Design for Change: Transformational Cross-cultural and Transdisciplinary Learning Experiences to Solve Global Healthcare Sustainability Challenges
As populations live longer and healthcare demands rise, building a sustainable and resilient healthcare system is urgent. Around the world, healthcare is under pressurenot just to treat more people, but to do so sustainably. However, what is often overlooked is the high environmental cost of modern healthcare systems, particularly through their carbon footprint and material waste. Globally, the healthcare sector contributes significantly to greenhouse gas emissions, comparable to large industries. In response to the challenges, this article presents an educational initiative centred on cross-cultural and multidisciplinary collaboration among undergraduate students in design and health sciences. Through immersive experiential learning and design sprints, students explore real-world healthcare sustainability challenges, generating context-sensitive, equitable, and environmentally responsible solutions. This model highlights the importance of integrating environmental stewardship, technological ethics, and inclusive design. The authors posit that a curriculum engaging undergraduate health and design students from diverse cultural backgrounds is essential for lasting change in healthcare systems.
Keywords: Design Education, Health Education, Design Sprints, Experiential Learning, Sustainability, Problem-based Learning
According to Harvard Medicine, the global healthcare sector contributes between 4.4% and 5.2% of greenhouse gas emissionscomparable to or exceeding aviation1. In Australia, healthcare accounts for approximately 7% of national carbon emissions, reaching 30% across the Asia-Pacific region2. These emissions are linked to climate-sensitive health conditions, including respiratory and cardiovascular diseases and heat-related morbidities. Beyond emissions, material waste in healthcare presents a pressing challenge, with over 16 billion injections administered each year globally, using single-use plastics that contribute to biohazardous and environmental waste3. Healthcare sustainability is one of the most pressing challenges of the 21st century, as modern systems also generate significant environmental impacts through emissions, waste, and energy use. Technological advancements tend to concentrate in urban, high-income regions, leaving rural and marginalised populations at a disadvantage, highlighting the need for inclusive innovation strategies, particularly as digital health systems introduce additional environmental considerations across their lifecycle4, including the growing intersection between artificial intelligence, healthcare, and climate impacts5. The challenge lies not only in technological deployment but also in governance, regulation, and ethical stewardship to prevent digital exclusion and systemic discrimination. This urgency is further reinforced by global policy frameworks calling for climate-resilient and low-carbon healthcare systems6.
Although these challenges are often assumed to be addressed within health sciences, the required skill sets extend beyond this domain. Design processes are recognised for supporting sustainability, particularly in product design, and as evidenced by Papanek, designers have contributed to the sustainable development agenda since the 1970s7. In Design for the Real World, Papanek describes designers as agents of change capable of innovating products, services, and systems. He positions design beyond aesthetics, with its success measured by its ability to deliver meaningful, functional solutions within context. These theories underpin contemporary design education, emphasising the role of design in shaping worldviews, relationships, and empathy.
Globalisation and the transfer of ideas across cultural and political boundaries require an understanding of cross-cultural relationships. To achieve effective and sustainable healthcare innovation, global competencies are essential. As Jensen notes, organisations must consider cross-cultural collaboration to connect global and local knowledge and build shared innovation cultures8, reinforcing the need for globally aware practitioners9.
Providing students with learning experiences in significantly different cultural contexts enhances cultural intelligence10 by broadening perspectives and supporting global learning outcomes11. The authors posit that these competencies can be developed through immersive experiential and problem-based learning (PBL), where cross-cultural and multidisciplinary design sprints enable students to address real-world healthcare sustainability challenges
Students addressing real-world problems in diverse cultural settings are pushed to transcend boundaries and create impactful solutions, with adaptation to cultural contexts fostering innovation12. An experiential PBL methodology supports knowledge sharing and equal participation among individuals from diverse backgrounds.
PBL draws on complex real-world problems without single solutions, with group work enabling multiple perspectives and a more comprehensive investigative approach13, aligning with design thinking approaches to problem-setting and need-finding in complex contexts14. To support this, students engaged in pre-work and a symposium featuring global experts who provided a strong knowledge base. Through these activities, students were introduced to the UN Sustainable Development Goals 3, 11, and 8, forming a foundation for developing solutions addressing global healthcare challenges.
Experiential learning extends beyond the classroom and relies on the formation and reformation of ideas through immersion in unfamiliar environments that promote rapid shifts in perspective15.
