ACOD1 deficiency promotes DDX1 methylation-mediated mitochondrial dysfunction and dermal papilla cell senescence in androgenetic alopecia.

Sex and gender (SG) are central biological and sociocultural variables that significantly impact health and disease [] relevant to all patients. However, lack of awareness and knowledge about their impact has been reported among health professions students [–]. Although efforts have been made to incorporate SG into medical education, both nationally and internationally [–], SG-related content remains insufficiently or inconsistently integrated into medical education curricula [–, –], including in postgraduate medical training [–]. This has resulted in the continued outdated education of future healthcare providers that is often harmful as women continue to receive care that is based on research conducted on men, or “discrepant clinical care” []. It has been suggested that SG-based content should be threaded through existing curriculum [, , ], e.g., successfully by Germany’s Charité [, ]. However, major barriers to curricular change include lack of sufficiently qualified educators [, ], time constraints [, ], knowledge gaps [, –], and the need for specific training regarding SG [–]. To address these challenges and facilitate the integration of SG-based content into medical curricula, the Sex and Gender Curricular Assessment and Revision Toolkit (SG-CART) and its accompanying workshop were developed to introduce faculty to SG-based medicine and provide a structured, step-by-step approach to curriculum update. This study aims to evaluate the implementation of the SG-CART and associated workshop, and to conduct an initial validation of the embedded assessment scale. The design and assessment of the SG-CART and accompanying workshop were informed by the Moore’s Outcomes Framework [], providing a theoretical foundation for interpreting the outcomes of this study and situating them within the broader continuum of educational effectiveness. We performed a parallel mixed-method study using a combination of pre- and post-intervention online surveys and focus group-based cognitive interviewing. The questionnaire used in this study was developed specifically for the purposes of this research and has not been previously published. The full questionnaire is provided in Additional File 1. The University of South Carolina Institutional Review Board (IRB) determined that the study did not meet the regulatory definition of human subject research and therefore did not require IRB oversight. All procedures nevertheless adhered to the ethical principles of the Declaration of Helsinki. Data collection was conducted between October 2023 and December 2024. Faculty were recruited via email and introduced to the SG-CART during faculty development workshops at the University of South Carolina School of Medicine Greenville (USCSOMG). Participation was voluntary. Recorded verbal consent was obtained from all focus group participants, and a written waiver of consent was granted by all survey participants. Incentives to complete the surveys included a $100 gift card draw and a $50 gift card for focus group participants. The reporting of this study adhered to the Consolidated Criteria for Reporting Qualitative Research (COREQ) guidelines [], and the completed checklist is provided in Additional File 2. In response to the lack of an established approach or assessment tool for evaluating the integration of sex and gender in the medical curricula, two of the co-authors (AM, MS) developed the Sex/Gender Responsiveness Assessment Scale for health education, adapted from two established assessment frameworks designed for policy and research: the World Health Organization (WHO) Gender Responsive Assessment Scale [] and the Canadian Institutes of Health Research (CIHR) Sex/Gender-Responsive Assessment Scale []. The scale, which is now a core component of the SG-CART toolkit, was first piloted in a faculty training course at the Warren Alpert Medical School at Brown University in 2021 []. Based on participant feedback and with the aim of creating a structured, comprehensive and user-friendly toolkit, the prototype materials were subsequently expanded by the research team to include, in addition to the assessment scale, checklists for reviewing didactic lectures and bedside teaching activities. The toolkit also incorporates curated resources to support evidence-based curriculum updates, including the validated Sex and Gender-Specific Health PubMed search tool, a freely available literature search instrument [], modules and slide library available on the Sex and Gender Specific Health [] and reference to the comprehensive textbook [].To support the dissemination and implementation, a dedicated faculty development workshop was created and held at the USCSOMG. Informed by the literature and the co-authors’ prior experience indicating that faculty members lack both confidence and foundational knowledge in SG [, –, ], the activity was designed to achieve mid-level educational outcomes, specifically Level 3 (Learning) and Level 4 (Competence) within Moo