Field Test Results of Sex- and Gender-Specific Health Multimedia Case-Based Learning Modules.

Background: The sex- and gender-specific health (SGSH) multimedia case-based learning modules (MCBLMs) were developed to address the absence of validated or peer-reviewed material that incorporates topics of sex and gender differences into medical curricula. This article provides the methodology for development of the modules and reports the results of a field test of the modules in different medical educational settings. Methods: MCBLMs were created by a multidisciplinary committee of scientists, health profession educators, and students. Two modules, osteoporosis and diabetes, were tested in various settings based on the curricular needs at each of the five accredited institutions. Each module consisted of a pretest and three interactive, multimedia stand-alone sections with post-tests. Scores on the tests were compared using a paired-samples t-test. A postmodule survey was used to evaluate the format. Results: Four hundred eighteen students participated in the field testing. For the 194 who completed the osteoporosis module, the post-test scores (M = 13.71, standard deviation [SD] = 2.09) were significantly higher than the pretest scores (M = 10.54, SD = 2.41), p < 0.001. Post-test scores for the 285 who completed the diabetes module (M = 16.55, SD = 2.46) were also significantly higher than the pretest scores (M = 13.71, SD = 2.09), p < 0.001. The postmodule survey showed positive acceptance of the format with an average score of 3.54/4 for osteoporosis and 3.45/4 for diabetes. Conclusion: The SGSH MCBLM field testing results show that the modules have a positive effect on content knowledge in multiple settings and are well accepted by learners.

The Influence of Nature Stimulus in Enhancing the Birth Experience.

The physical environment is one of the factors that affect women's experience of labor. The basics of the childbirth process have not changed since the beginning of human existence; however, the environment in which women today give birth has changed significantly. Incorporating design elements and strategies that calm and reduce negative emotions may create positive experiences for women in labor. The purpose of this study was to examine the impact of one such strategy, namely, the presentation of images of nature, on the labor and delivery experience. The study findings showed that the experimental condition has a higher score on the Quality of Care From the Patient's Perspective (QPP) subscale. In addition, there was an increase in the QPP scores associated with the increase in Nature TV watching time, QPP mean of watching time (less than 1 hr) group, m = 4.5 and QPP mean of watching time (more than 3 hs), m = 4.8. The mean score for the heart rate was lower in the experimental condition, m = 84.60, than in the control one, m = 90.49. For Apgar, the mean score was higher for Group A, m = 8.65, and Group B, m = 8.92. These findings support the study hypothesis which states that the nature images would influence the labor experience positively. In addition, the findings emphasize the importance of incorporating nonpharmacological techniques in the labor and delivery room (LDR) units to sooth the pain. Adding nature imagery to the LDR environment can be one of these techniques.

Instructional design framework for the sex and gender-specific health multimedia case-based learning modules.

The goal of the Sex and Gender Specific Health (SGSH) curriculum at the Texas Tech University Health Sciences Center (TTUHSC) is to advance the understanding of sex/gender differences, increase the awareness of gender-specific health issues, and improve the knowledge of sex and gender evidence-based medicine. The purpose of this paper is to explain the development and theoretical rationale for an important aspect of the curriculum: the SGSH Multimedia Case-Based Learning Modules (MCBLMs). The MCBLMs are designed to be used throughout the TTUHSC curriculum as a stand-alone or a supplementary instructional resource. The MCBLMs provide students with authentic learning opportunities that integrate the learning of SGSH with more traditional clinical knowledge and skills. The MCBLMs are specifically designed to enhance students' clinical reasoning and decision-making skills by portraying realistic clinical scenarios. In this way, students are able to practice effective SGSH as competent health-care professionals.

Sex and Gender Medical Education Summit: a roadmap for curricular innovation.

The Sex and Gender Medical Education Summit: a roadmap for curricular innovation was a collaborative initiative of the American Medical Women's Association, Laura W. Bush Institute for Women's Health, Mayo Clinic, and Society for Women's Health Research (www.sgbmeducationsummit.com). It was held on October 18-19, 2015 to provide a unique venue for collaboration among nationally and internationally renowned experts in developing a roadmap for the incorporation of sex and gender based concepts into medical education curricula. The Summit engaged 148 in-person attendees for the 1 1/2-day program. Pre- and post-Summit surveys assessed the impact of the Summit, and workshop discussions provided a framework for informal consensus building. Sixty-one percent of attendees indicated that the Summit had increased their awareness of the importance of sex and gender specific medicine. Other comments indicate that the Summit had a significant impact for motivating a call to action among attendees and provided resources to initiate change in curricula within their home institutions. These educational efforts will help to ensure a sex and gender basis for delivery of health care in the future.

Auditing sex- and gender-based medicine (SGBM) content in medical school curriculum: a student scholar model.

