DOI: 10.5061/dryad.djh9w0wbr
title: Audit of SGIM in medical school pre-clinical curriculum

description: 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. We performed an audit
 of five courses of a medical school's 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 follows: 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. 
description: Case-based collaborative learning (CBCL) cases that students
 worked through during class. Cases were accessed via the school's
 web-based learning management system.
description: # Audit of SGIM in medical school pre-clinical curriculum Dataset DOI:
 [10.5061/dryad.djh9w0wbr](10.5061/dryad.djh9w0wbr)
 Audit_of_SGIM_in_Pre-Clinical_Curriculum.xlsx ## Description of the data
 and file structure #### File:
 Audit_of_SGIM_in_Pre-Clinical_Curriculum.xlsx **Description:**  * First
 sheet of data includes the codebook for data analysis. * Sheets for
 courses 1-5 include data collected from 591 individual patient cases
 created for pre-clinical medical education (cases are not real patients,
 and the data collected does not include real patient information). The
 variables collected are listed below. * The sheet entitled
 "Intentional SG" (sex/gender) collects the cases across all
 course sheets that had "Y" listed for S/G/P intentional,
 specifically including the diagnosis, gender, and sex of the patient, as
 well as whether further discussion was had. Additionally, it includes the
 reason why the S/G/P were thought to be intentional (marked as a 1; cases
 could have multiple reasons), broken down into: disease prevalence
 ("Prevalence"), physiology, menses (i.e. menses were crucial to
 the design of the case), pregnancy, and practice of medicine. * Finally,
 the sheet entitled "Further Discussion" collects the cases
 across all course sheets that had a further discussion of sex/gender and
 the disease process.  ##### Variables Missing values are either indicated
 with: u=unspecified or a blank cell | Organ system | Defined for each
 class by course directors in syllabus | Per syllabus: Histology, CBB (cell
 biology and biochemistry), genetics, anatomy, immunology, microbiology,
 pathology, developmental biology, cancer, pharmacology, dermatology,
 rheumatology, ID (infectious disease), pulmonology, cardiovascular,
 hematology, GI (gastroenterology), endocrinology, nephrology, neurology,
 psychiatry integration (course 3= integration of pulmonology,
 cardiovascular, and hematology; course 4=endocrinology, GI, and
 nephrology) | | :---------------------------- |
 :------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | :--------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------------- | | Time | Time calculated per case (number of CBCL cases divided by total class time dedicated to CBCL) | Minutes; Calculate by taking total time allotted for class session, divided by the number of cases included in the class session | | Case | Which case from all cases included in that individual class period (ex: 1/3 is the first of three cases) | | | Diagnosis | What was the final diagnosis or focus of learning (if no official diagnosis is given) of the case? | | | Age | As stated specifically in the case, typically in years for children and adults and months in infants. | Code in years (specify unit if not recorded in years); unspecified = u. | | Gender | Gender identity explicitly stated in a sentence or in introduction of the patient as man, woman, or non-binary (or can utilize pronouns as presumption of gender). Non-binary defined as explicit statement that patient uses they/them pronouns or explicit mention in the case that patient identifies as non-binary. | Man = m; woman = w; non-binary = nb; unspecified = u. | | Sex | Stated explicitly as male, female, intersex, or sex assigned at birth. If unspecified, biological and physiological references such as anatomy, chromosomes, or multiple secondary sex characteristics, can be used. | Male = m; female = f; unspecified = u | | How Specified (Patient sex) | How was biological sex explicitly demonstrated in the content of the case. | Freeform | | Pronouns (PN) specified | Yes: pronouns are explicitly stated either in an introductory sentence (eg. Patient uses \_\_\_\_ pronouns) or in parenthesis in the introduction of the patient; implication that pronouns used were provided by the patient (e.g. Patient Jane (she/her) is a 30-year-old…). | Y/N | | Pronouns (PN) Used | Pronouns used for the patient throughout the case text. | he/him, she/her, they/them, u = unspecified | | Sex/Gender (S/G) Intentional  | By coder impression, was the sex/gender of the patient integral to the content of the case or believed to be specifically chosen by the faculty in case development (Yes)? Or was patient sex/gender irrelevant to the medical content of the case (No)? | Yes (y) or no (n); followed by freeform option | | Intercourse Relevant | Is sexual intimacy mentioned or implied as having impacted the patient’s health in the case?  | Yes (y) or no (n) | | Partner mentioned | Is a romantic or intimate partner mentioned in the case?  | Yes (y) or no (n); followed by freeform option and record of partner gender. | | Sexual Orientation  | If a romantic or intimate partner is mentioned in the case, is the partner’s gender the same (concordant) or different (discordant) than the patient’s gender, or is it not mentioned (unspecified). | Concordant = c; discordant=d; unspecified=u | | Further Discussion  | Did the case include an explicit mention, even minor, of the impact of sex and/or gender on health related to the medical condition discussed in the case? Please yes (y) or no (n) into appropriate categories: - Disease presentation: Is there a discussion of differences in disease presentation between sex and gender? - Statistics: Are there statistics about the disease by sex or gender? - Anatomy: Are anatomical differences by sex discussed? - Physiology: Are physiological differences by sex discussed? - Response to Treatment: Are differences in response to treatment discussed? - Risk Factor: Is sex or gender discussed as a risk factor? - Socioeconomic Factors: Are socioeconomic differences between sexes/genders discussed as these relates to their health and care? - Interaction with the Healthcare System: Is there a discussion of the patient's engagement or interaction with the healthcare system as it impacts their health and care? | Yes (y) or no (n); followed by freeform option | ## Code/software This data is able to be downloaded and viewed as an excel spreadsheet or as a CSV file.  ## Access information Other publicly accessible locations of the data: * This data is also available at the following source:  Bartz, Deborah. Audit of SGIM in Medical School Pre-Clinical Curriculum. Ann Arbor, MI: Inter-university Consortium for Political and Social Research [distributor], 2025-02-24. [https://doi.org/10.3886/E220587V1](https://doi.org/10.3886/E220587V1) Data was derived from the following sources: * Data was collected from Case-based collaborative learning (CBCL) cases utilized in Harvard Medical School's pre-clinical curriculum. These cases were accessed via the school's web-based learning management system, which is not publicly available for access.