Advancing planetary health graduate medical education assessment and evaluation methods: leveraging the entrustable professional activities model in a pediatric residency program

Introduction: Planetary health content in graduate medical education (GME) is growing, mainly through incorporation of climate health content due to the evolving urgency of patient needs in response to crisis. As content expands, more objective measures of GME trainee assessment are required to evaluate trainee skill application in practice. Evaluation design: We propose a multi-stage evaluation and assessment protocol to improve objective measurement of planetary health education outcomes in a single pediatric residency program beginning in 2026. Using quality improvement methodology and an environmental health history and resource referral toolkit, we will work to improve planetary health clinical communications in pediatric well child visits. Retrospective chart review data of climate related clinical communications will then be linked with additional assessment activities using the Entrustable Professional Activities (EPAs) and Competency Based Medical Education frameworks linked to existing Accreditation Council of Graduate Medical Education Competencies and Milestones. Upon successful integration of the evaluation protocol, faculty Clinical Competency Committee meetings will have access to objective assessment data to inform assignment of EPA Supervision Levels on planetary health-informed clinical competencies. Discussion: Educating trainees on planetary health topics, linked to expertly vetted tools and resources designed for easy use in clinical encounters, will help translate education into practical clinical skills. These competencies can then be assessed using the planetary health-informed EPA framework for residency training. This protocol can serve as an example for GME innovators who wish to incorporate expanding planetary health knowledge into their curricula with more rigorous assessment grounded in evolving EPA methodology.