BACKGROUND: Sex- and gender-based medicine (SGBM) aims to (1) delineate and investigate sex- and gender-based differences in health, disease, and response to treatment and (2) apply that knowledge to clinical care to improve the health of both women and men. However, the integration of SGBM into medical school curricula is often haphazard and poorly defined; schools often do not know the current status of SGBM content in their curricula, even if they are committed to addressing gaps and improving SGBM delivery. Therefore, complete auditing and accounting of SGBM content in the existing medical school curriculum is necessary to determine the baseline status and prepare for successful integration of SGBM content into that curriculum. METHODS: A review of course syllabi and lecture objectives as well as a targeted data analysis of the Curriculum Management and Information Tool (CurrMIT) were completed prior to a real-time curriculum audit. Subsequently, six "student scholars," three first-year and three second-year medical students, were recruited and trained to audit the first 2 years of the medical school curriculum for SGBM content, thus completing an audit for both of the pre-clinical years simultaneously. A qualitative analysis and a post-audit comparative analysis were completed to assess the level of SGBM instruction at our institution. RESULTS: The review of syllabi and the CurrMIT data analysis did not generate a meaningful catalogue of SGBM content in the curriculum; most of the content identified specifically targeted women's or men's health topics and not sex- or gender-based differences. The real-time student audit of the existing curriculum at Texas Tech revealed that most of the SGBM material was focused on the physiological/anatomical sex differences or gender differences in disease prevalence, with minimal coverage of sex- or gender-based differences in diagnosis, prognosis, treatment, and outcomes. CONCLUSIONS: The real-time student scholar audit was effective in identifying SGBM content in the existing medical school curriculum that was not possible with a retrospective review of course syllabi and lecture objectives or curriculum databases such as the CurrMIT. The audit results revealed the need for improved efforts to teach SGBM topics in our school's pre-clinical curriculum.

Workshop summaries from the 2015 Sex and Gender Medical Education Summit: utilization of sex and gender based medical education resources and creating student competencies.

BACKGROUND: Despite overwhelming evidence that sex and gender are critical factors in the delivery and practice of medicine, there is no unified sex- and gender-based medicine (SGBM) undergraduate medical education curriculum. Two Workshops within the 2015 Sex and Gender Medical Education Summit: a Roadmap to Curricular Innovation sought to lay the framework for such a curriculum. METHODS: Attendees to the Sex and Gender Educational Summit self-selected attendance for one of two Workshops: (A) Utilization of SGBM Resources in U.S. Medical Schools or (B) Creating SGBM Student Competencies. RESULTS: Workshop A identified gaps in existing curricula as well as strategies for incorporating available SGBM content into existing educational activities or curricular threads. Focus was given to the use of advisory committees to nurture collaboration and sharing of resources. Workshop B created a framework for national SGBM competencies by adapting existing materials from women's health curricula such as Brown University's SGBM Emergency Medicine subspecialty. The importance of student engagement, assessment, and faculty development were stressed as well as engaging the Liaison Committee on Medical Education (LCME) in awareness of the vital nature of including SGBM content into all medical school curricula. CONCLUSION: These Workshops provided a forum for national and international institutional representatives to lay a foundation for integration of SGBM into medical school curricula and the development of national SGBM Student Competencies.

Integrating topics of sex and gender into medical curricula-lessons from the international community.

In the era of individualized medicine, training future scientists and health-care providers in the principles of sex- and gender-based differences in health and disease is critical in order to optimize patient care. International successes to incorporate these concepts into medical curricula can provide a template for others to follow. Methodologies and resources are provided that can be adopted and adapted to specific needs of other institutions and learning situations.

Medical students' perceptions of their teachers' and their own cultural competency: implications for education.

BACKGROUND: Enhancing the cultural competency of students is emerging as a key issue in medical education; however, students may perceive that they are more able to function within cross-cultural situations than their teachers, reducing the effectiveness of cultural competency educational efforts. OBJECTIVE: The purpose of our study was to compare medical students' perceptions of their residents, attendings, and their own cultural competency. DESIGN: Cross-sectional study. MAIN MEASURES: A questionnaire containing previously validated instruments was administered to end-of-third-year medical students at four institutions throughout the US. Repeated measures multivariate analysis was used to determine differences in student ratings. PARTICIPANTS: Three hundred fifty-eight medical students from four schools participated, for an overall response rate of 65%. RESULTS: Analysis indicated overall statistically significant differences in students' ratings (p < 0.001, eta(2) = 0.33). Students rated their own cultural competency as statistically significantly higher than their residents, but similar to their attendings. For reference, students rated the patient care competency of themselves, their residents, and their attendings; they rated their attendings' skills as statistically significantly higher than residents, and residents as statistically significantly higher than themselves. There were differences between cultural competency and patient care ratings. CONCLUSIONS: Our results indicate that students perceive the cultural competency of their attendings and residents to be the same or lower than themselves. These findings indicate that this is an important area for future research and curricular reform, considering the vital role that attendings and residents play in the education of medical students.