One Health is an inclusive concept that refers to the holistic integration of human, animal and environmental health. As such, this has important implications for how we prepare biomedical professionals for everyday practice.
Its implementation requires multidisciplinary knowledge and intersectoral collaboration to bring together biomedical professionals (doctors, veterinarians, pharmacists, agronomists and environmental scientists) to advance knowledge and science.
Such intersectoral collaboration is fundamental if we are to effectively address global challenges, such as prevention, preparedness and crisis management of existing and emerging health threats.
A pan-European survey conducted in 2018 among 41 veterinary education organizations in the European Union and the European Free Trade Area showed that there is consensus among veterinary academics on the benefits of interdisciplinary education.
This teaching model offers a different educational experience and helps to create a common understanding of One Health, expanding students’ horizons, providing new opportunities and promoting “thinking outside the box”.
In doing so, it better prepares students and professionals to deal with complex health issues in their daily practice. Education has a crucial role to play in shaping the necessary attitudes and skills of future biomedical professionals and in preparing them for their important role in ensuring one health.
Barriers to One Health Education
The survey shows that, while the benefits of interdisciplinary education for students, professionals and society are indisputable, the interdisciplinary model is still difficult to implement at the undergraduate level and remains relatively little explored.
Although the findings are limited to one discipline – veterinary medicine – they provide good insight and food for thought. It is evident that changing the educational culture to encompass One Health requires a complete change in the way health professionals approach all aspects of biomedical practice, from observation, examination and diagnosis to prevention, monitoring, processing and research.
University education should therefore offer inter-professional education at university level to facilitate a horizontal change of attitudes, inspire more openness and promote interdisciplinary collaboration throughout a person’s professional career.
The survey revealed that different regulations are the most important factors hindering innovation and openness in teaching methods in Europe.
European laws, national laws, academic and structural regulations and the implementation of different accreditation systems are often obstacles to the development of any new learning process.
The paradigm of veterinary training in Europe, which is regulated at EU level by the Professional Qualifications Directive (Directive 2005/36 / EC amended by Directive 2013/55 / EU), promotes disciplinary education and makes difficult to integrate a culture of health in universities.
Even in the European Union, a region subject to a common legislative framework, education remains a policy area that falls under the principle of subsidiarity. Significant variations are still present in policies and regulations from country to country and between higher education institutions.
In addition, there are educational and curriculum challenges. Creating an interdisciplinary course requires special attention in class composition in order to identify the appropriate level of knowledge needed by students from different backgrounds.
In addition, it requires an appropriate design of learning outcomes as well as assessment methods suitable for all students.
Basic skills and quality assurance
These considerations, as well as the international policy recommendations of the World Health Organization (WHO) (Transform and intensify the education and training of health professionals: WHO Guidelines, 2013), the World Organization for Animal Health (Fourth OIE World Conference on Veterinary Education: Final Recommendations, 2016) and other similar bodies, have led to reflection more depth on how to facilitate the implementation of an open and holistic approach to vocational education and training in order to increase multisectoral and intersectoral interactions, enabling the introduction of a true One Health culture in the education.
There is a need for policy reform regarding the regulation of professional qualifications for everyone in biomedical sciences in the EU. This would include a framework outlining the core competencies of One Health, which could then be incorporated into the different programs, regardless of the scientific field they cover.
Listing the competencies from Day One of One Health would help academic institutions, regardless of their area of expertise, identify the subjects in their curriculum where interdisciplinary training could be introduced as a as an important educational tool.
The One Health core competencies should integrate knowledge, skills and attitudes, which will enable health professionals to think, design and apply their health care skills in a holistic way.
In addition to the need for a new regulatory framework, education should encompass a range of professionals from different backgrounds with a common understanding of One Health, who could join forces to prepare programs suitable for different students.
Academic institutions should encourage and train educators to broaden the learning process by partnering with experts from other disciplines. University leaders should champion discussions on intersectoral collaboration and measures to facilitate interdisciplinary mobility for educators and students.
Further policy reform is also needed to endorse the implementation of a harmonized approach to quality assurance in the European Higher Education Area, which will facilitate the development of a common perception of a single health in all disciplines.
So far very few European-wide profession-specific accreditation systems exist in the EU; for example, when it comes to veterinary training, there is the European Veterinary Training Assessment System. Such initiatives must be formally adopted, legally approved and promoted.
It is evident that the time has come for an open global dialogue on how to rethink university education with a view to preparing health professionals to be able to implement a holistic approach and to be innovative and more effective.
Dr Despoina Iatridou is Senior Policy Officer at the Federation of Veterinarians of Europe and Secretary General of VetCEE (Continuing Veterinary Education in Europe), Professor Jimmy Sanders is President of VetCEE and Professor Ana Bravo is President of the European Association of veterinary education establishments.