Applying the Gender Lens to Emergency Care: From Bench to Bedside.

This article outlines the history, need, and evolution of gender medicine in emergency care research. Clinical examples are used where sex and gender play a role in diagnosis, management, or prognosis of patients in the emergency department (ED). The ED serves as an ideal setting to advance sex- and gender-specific research as the primary access point for health care for much of the U.S. population, with more than 136 million annual visits. Gender medicine provides the biologic and social framework to provide high-quality, safe, equitable, and cost-effective sex- and gender-specific care in the ED. With a 24-hour hospital presence, and with access to high-acuity patients, emergency physicians are well positioned to lead sex- and gender-specific clinical studies for time-sensitive conditions and also to serve as vital partners in interdisciplinary research projects. The ED also provides the primary access point for less life-threatening conditions such as substance abuse, mental health, and pain management (both acute and chronic). Because one-fifth of the U.S. population is without health insurance, and many more lack a regular provider or rapid access to their providers, the ED is often the only point of contact for advancing gender medicine in this population

Sex as a Biological Variable in Emergency Medicine Research and Clinical Practice: A Brief Narrative Review.

The National Institutes of Health recently highlighted the significant role of sex as a biological variable (SABV) in research design, outcome and reproducibility, mandating that this variable be accounted for in all its funded research studies. This move has resulted in a rapidly increasing body of literature on SABV with important implications for changing the clinical practice of emergency medicine (EM). Translation of this new knowledge to the bedside requires an understanding of how sex-based research will ultimately impact patient care. We use three case-based scenarios in acute myocardial infarction, acute ischemic stroke and important considerations in pharmacologic therapy administration to highlight available data on SABV in evidence-based research to provide the EM community with an important foundation for future integration of patient sex in the delivery of emergency care as gaps in research are filled

Organization, Execution and Evaluation of the 2014 Academic Emergency Medicine Consensus Conference on Gender-Specific Research in Emergency Care - an Executive Summary.

With the goal of reducing inequalities in patient care, the 2014 Academic Emergency Medicine (AEM) consensus conference, Gender-Specific Research in Emergency Care: Investigate, Understand, and Translate How Gender Affects Patient Outcomes, convened a diverse group of researchers, clinicians, health care providers, patients, and representatives of federal agencies and policy-makers in Dallas, Texas, in May 2014. The executive and steering committees identified seven clinical domains as key to gender-specific emergency care: cardiovascular, neurological, trauma/injury, substance abuse, pain, mental health, and diagnostic imaging. The main aims of the conference were to: 1) summarize and consolidate current data related to sex- and gender-specific research for acute care and identify critical gender-related gaps in knowledge to inform an EM research agenda; 2) create a consensus-driven research agenda that advances sex- and gender-specific research in the prevention, diagnosis, and management of acute diseases and identify strategies to investigate them; and 3) build a multinational interdisciplinary consortium to disseminate and study the sex and gender medicine of acute conditions. Over a 2-year period, this collaborative network of stakeholders identified key areas where sex- and gender-specific research is most likely to improve clinical care and ultimately patient outcomes. The iterative consensus process culminated in a daylong conference on May 13, 2014, with a total of 133 registrants, with the majority being between ages 31 and 50 years (57%), females (71%), and whites (79%). Content experts led the consensus-building workshops at the conference and used the nominal group technique to consolidate consensus recommendations for priority research. In addition, panel sessions addressed funding mechanisms for gender-specific research as well as gender-specific regulatory challenges to product development and approval. This special issue of AEM reports the results of the 2014 consensus conference as well as related original research with the goal of bringing high-quality equitable care to male and female emergency patients

Incorporating Sex and Gender into Culturally Competent Simulation in Medical Education.

BACKGROUND AND OBJECTIVES: Simulation provides a vehicle to introduce sex and gender competent training into the education of medical trainees. MATERIALS AND METHODS: Using the previously validated Texas Tech University Health Sciences Center Sex and Gender Specific Health PubMed Advanced Search Tool, we reviewed the existing sex- and gender-based medical simulation education literature. A single article specifically addressed the incorporation of sex- and gender-based medicine in the development of simulation-based training. The Society for Academic Emergency Medicine Sex and Gender Interest Group then collaboratively developed recommendations for the incorporation of these concepts into simulation training. RESULTS: Collaboratively developed recommendations were as follows. Knowledge-based competency in sex- and gender-based medicine involves understanding the relevant key terminology. Attitude-based competencies include an understanding of tendencies toward bias in patient assessment and care, which can be addressed in the self-reflection component of a simulation debrief. Skill-based competencies include communication skills, assessing the social context in which a patient is pursuing medical care, and recognition of gender-based cultural models of health and disease. Successful implementation includes specific faculty development, administrative and financial resources, gender-specific simulation equipment and selection of standardized patients, and scenarios that address sex- and gender-based medical care. CONCLUSION: The adoption of sex and gender competent simulation has the potential to significantly impact medical training and the provision of empathetic and humanistic care while reducing sex- and gender-based health care disparities