Core Competencies for Planetary Health Education
An AI-Assisted Review of Health Professions Literature
Zia Hassan, Hunter Gehlbach, Molly Robey
Diseases like Dengue are moving into new latitudes
Messina, et al., 2014
"Eco-anxiety" is a standard youth diagnosis
Galway & Field, 2023
Our health systems are being wrecked by weather they weren't built to handle.
NY Health, 2025
Out of necessity, a new field is emerging...
Enter Planetary Health 🌏
The sustainability of Earth’s systems, human health, and the role of human behaviors (Faerron Guzmán et al., 2021; Jacobsen et al., 2024; Redvers et al., 2023)
Planetary Health in a Nutshell
Myers, 2017
It's an emerging field.
How emergent? Well...
| Year | Milestone | Impact & Significance |
|---|---|---|
| 2014 | Term Coined | Richard Horton (Editor of The Lancet) officially introduces "Planetary Health" in a published manifesto. |
| 2015 | Field Launched | The Rockefeller Foundation-Lancet Commission formally defines the discipline and its core goals. |
| 2015–2017 | Institutionalization | The Planetary Health Alliance is founded at Harvard; specialized journals begin peer-reviewing dedicated research. |
| 2025–2026 | Scaling Phase | The field moves from theory to practice, focusing on standardized education and global policy integration. |
When it comes to educating practitioners, we need to get it right.
The "Knowledge-Practice" Gap
We are training students for a world that no longer exists when they graduate.
Myers, 2017
We've got frameworks galore...
| Framework / Source | Citation | Focus / Key Contribution |
|---|---|---|
| Planetary Health Education | Guzmán et al. (2021) | Comprehensive education for planetary health |
| Global Consortium on Climate and Health Education | Columbia University (2020) | Climate change and health education standards |
| Association of Schools and Programs of Public Health | Magana et al. (2023) | Public health education competencies |
| Climate Competencies | Various | Specific skills/knowledge for climate action |
| One Health Framework | Zinsstag et al. (2011) | Integrative health of humans, animals, and environment |
But when information is changing and evolving so quickly, how do we...
🤷 decide what to teach practitioners?
🤷♀️ keep up with the ever-changing literature?
🤷🏾 identify emerging essential skillsets?
The information is disparate and inconsistent. 😔
We could...
use a systematic review process.
But...
these are lengthy, expensive, and rely on many moving parts.
We could...
use a rapid review process.
But...
we give up some accuracy for speed.
Introducing...
The AI-Assisted Review
Why a generative AI-assisted review?
- Read and synthesize large amounts of data in seconds
- Easily recalibrated and re-used quarterly, semi-annually, annually, etc.
What do we mean by competencies?
What students should be able to do, what attitudes they might hold, and what natural inclinations or capacities they might develop.
Methodology: The AI-Assisted Workflow
| Phase | Action | Role |
|---|---|---|
| Data Retrieval | Scraped 124 peer-reviewed (JHU Catalyst) and "Grey" literature (Websites/Curriculum Maps). | Human-Directed |
| Screening | Custom Python workflow used LLMs to make inclusion/exclusion decisions (106 documents included). | AI-Automated |
| Synthesis | LLM prompted to extract competency statements only from the provided corpus. | AI-Driven |
| Validation | Compared outputs from two different LLMs to ensure stability and consistency. | Dual-Model Check |
Initial Search
"planetary health" AND ("competencies" OR "objectives" OR "learning outcomes" OR "curriculum")
Inclusion/Exclusion criteria handled by Python/Anthropic API
| Criterion | Inclusion | Exclusion |
|---|---|---|
| Topic Focus | Articles discussing planetary health, climate health, environmental health, or One Health in educational contexts | Articles solely about clinical care, policy, or research without educational/training components |
| Competencies | Articles that describe, define, or propose specific competencies, skills, dispositions, abilities, learning objectives, or learning outcomes for practitioners/students | Articles that only discuss general concepts without specifying what practitioners should be able to do, know, or demonstrate |
| Educational Context | Articles focused on health professions education (medical, nursing, public health, occupational therapy, physiotherapy, nutrition, etc.) at undergraduate, graduate, or continuing education levels | Articles about K-12 education, general environmental education, or non-health professions |
| Content Type | Empirical studies, curriculum descriptions, framework developments, competency assessments, scoping/systematic reviews, educational innovations | Opinion pieces, editorials, or commentaries without substantive competency content; purely theoretical papers without practical applications |
| Competency Definition | Articles explicitly addressing what students/practitioners should be able to DO (skills), KNOW (knowledge), or demonstrate as VALUES/ATTITUDES/DISPOSITIONS | Articles only discussing importance of planetary health or describing problems without identifying required competencies |
| Language | English language publications | Non-English language publications |
| Publication Type | Peer-reviewed journal articles, conference proceedings, grey literature (if describing implemented curricula or competency frameworks) | Abstracts only, posters without full text, unpublished dissertations |
| Time Period | No date restrictions (all years included) | N/A |
| Availability | Full text accessible through institutional access or open access | Full text not available despite institutional access attempts |
Parsing the data
Received AI decision for each source:
a. Decision: INCLUDE or EXCLUDE
b. Confidence: High/Medium/Low
c. Reasoning: 2-3 sentence explanation
d. Key Competencies: List of competencies found (or "None")
Final synthesis prompt
Extract and synthesize all competency statements from this CSV file that describe what students should be able to do upon graduation in planetary health education.
