Actor network theory to map planetary health interconnections: a clinical case study

Abstract

BackgroundIn 2017, the World Organization of Family Doctors (WONCA) officially stated “[it is] imperative that planetary health be included in the core curriculum of medical schools, family medicine residencies and further professional development”. In 2019 WONCA urged “family doctors around the world to commit to acting on planetary health”. Despite positive repercussions from major medical journals, the integration of planetary health into medical education remains a challenge. In this context it seems relevant to search for and develop tools to facilitate planetary health medical teaching. We aimed to apply actor-network theory (ANT) to describe interconnections between a patient with a clinical problem and planetary health proximal and distal issues. MethodsUsing ANT anthropological methodology, we describe the human and non-human actors involved in the interdependent network around the visit of a patient with obesity, hypertension, and diabetes to a community health clinic in southern Brazil. Perceived relevant proximal and distal planetary health issues involved in the clinical case were described, then organised into one diagram. This ANT clinical case diagram was subsequently used as a teaching tool. FindingsThis ANT clinical case diagram was presented to medical students and other health professionals in a few conferences and lectures in Brazil during the second semester of 2018 and initial months of 2019. Informal feedback from students and peers has been positive so far. The ANT diagram seemed to significantly facilitate comprehension of the planetary health framework to address clinical issues. InterpretationANT methodology could potentially be used in different clinical cases in diverse scenarios. Further formal quantitative and qualitative assessment of the utility of this teaching tool is required. FundingNone.