Design sprints are intensive studio experiences, typically lasting 5 days or less, where teams ideate, prototype, and test solutions through guided design thinking processes, widely applied in healthcare to develop user-centred solutions in complex systems16, often incorporating expert insights and co-design with users17.
To foster culturally adaptable healthcare prototypes, the authors designed a design sprint integrating experiential and PBL approaches.
The authors facilitated a two-week learning experience for 108 design and health students from multiple international institutions. In June 2024 and 2025, participants travelled to Malaysia and Singapore to engage in a symposium and design sprint focused on healthcare sustainability. Students from diverse disciplines worked in multicultural teams. They examined healthcare systems through multidisciplinary perspectives to better understand end users and develop inclusive, actionable solutions. The program began with a symposium featuring global experts equipping students to address SDGs 3, 11, and 8. Experiential learning was further supported through cultural immersion activities and visits to healthcare facilities, exposing students to different practices, environments, and challenges. During a five-day design sprint, teams developed solutions informed by both multidisciplinary insights and cultural understanding, aiming to create tools that operate across cultural boundaries.
The program provided students with experience in cross-disciplinary collaboration, a critical approach for addressing global challenges. It also fostered a sense of empowerment in navigating complex global issues. The project demonstrates how systems thinking, materials science, and design innovation can converge to support circular healthcare solutions.
To illustrate this, the design thinking process undertaken by student teams is outlined below.
After the symposium and site visits, teams identified key problems, such as sterile wrap waste, reframing it as an opportunity for circular innovation within a sector recognised as highly resource-intensive and emissions-heavy18, where plastic recycling rates remain low despite technical recyclability19, reflecting broader challenges in medical waste management systems20, particularly in land-constrained contexts where waste disposal capacity is limited21.
Teams mapped system lifecycles and conducted stakeholder analysis, developing personas and journey maps to inform co-design processes.
Teams developed functional prototypes and presented them to industry panels, including concepts such as Enzima, which explores advanced recycling of sterile wrap waste22.
Student engagement was supported through visual communication strategies to promote awareness and adoption of sustainable practices.
Healthcare innovations with global relevance are developed by teams capable of navigating diverse cultures. Traditional education models often struggle to equip students with the interdisciplinary and systemic thinking needed to address complex challenges. The Design for Change initiative supports rapid innovation and cross-cultural understanding, which are essential for addressing healthcare sustainability.
Cultural intelligence is critical, and unfamiliar contexts challenge assumptions and foster innovation.
Transdisciplinary approaches enhance problem-solving by integrating diverse perspectives across cultures.
Collaboration accelerates skill development and prepares students for global professional contexts.
Bender-Salazar, R. Design Thinking as an Effective Method for Problem-Setting and Needfinding for Entrepreneurial Teams Addressing Wicked Problems. Journal of Innovation and Entrepreneurship 12 (2023): 24. https://doi.org/10.1186/s13731-023-00291-2.
Chamorro-Koc, Marianella, and Lisa Scharoun. Design Sprints, Designathons and Place-Based Learning in the Context of Real-World Health Problems. International Journal of Art and Design Education 44, no. 3 (2025): 67792. https://doi.org/10.1111/jade.12578.
Chan, Jeremy. Managing Asias Healthcare Waste and Emissions Remains Challenging Amid Increasing Climate Risks. Eco-Business, 2024. https://www.eco-business.com/news/ managing-asias-healthcare-waste-and-emissions-remains-challenging-amid-increasing-climate-risks/.
COP28 UAE. COP28 UAE Declaration on Climate and Health. United Nations Framework Convention on Climate Change, 2023. https://www.cop28.com/en/cop28-uae-declaration-on-climate-and-health.
Dutchen, Stephanie. Confronting Health Cares Carbon Footprint. Harvard Medicine: Nature, Nurture, 2023. https://magazine.hms.harvard.edu/articles/confronting-health-cares-carbon-footprint.
Eckelman, Matthew J., and Jodi Sherman. Environmental Impacts of the U.S. Health Care System and Effects on Public Health. PLOS One 11, no. 6 (2016): e0157014. https://doi.org/10.1371/ journal.pone.0157014.
Hadjiat, Yacine. Framework for the Environmental Sustainability of Digital Health Systems. PLOS Digital Health 2, no. 5 (2023): e0000268. https://doi.org/10.1371/journal.pdig.0000268.
Jensen, Karina R. Global Innovation and Cross-Cultural Collaboration: The Influence of Organizational Mechanisms. Management International / International Management / Gestin Internacional 19 (2015): 101.