Output format:
• Group results by competency domain (e.g., Systems Thinking, Advocacy, Ethics).
• Under each domain, list 2–4 action-oriented learning outcomes in plain language (starting with verbs like “analyze,” “advocate,” “apply,” “collaborate,” etc.).
• After each bullet, include an in-file citation in the format [Title, Row # or line #].
Source constraint:
• Use only text found in the columns Reasoning, Key_Topics, or Abstract in this file. Do not draw from external knowledge.
Goal:
Produce a concise planetary health competency framework reflecting what students should be able to do (skills, behaviors, applied knowledge), not just know.
Key Technical Safeguards
- Zero-Shot Constraint: relied strictly on the identified literature to prevent hallucinations.
- Stability Assessment: used different models to confirm findings
Results: The 12 Planetary Health Domains
| # | Domain | Core Competency Statement |
|---|---|---|
| 1 | Earth Systems Knowledge | Explain how Earth systems and planetary boundaries affect health. |
| 2 | Clinical Assessment & Management | Assess and manage climate- and environment-related health risks. |
| 3 | Systems Thinking | Apply systems thinking and complexity to health–environment problems. |
| 4 | Sustainable Healthcare | Practice and improve sustainable, low-carbon, resilient healthcare. |
| 5 | Communication | Communicate and counsel effectively on planetary health. |
| 6 | Advocacy & Leadership | Advocate and lead for policy, justice, and systems change. |
| 7 | Equity & Justice | Address environmental justice and inequity. |
| 8 | Interdisciplinary Collaboration | Collaborate across disciplines and sectors. |
| 9 | Research & Evidence | Use evidence and critical appraisal to guide action. |
| 10 | Ethics & Reflexivity | Exercise eco-ethical reasoning and planetary citizenship. |
| 11 | Food Systems | Engage with food systems and sustainable nutrition. |
| 12 | Education & Implementation | Design, implement, and evaluate planetary health initiatives. |
Discussion
Human curated models focused more on learning objectives, compared to skills/dispositions/capacities
Our model was more flexible than human-curated lists, but it lacked granularity
Customizable to the institution
Methodological Validation Gap
- Methodology lacks external benchmarking
- Future study idea: head-to-head comparison against a human-led systematic review
- Determine the exact delta between AI efficiency and human interpretive depth
Key strength of our model: we did not rely on pre-trained data.
The AI-Assisted Review process can be used in other emergent fields.
| Field | The "Information Mess" | AI-Assisted Solution |
|---|---|---|
| Artificial Intelligence | 1,000+ new papers weekly. | Automate "Living Reviews" of the latest SOTA models. |
| Cybersecurity | Constant stream of new threat data. | Synthesize real-time defense playbooks from forum data. |
| Law & Policy | Fragmented laws across 50+ countries. | Map global regulatory trends for emerging tech (e.g., Crypto). |
| Engineering | Siloed data in Robotics vs. Materials. | Bridge disciplines to define "Core Skills" for new degrees. |
References
- Faerron Guzmán, C. A., et al. (2021). The Planetary Health Education Framework. The Lancet Planetary Health, 5(1), e6-e7.
- Horton, R., & Lo, S. (2015). Planetary health: a new epoch for humanity. The Lancet, 386(10007), 1921-1922.
- Jacobsen, K. H., et al. (2024). Global health education in the Anthropocene. Journal of Global Health Reports.
- Magana, A., et al. (2023). Climate change and health competencies for public health schools. ASPPH Reports.
- Messina JP, et al. Global spread of dengue virus types: mapping the 70 year history. Trends Microbiol. 2014 Mar;22(3):138-46. doi: 10.1016/j.tim.2013.12.011. Epub 2014 Jan 24. PMID: 24468533; PMCID: PMC3946041.
- Redvers, N., et al. (2023). Indigenous health and the planetary health lens. Nature Medicine, 29, 2123–2125.
- Rockefeller Foundation–Lancet Commission. (2015). Safeguarding human health in the Anthropocene epoch. The Lancet, 386(10007), 1973-2028.