The Climate Health Curriculum Tool (CHCT): an assessment framework for integrating climate health education in U.S. undergraduate medical curricula

Climate change poses urgent and complex threats to public health, yet major gaps persist in integrating climate health education into medical curricula. We developed the Climate Health Curriculum Tool (CHCT), an evidence-based framework to guide medical educators in designing, implementing, and evaluating climate health content across U.S. undergraduate medical education. A transdisciplinary expert panel reviewed and integrated existing climate health competency frameworks with the Association of American Medical Colleges (AAMC) foundational competency domains. The panel utilized structured mapping, iterative review, and consensus building processes to develop domain-specific, measurable learning objectives. The CHCT, adapted from the validated AAMC Tool for Assessing Cultural Competence Training (TACCT), organizes climate health competencies across six domains: Patient Care, Knowledge for Practice, Practice-Based Learning and Improvement, Interpersonal and Communication Skills, Systems-Based Practice, and Professionalism. For each domain, the tool specifies learning objectives that can be mapped to existing courses or integrated in new courses, facilitating incremental integration into curricula. The CHCT provides a structured, adaptable, and competency-aligned framework for integrating climate health into U.S. undergraduate medical education. It addresses a critical educational gap and supports adoption across diverse institutional contexts. Future research should evaluate its implementation and impact on learner outcomes.