Knapp, Jake, John Zeratsky, and Braden Kowitz. Sprint: How to Solve Big Problems and Test New Ideas in Just Five Days. Bantam Press, 2016.
Muratovski, Gjoko, Lisa Scharoun, Nina Hansopaheluwakan, Mengyu Chen, and Camilo Potocnjak-Oxman. Approaching Global and Local Examples of Transdisciplinary Projects in the United States, Indonesia, China and Australia. In Contemporary Design Education in Australia: Creating Transdisciplinary Futures, edited by Lisa Scharoun, Deanna Meth, Philip Crowther, Dean Brough, Muge Fialho Leandro Alves Teixeira, and Lindy Osborne Burton. Intellect, 2023.
National Environment Agency. Semakau Landfill 20th Anniversary. 2020. https://www.nea.gov.sg/ corporate-functions/resources/publications/books-journals-and-magazines/envision-lite/june-july-2020/semakau-landfill-20th-anniversary.
Pakarinen, Anni, Thomas Lemstrm, Eeva Rainio, and Eriikka Siirala. Design Thinking in Healthcare: From Problem to Innovative Solution. Springer Cham, 2023. https://doi.org/10.1007/978-3-031-24510-7.
Papanek, Victor. Design for the Real World: Human Ecology and Social Change. Academy Chicago Publishers, 1971.
Prototype for Humanity. Enzima Project: Chemical Recycling of Sterile Wraps to Reduce Clinical Waste. 2024. https://www.prototypesforhumanity.com/project/enzima/.
Scharoun, Lisa. Short-Term Study Tours as a Driver for Increasing Domestic Student Mobility in Order to Generate Global Work-Ready Students and Cultural Exchange in Asia Pacific. Perspectives: Policy and Practice in Higher Education 20, nos. 23 (2015): 8390. https://doi.org/10.1080/13603108.2015.1075917.
Scharoun, Lisa, Mge Belek Fialho Teixeira, Danny Hills, Frederico Fialho Teixeira, Daphne Flynn, and Raghavendra Gudur. Understanding Design Culture from East to West: A Transdisciplinary Approach to Teaching. In Contemporary Design Education in Australia: Creating Transdisciplinary Futures, edited by Lisa Scharoun, Deanna Meth, Philip Crowther, Dean Brough, Muge Fialho Leandro Alves Teixeira, and Lindy Osborne Burton. Intellect, 2023.
Scharoun, Lisa, Rafael Gomez, and Tim Williams. Transforming Perspectives: Fostering Cross-Cultural and Transdisciplinary Competencies through Industry Engagement on Short-Term Study Tours. In Contemporary Design Education in Australia: Creating Transdisciplinary Futures, edited by Lisa Scharoun, Deanna Meth, Philip Crowther, Dean Brough, Muge Fialho Leandro Alves Teixeira, and Lindy Osborne Burton. Intellect, 2023.
Ueda, Daiju, Shannon L. Walston, Shohei Fujita, Yasutaka Fushimi, Takahiro Tsuboyama, and Koji Kamagata. Climate Change and Artificial Intelligence in Healthcare: Review and Recommendations Towards a Sustainable Future. Diagnostic and Interventional Imaging 105, no. 11 (2024): 45359. https://doi.org/10.1016/j.diii.2024.06.002.
United States Environmental Protection Agency. Advancing Sustainable Materials Management: 2018 Fact Sheet. EPA, 2020. https://www.epa.gov/sites/default/files/2020-11/documents/2018_ff_ fact_sheet.pdf.
Windfeld, Elliott Steen, and Marianne Su-Ling Brooks. Medical Waste Management A Review. Journal of Environmental Management 163 (2015): 98108. https://doi.org/10.1016/j. jenvman.2015.08.013.
World Health Organization. Healthcare Waste. WHO, 2024. https://www.who.int/news-room/fact-sheets/detail/health-care-waste.
1Stephanie Dutchen, Confronting Health Cares Carbon Footprint, Harvard Medicine: Nature, Nurture, 2023, https://magazine.hms.harvard.edu/articles/confronting-health-cares-carbon-footprint.
2Jeremy Chan, Managing Asias Healthcare Waste and Emissions Remains Challenging Amid Increasing Climate Risks, Eco-Business, 2024, https://www.eco-business.com/news/managing-asias-healthcare-waste-and-emissions-remains-challenging-amid-increasing-climate-risks/.
