Effectiveness of online learning on health researcher capacity to appropriately integrate sex, gender, or both in grant proposals

Sex Difference in the Treatment of Dupuytren's Disease: A Systematic Review and Meta-Analysis of Clinical Trials

Purpose: The aim of this study was to assess the sex differences in enrollment into clinical trials for Dupuytren's disease (DD), treatment efficacy, and complications. Methods: Three databases were searched; Ovid MEDLINE, Ovid EMBASE, and EBSCO CINAHL. Included studies were clinical trials on adult patients with DD. Exclusion criteria were non-English studies and other study designs. Two independent reviewers completed abstract screening, full-text review, and data extraction. The number and percentage of studies that reported ad hoc analyses for sex differences in treatment efficacy, tolerability, and complications were reported. A meta-analysis was performed on the proportion of female participants enrolled in clinical trials for DD. Results: A total of 3172 references were screened, and 59 studies were identified for full-text review. We identified 28 clinical trials for DD of which none reported secondary analyses for sex differences. Only 2 trials discussed sex differences in complications, and one trial reported sex differences in tolerability. The proportion of female participants in the meta-analysis was 19.5% [95% CI: 16.1-23.0%]. Conclusion: Sex differences in the clinical trials for DD are not widely considered in clinical trials despite their critical role. Males and females do not have equal representation in clinical trials for DD. Future studies should account for sex differences in the design and the analysis of clinical trials.

Training in the implementation of sex and gender research policies: an evaluation of publicly available online courses

BACKGROUND

Recently implemented research policies requiring the inclusion of females and males have created an urgent need for effective training in how to account for sex, and in some cases gender, in biomedical studies.

METHODS

Here, we evaluated three sets of publicly available online training materials on this topic: (1) Integrating Sex & Gender in Health Research from the Canadian Institutes of Health Research (CIHR); (2) Sex as a Biological Variable: A Primer from the United States National Institutes of Health (NIH); and (3) The Sex and Gender Dimension in Biomedical Research, developed as part of "Leading Innovative measures to reach gender Balance in Research Activities" (LIBRA) from the European Commission. We reviewed each course with respect to their coverage of (1) What is required by the policy; (2) Rationale for the policy; (3) Handling of the concepts "sex" and "gender;" (4) Research design and analysis; and (5) Interpreting and reporting data.

RESULTS

All three courses discussed the importance of including males and females to better generalize results, discover potential sex differences, and tailor treatments to men and women. The entangled nature of sex and gender, operationalization of sex, and potential downsides of focusing on sex more than other sources of variation were minimally discussed. Notably, all three courses explicitly endorsed invalid analytical approaches that produce bias toward false positive discoveries of difference.

CONCLUSIONS

Our analysis suggests a need for revised or new training materials that incorporate four major topics: precise operationalization of sex, potential risks of over-emphasis on sex as a category, recognition of gender and sex as complex and entangled, and rigorous study design and data analysis.

Remote training for strengthening capacity in sexual and reproductive health and rights research: a systematic review

BACKGROUND

Training has been used to develop research skills among sexual and reproductive health and rights (SRHR) researchers. Remote education may accelerate transfer of skills and reduce barriers to strengthening research capacity. This systematic review aimed to assess the effectiveness of remote training on SRHR research and describe enablers and barriers of effective remote training.

METHODS

PubMed, Embase, and Scielo were searched up to December 2022 for studies that evaluated in any language online research training programmes either on a SRHR topic or tailored for professionals working in SRHR published since 1990. Characteristics of included studies, the programmes they evaluated, the programme's effectiveness, and reported barriers and enablers to remote learning were extracted. Three researchers synthesized and described findings on effectiveness, impact and outcomes mapping them against the Kirkpatrick model. Additionally, thematic analysis from qualitative data was conducted to identify themes relating to the barriers and enablers of remote learning.

RESULTS

Of 1,510 articles retrieved, six studies that included 2,058 remote learners met the inclusion criteria. Five out of six studies described empirical improvements in participant research knowledge/skills and three studies reported improvements in attitudes/self-efficacy towards research. Follow-up surveys from four studies revealed frequent application of new research skills and improved opportunities for career advancement and publication following online trainings. Cited barriers to effective online SRHR research training included time management challenges and participants' competing professional obligations; limited opportunities for interaction; and lack of support from home institutions. Cited enablers included well-structured and clear courses, learning objectives and expectations with participants; ensuring a manageable workload; facilitating interactions with mentors and hands-on experience; and selecting programme topics relevant to participants' jobs.

CONCLUSION

Remote SRHR training can lead to improvements in research knowledge, skills, and attitudes, particularly when course learning objectives, structure, and expectations are outlined clearly, and ongoing mentorship is provided.

Assessing perceptions about critical thinking, motivation learning strategies in online psychiatric and mental health nursing education among Egyptian and Saudi undergraduate nursing students

BACKGROUND

The pandemic context prompts nursing students to be involved in online learning. Researchers indicated that critical thinking develops through the learning process, but the link between critical thinking and online learning in nursing does not have sufficient evidence.

AIM OF STUDY

This research examines student perceptions about critical thinking, motivation, and learning strategies in online psychiatric nursing education among nursing students at Imam Abdulrahman bin Faisal University in Saudi Arabia and Alexandria University in Egypt.

SUBJECT AND METHODS

An online survey was designed to collect data anonymously. A total of 75 Saudi undergraduates and 105 Egyptian nursing students who met the inclusion criteria participated. The online survey assessed three parts: socio-demographic data, critical thinking motivational, and cognitive processing strategy scales.

