• Leadership
• Integral Theory
• Ecological Literacy
• Sustainability
• Creating a Sustainable Medicine
• Precautionary Principle
• Biological Systems and Stressors: 4 T's: Toxicant, Totality, Tolerance, and Trajectory
• Green Pharmacy

This module demonstrates the need for and value of professional leadership in medicine. Participants identify personal leadership roles in their respective medical environments including the need for leadership in environmental health and sustainability.

Objectives:
Upon completion of this module, students will be able to:
1) Describe the role of leadership in improving the quality of care in medicine
2) Compare the traditional model of medical practice with a more economically and environmentally sustainable model of medicine in regard to facility operations and approaches to environmental health and preventative care.
3) Develop collaborative partnerships to foster successful outcomes

Fostering a collaborative vision, Integral Medicine, using the model of Ken Wilber, has the potential for integrating the best of conventional medicine with complementary and alternative medicine in a balanced manner. The purpose of this session is to introduce the basics of Ken Wilber’s Integral Methodological Pluralism.

Objectives
Upon completion of this module participants will:
1) Describe the difference between subjective and objective perspectives in both individual and plural modes.
2) Examine the and explain the difference between conventional medicine, integrative medicine, green hospitals, green health care and integral medicine

If literacy is the ability to read, ecological literacy is the ability to understand our place in the world. Due to its increase in scale, medicine is continuing to have more significant negative impacts on the environment. The purpose of this module is to introduce the principles of ecological literacy as they apply to the health and the practice of medicine.

Objectives:
Upon completion of this module participants will:
1) Have a basic knowledge of principles of ecology, including: networks, nested systems, cycles, flows, development, and dynamic balance
2) Compare the six principles of ecological literacy with the principles of ecological healing.
3) Examine the four principles of the Natural Step and formulate an assessment of current medical practices in the US.

In order to apply principles of sustainability to issues of medicine and health care, sustainability needs to be introduced and some of its complexities need to be understood. This module introduces sustainability from a historical perspective, including the difference between qualitative and quantitative growth.

Objectives:
Upon completion of this module participants will:
1) Describe the three major modes of sustainable development
2) Differentiate quantitative growth with qualitative growth in natural and social systems
3) Examine the eight principles of qualitative growth
4) Assess current trends in primary care for potential applications of qualitative growth.

Principles of sustainability are relatively new to medicine. It’s application requires ethical considerations that are best done before clinical encounters. Work has been done by Daniel Callahan founder of the Hastings Institute. This module introduces readers to his work and facilitates opportunities for clinical integration of the principles of sustainability.

Objectives
Upon completion of this module participants will:
1) Understand and differentiate the pre-scientific and the scientific eras of medicine as a developmental process
2) Define three characteristics of sustainable medicine
a. Sufficient medical care to be physically and mentally competent
b. Health care that is equitably distributed
c. Embrace a steady-state goal
3) Discuss the ethical difficulties between technological innovation and community based medicine

Essential to the development of a sustainable health care system is community health and public policy. The fundamental principle involved with creating sustainable communities and a healthy environment is the Precautionary Principle. This module examines the role of the Precautionary Principle in the development and implementation of public policies which support sustainable medicine.

Objectives:
Upon completion of this module participants will:
1. Describe the Precautionary Principle
2. Assess the value of using the precautionary principle for preventative medicine in a clinical setting.
3. Differentiate appropriate circumstances for using the precautionary principle in primary care

Assessment of biological stressors on human health and non-human health has relied on the single toxicant/single organism model since the inception of modern toxicology. However, in nature all organisms including humans are exposed to multiple stressors constantly. The purpose of this module is to introduce participants to a systems model for evaluating biological stressors called 4Ts: Toxicant, totality, tolerance and trajectory.

Objectives:
Upon completion of this module participants will be able to:
1) Discuss a systems perspective of biological stressors called the 4Ts: toxicity, totality, tolerance and trajectory in regards to its ability to assess stressors on human health and illness
2) Compare current methods of toxicological assessment with the 4T’s model.
3) Complete a brief environmental history screening

The purpose of this module is to provide the evidence of ecotoxicity by pharmaceutical and personal care products, and to offer practical solutions for limiting the potential damage of these expired and unwanted chemicals in the environment.

Objectives:
Upon completion of this module participants will be able to:
1. Analyze the occurrence and fate of pharmaceuticals and other wastewater derived compounds.
2. Assess the ecotoxicological effects of common pharmaceuticals and personal care products
3. Examine the six primary methods for reducing pharmaceutical waste in primary care
4. Discuss the cradle-to-cradle product stewardship model for pharmaceutical waste and its potential impact on the environment
5. Identify and select community-based solutions for reducing pharmaceutical waste in accordance to regulations.