3World Health Organization, Healthcare Waste, WHO, 2024, https://www.who.int/news-room/fact-sheets/detail/health-care-waste.
4Yacine Hadjiat, Framework for the Environmental Sustainability of Digital Health Systems, PLOS Digital Health 2, no. 5 (2023): e0000268, https://doi.org/10.1371/journal.pdig.0000268.
5Daiju Ueda et al., Climate Change and Artificial Intelligence in Healthcare: Review and Recommendations Towards a Sustainable Future, Diagnostic and Interventional Imaging 105, no. 11 (2024): 45359, https://doi.org/10.1016/j.diii.2024.06.002.
6COP28 UAE, COP28 UAE Declaration on Climate and Health (United Nations Framework Convention on Climate Change, 2023), https://www.cop28.com/en/cop28-uae-declaration-on-climate-and-health.
7Victor Papanek, Design for the Real World: Human Ecology and Social Change (Academy Chicago Publishers, 1971).
8Karina R. Jensen, Global Innovation and Cross-Cultural Collaboration: The Influence of Organizational Mechanisms, Management International / International Management / Gestin Internacional 19 (2015): 101.
9Lisa Scharoun et al., Understanding Design Culture from East to West: A Transdisciplinary Approach to Teaching, in Contemporary Design Education in Australia: Creating Transdisciplinary Futures, ed. Lisa Scharoun et al. (Intellect, 2023).
10Lisa Scharoun et al., Transforming Perspectives: Fostering Cross-Cultural and Transdisciplinary Competencies through Industry Engagement on Short-Term Study Tours, in Contemporary Design Education in Australia: Creating Transdisciplinary Futures, ed. Lisa Scharoun et al. (Intellect, 2023).
11Lisa Scharoun, Short-Term Study Tours as a Driver for Increasing Domestic Student Mobility in Order to Generate Global Work-Ready Students and Cultural Exchange in Asia Pacific, Perspectives: Policy and Practice in Higher Education 20, nos. 23 (2015): 8390, https://doi.org/10.1080/13603108.2015.1075917.
12Marianella Chamorro-Koc and Lisa Scharoun, Design Sprints, Designathons and Place-Based Learning in the Context of Real-World Health Problems, International Journal of Art and Design Education 44, no. 3 (2025): 67792, https://doi.org/10.1111/jade.12578.
13Gjoko Muratovski et al., Approaching Global and Local Examples of Transdisciplinary Projects in the United States, Indonesia, China and Australia, in Contemporary Design Education in Australia: Creating Transdisciplinary Futures, ed. Lisa Scharoun et al. (Intellect, 2023).
14R. Bender-Salazar, Design Thinking as an Effective Method for Problem-Setting and Needfinding for Entrepreneurial Teams Addressing Wicked Problems, Journal of Innovation and Entrepreneurship 12 (2023): 24, https://doi.org/10.1186/s13731-023-00291-2.
15Scharoun et al., Understanding Design Culture from East to West: A Transdisciplinary Approach to Teaching.
16Anni Pakarinen et al., Design Thinking in Healthcare: From Problem to Innovative Solution (Springer Cham, 2023), https://doi.org/10.1007/978-3-031-24510-7.
17Jake Knapp et al., Sprint: How to Solve Big Problems and Test New Ideas in Just Five Days (Bantam Press, 2016).
18Matthew J. Eckelman and Jodi Sherman, Environmental Impacts of the U.S. Health Care System and Effects on Public Health, PLOS One 11, no. 6 (2016): e0157014, https://doi.org/10.1371/journal.pone.0157014.
19United States Environmental Protection Agency, Advancing Sustainable Materials Management: 2018 Fact Sheet (EPA, 2020), https://www.epa.gov/sites/default/files/2020-11/documents/2018_ff_fact_sheet.pdf.
20Elliott Steen Windfeld and Marianne Su-Ling Brooks, Medical Waste Management A Review, Journal of Environmental Management 163, November (2015): 98108, https://doi.org/10.1016/j.jenvman.2015.08.013.
21National Environment Agency, Semakau Landfill 20th Anniversary (National Environment Agency, 2020), https://www.nea.gov.sg/corporate-functions/resources/publications/books-journals-and-magazines/envision-lite/june-july-2020/semakau-landfill-20th-anniversary.
22Prototype for Humanity, Enzima Project: Chemical Recycling of Sterile Wraps to Reduce Clinical Waste (Prototype for Humanity, 2024), https://www.prototypesforhumanity.com/project/enzima/.