Academics' perspectives on climate change in nursing and midwifery education: a mixed-methods study

Abstract

Background: Climate change poses major, escalating health risks and demands curricular responses in nursing and midwifery education. However, academics' awareness, concerns, and approaches to climate change integration into the nursing/midwifery programs remain limited. Aim: To examine academics' awareness, and levels of concern regarding climate change and explore their perspectives on integrating climate-related content into nursing and midwifery curricula. Design: Convergent parallel mixed-methods design was used and guided by the Sustainability in Global Nursing Framework. Settings: Universities with nursing and/or midwifery programs. Participants: For the quantitative strand, 160 faculty members were recruited through a voluntary online survey shared via university listings and professional/social media channels. For the qualitative strand, purposeful maximum variation sampling was used to select 12 participants representing diverse academic titles, specialties, and years of experience. Methods: Quantitative data were collected online using the Climate Change Awareness Scale, Climate Change Worry Scale, self-ratings, and curricular practice items. Analyses included descriptive statistics, group comparisons, and correlations. Qualitative data were thematically analyzed through a framework-informed, inductive-deductive approach with double coding and consensus. Findings were integrated into joint display tables. Results: Participants reported high self-rated knowledge of climate causes and health effects, and moderately high practice awareness, while climate-related concern was moderate. Three qualitative themes emerged: (1) knowledge and perceived importance, (2) educational integration and partnerships, and (3) anticipated positive, sustained outcomes. Integrated findings indicated higher concern among academics but highlighted fragmented, elective-heavy content and credit constraints, revealing a persistent gap between motivation and institutional capacity. Conclusions: Climate change content should be integrated into the core of nursing and midwifery education rather than treated as peripheral. Higher concern among faculty in state universities suggests educator motivation surpasses institutional support, highlighting an awareness-implementation gap. Strengthening credit allocation, accreditation expectations, and targeted resources is essential for consistent and sustainable integration.