Abstract
BACKGROUND: Climate change poses significant threats to human health, necessitating the integration of environmental protection into public health efforts. Planetary health education (PHE) represents an emerging paradigm connecting human well-being with natural systems; however, its global implementation remains inadequately documented, particularly in environmentally vulnerable regions. This scoping review aimed to investigate how PHE is implemented across educational settings and to identify current challenges and best practices to inform future educational program development for university students, educators, and healthcare professionals. METHODS: Following Arksey and O'Malley's framework and the PRISMA-ScR guidelines, we systematically searched the following databases for English and Japanese literature published up to September 30, 2025: Web of Science, Cochrane Central Register of Controlled Trials (CENTRAL), CINAHL, Scopus, EMBASE, PubMed, OpenGrey, and Ichushi-Web. Using the Patient-Concept-Context framework, we extracted data on educational programs, implementation methods, challenges, outcomes, and curriculum integration. RESULTS: Forty-one studies met the inclusion criteria. These studies were predominantly from high-income countries with varying Climate Change Performance Index rankings. Implementation was concentrated in higher education institutions, particularly medical and nursing schools. Educational approaches included lecture-based teaching, group work, practical training, online learning, and simulations. Key content areas were most frequently climate change and health/climate-sensitive care and sustainability/SDG-related topics, whereas pollution/waste and environmental toxins, food systems, and equity/justice-related content were reported less frequently. Primary challenges included difficulties with curriculum integration, time constraints, and insufficient awareness among educators. Reported outcomes demonstrated improvements in knowledge, critical thinking, and motivation for sustainable practices; however, longitudinal impact studies were notably absent. CONCLUSIONS: PHE requires expansion beyond medicine into diverse disciplines and geographical contexts, particularly in low-income countries. Longitudinal studies and randomized controlled trials are needed to assess the long-term educational impact. Successful implementation depends on interdisciplinary approaches, strategic curriculum integration, and educator development programs. These efforts will help address global health challenges through education that connects human health with environmental sustainability.