Audit of SGIM in Medical School Pre-Clinical Curriculum

Despite the expanding literature demonstrating widespread sex and gender differences across all organ systems, the inclusion of this material in medical education is lacking, leaving medical students without an appreciation for physiologic and sociocultural differences that affect health, disease, and healthcare delivery.<b> </b>We performed an audit of five courses of a medical school pre-clinical curriculum that teach physiology and pathophysiology using case-based collaborative learning (CBCL) that utilizes "patient" cases for students to work through during class. The courses (referred to as “Courses 1-5”) divided material as followed: 1) biochemistry, anatomy, genetics, immunology 2) dermatology, infectious disease, rheumatology 3) cardiology, pulmonology, hematology 4) gastroenterology, nephrology, endocrinology, and 5) neurology, and psychiatry. Using a standard codebook, reviewers recorded: time per case, diagnosis/focus of case, age, sex, gender, pronouns, and sexual orientation. Coders were asked to determine if the CBCL patient’s sex/gender chosen was “intentional” and if there was further discussion around sex- and gender-specific influences on disease. Each case was coded by two auditors, with discrepancies adjudicated by a third. This file contains the coded data from the cases, which were originally retrieved from the school's web-based learning management system.

尽管现有研究文献日益表明，所有器官系统均广泛存在生理性别（sex）与社会性别（gender）差异，但医学教育对这类内容的覆盖却存在明显不足，致使医学生无法充分理解影响健康、疾病发生及医疗服务交付的生理与社会文化层面差异。
我们对某医学院临床前期预科阶段的5门讲授生理学与病理生理学、采用基于病例协作学习（case-based collaborative learning, CBCL）模式的课程开展了审核，该模式以"患者"病例为教学载体，供学生在课堂上协作分析推演。本次审核涉及的5门课程（下文简称"课程1至课程5"）的内容模块划分如下：课程1涵盖生物化学、解剖学、遗传学与免疫学；课程2涵盖皮肤病学、传染病学、风湿病学；课程3涵盖心脏病学、肺病学与血液学；课程4涵盖胃肠病学、肾脏病学与内分泌学；课程5涵盖神经病学与精神病学。
审核人员采用标准化编码手册，记录每例病例的用时、诊断主题、病例聚焦方向、患者年龄、生理性别、社会性别、代词使用及性取向。编码人员需完成两项判定：一是所选CBCL病例的生理性别/社会性别设定是否为"有意为之"，二是病例是否围绕性别特异性疾病影响因素展开了相关讨论。每例病例均由2名审核人员独立编码，若出现编码分歧，则由第三名审核人员进行最终裁定。本数据集包含上述病例的编码后数据，原始病例信息均从该校基于网页的学习管理系统（learning management system, LMS）中调取获取。