Exploring Nursing and Medical Students' Attitudes Towards Sustainable Environmental Education Across Eight MENA Countries: A Multinational Cross-Sectional Study.

OBJECTIVE

To assess sustainability awareness, behaviors, attitudes, and commitment among nursing and medical students in eight MENA countries, and to identify predictors of commitment to sustainability in future practice.

DESIGN AND SAMPLE: A multinational cross-sectional survey (n = 2,284) of eligible students (≥ 18 years) from Iraq, Egypt, Yemen, Libya, Saudi Arabia, Palestine, Syria, and Oman.

MEASUREMENTS: Data were collected using a demographics/awareness tool; the 29-item Behavior Scale Towards Sustainable Environmental Education; the 5-item Sustainability Attitudes in Nursing Survey-2; and a 5-item commitment scale. All instruments underwent forward-backward Arabic translation and pilot testing.

RESULTS

Awareness and sustainability behaviors were moderate. Energy-saving practices were the most common behavior. Although attitudes toward sustainability in healthcare education were generally positive, only 11.8% of students described themselves as "very committed." Country, income, and academic level were significantly associated with awareness and behavior. In regression analysis, self-reported behavior (β = 0.464), awareness (β = 0.166), and attitude (β = 0.134) significantly predicted commitment (R2 = 0.385).

CONCLUSION

Commitment to sustainability was most strongly associated with self-reported sustainability behavior, followed by awareness and attitudes; however, the cross-sectional self-report design prevents causal or enacted-behavior interpretations. Curricula should emphasize applied, practice-based sustainability training, and future longitudinal or intervention studies should test whether such training improves sustainable practice over time. Limitations include self-report, non-probability sampling, and cross-sectional design.