerns about the impact of sustainable practices on patient care, and to quantify the benefits of small changes. For education, leveraging summer research projects to explore planetary health issues is a powerful way to stimulate debate and action in this area.
Acknowledgements
This project was funded by the Irish Health Research Board Summer Studentship Award.
Authors
Dr Cuisle Forde, Associate Professor in Physiotherapy, School of Medicine, Trinity College Dublin, Ireland and Education for Sustainable Development Fellow of Trinity College Dublin, Ireland.
Mr Shane O’Farrelly, Senior Physiotherapist, Connolly Hospital, Blanchardstown, Dublin 15, Ireland.
Mr Nithiesh Loganathan, School of Medicine, Trinity College Dublin.
References
Header image by Haneen Krimly on Unsplash
Chi, L., Boucaut, R., Li, L. S. K., Fryer, C. E., & Kumar, S. (2024, Apr). Australian physiotherapists’ knowledge and views on the relationship between climate change, health, and physiotherapy. Physiother Res Int, 29(2), e2085. https://doi.org/10.1002/pri.2085
Francis, D., Cohen, G., Bhatt, J., Brask, C., Devnani, M., & Surgenor, G. (2019, Jun 17). How healthcare can help heal communities and the planet. BMJ, 365, l2398. https://doi.org/10.1136/bmj.l2398
Jones, L. E. (2009, Jun). Physiotherapy and the Earth’s global climate: a need for cultural change. Physiother Res Int, 14(2), 73-76. https://doi.org/10.1002/pri.441
Lister, H. E., Mostert, K., Botha, T., van der Linde, S., van Wyk, E., Rocher, S. A., Laing, R., Wu, L., Muller, S., des Tombe, A., Kganyago, T., Zwane, N., Mphogo, B., & Maric, F. (2022, Aug 16). South African Healthcare Professionals’ Knowledge, Attitudes, and Practices Regarding Environmental Sustainability in Healthcare: A Mixed-Methods Study. Int J Environ Res Public Health, 19(16). https://doi.org/10.3390/ijerph191610121
Maric, F., & Nicholls, D. A. (2022, Nov). Environmental physiotherapy and the case for multispecies justice in planetary health. Physiother Theory Pract, 38(13), 2295-2306. https://doi.org/10.1080/09593985.2021.1964659
Palstam, A., Sehdev, S., Barna, S., Andersson, M., & Liebenberg, N. (2022). Sustainability in physiotherapy and rehabilitation. SUSTAINABILITY IN ORTHOPAEDICS AND TRAUMA, 36(5), 5. https://doi.org/https://doi.org/10.1016/j.mporth.2022.07.005
Stange, K. C. (2018). In This Issue: Teachable Moments for Patients, Practices, and Systems [Ediorial]. Ann Fam Med, 16. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6037515/pdf/0160286.pdf
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