The environmental cost of learning: CO<sub>2</sub> emission comparisons of virtual reality, online, and alternative distance education.

Istrate, Gizella Melania; Van Gelder, Frank; Szőllősi, Gergő József; Gevaers, Roel; Barth, Anita; Povoa, Pedro; Ostermann, Marlies; De Waele, Jan et al. · Intensive Care Med · 2026

cross_sectional · Level IV

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Abstract

Environmental sustainability has become a critical concern across various sectors, including education and healthcare. Professional training programmes, particularly in intensive care medicine, are essential for maintaining competency but often lack consideration of their environmental impact. This study was conducted by European Society of Intensive Care Medicine (ESICM) and investigated the carbon footprints of three distinct training modalities: in-person alternative distance training, online training, and virtual reality (VR) training. Data from 116 participants in ESICM training programs were used to estimate CO<sub>2</sub> emissions for each training modality, considering travel distances, transportation modes, and standardized emission factors. CO<sub>2</sub> emissions were significantly lower for both online (median: 43 kg per participant, interquartile range: 32-64 kg) and VR training (median: 43 kg, interquartile range: 28-56 kg) compared to in-person training (median: 429 kg, interquartile range: 345-490 kg; p < 0.001 for both comparisons). No significant difference was found between online and VR training (p = 0.893) in terms of CO<sub>2</sub> emission. The findings highlight the environmental benefits of digital education modalities, contributing to a significant reduction in CO<sub>2</sub> regarding online and VR training compared to in-person alternatives.

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