RESULTS

The current study found that using a motivating method for online learning inspired students to engage in critical thinking and cognitive processing strategies in a psychiatric and mental health nursing course, even in two different contexts.

CONCLUSION

This study demonstrates that using motivational methods for online learning encourages students to engage in critical thinking and cognitive processing strategies in psychiatry and mental health care courses, even in two different settings.

Best Practices in the Study of Gender

Integrating sex- and gender-related aspects into research and innovation content has become an urgent requirement of major science funding bodies as f.e. the European Commission, the Canadian Institutes of Health Research and the US NIH/Office of Women's Health Research.It was the only right response in reaction to the documented failure of the 'one size fits all' approach in traditional biomedical research practices. Attention to sex differences seems to be taken up by researchers quite well, however integrating a gender analysis has met with difficulties. Of prime importance here is to consider gender as a multidimensional concept, covering gender norms, gender identities and gender relations. A research design should clarify from the outset whether gender norms, identities or relations are of relevance to the research question at hand. This chapter provides an overview of international policies insisting on integrating a sex, gender and intersectional analysis into research and innovation with a focus on the the gender equality policy of the European Union. Next, more in depth, a collection of best practices, to be understood as a coherent set of processes and activities, corresponding to the starting points, theories and evidence of the field concerned of which it can be expected to contribute to the intended results in a particular context is described. Finally some challenges ahead are identified.

A framework for sex, gender, and diversity analysis in research

Funding agencies have ample room to improve their policies.

The Integration of Sex and Gender Considerations Into Biomedical Research: Lessons From International Funding Agencies

To improve the outcomes of research and medicine, government-based international research funding agencies have implemented various types of policies and mechanisms with respect to sex as a biological variable and gender as a sociocultural factor. After the 1990s, the US National Institutes of Health (NIH), the Canadian Institutes of Health Research (CIHR), and the European Commission (EC) began requesting that applicants address sex and gender considerations in grant proposals, and offering resources to help the scientific community integrate sex and gender into biomedical research. Although it is too early to analyze data on the success of all of the policies and mechanisms implemented, here we review the use both of carrots (incentives) and sticks (requirements) developed to motivate researchers and the entire scientific research enterprise to consider sex and gender influences on health and in science. The NIH focused on sex as a biological variable (SABV) aligned with an initiative to enhance reproducibility through rigor and transparency; CIHR instituted a sex- and gender-based analysis (SGBA) policy; and the EC required the integration of the "gender dimension," which incorporates sex, gender, and intersectional analysis into research and innovation. Other global efforts are briefly summarized. Although we are still learning what works, we share lessons learned to improve the integration of sex and gender considerations into research. In conjunction with refining and expanding the policies of funding agencies and mechanisms, private funders/philanthropic groups, editors of peer-reviewed journals, academic institutions, professional organizations, ethics boards, health care systems, and industry also need to make concerted efforts to integrate sex and gender into research, and we all must bridge across silos to promote systemwide solutions throughout the biomedical enterprise. For example, policies that encourage researchers to disaggregate data by sex and gender, the development of tools to better measure gender effects, or policies similar to SABV and/or SGBA adopted by private funders would accelerate progress. Uptake, accountability for, and a critical appraisal of sex and gender throughout the biomedical enterprise will be crucial to achieving the goal of relevant, reproducible, replicable, and responsible science that will lead to better evidence-based, personalized care for all, but especially for women.

Perception of the Online Learning Environment of Nursing Students in Slovenia: Validation of the DREEM Questionnaire

At the time of the outbreak of the coronavirus pandemic, several measures were in place to limit the spread of the virus, such as lockdown and restriction of social contacts. Many colleges thus had to shift their education from personal to online form overnight. The educational environment itself has a significant influence on students’ learning outcomes, knowledge, and satisfaction. This study aims to validate the tool for assessing the educational environment in the Slovenian nursing student population. To assess the educational environment, we used the DREEM tool distributed among nursing students using an online platform. First, we translated the survey questionnaire from English into Slovenian using the reverse translation technique. We also validated the DREEM survey questionnaire. We performed psychometric testing and content validation. I-CVI and S-CVI are at an acceptable level. A high degree of internal consistency was present, as Cronbach’s alpha was 0.951. The questionnaire was completed by 174 participants, of whom 30 were men and 143 were women. One person did not define gender. The mean age of students was 21.1 years (SD = 3.96). The mean DREEM score was 122.2. The mean grade of student perception of learning was 58.54%, student perception of teachers was 65.68%, student academic self-perception was 61.88%, student perception of the atmosphere was 60.63%, and social self-perception of students was 58.93%. Although coronavirus has affected the educational process, students still perceive the educational environment as positive. Nevertheless, there is still room for improvement in all assessed areas.

A 10-year longitudinal evaluation of science policy interventions to promote sex and gender in health research

BACKGROUND

Over the past decade, the Canadian Institutes of Health Research (CIHR) has implemented multicomponent interventions to increase the uptake of sex and gender in grant applications. Interventions included mandatory reporting on applicant forms, development of resources for applicants and evaluators, and grant review requirements. Here, we aim to inform science policy implementation by describing the 10-year outcomes and lessons learned from these interventions.

METHODS

This is a prospective longitudinal study. The population is all applicants across 15 investigator-initiated CIHR competitions from 2011 to 2019 and grant evaluators from 2018 to 2019. Quantitative data were derived from applicants' and grant evaluators' mandatory reporting of sex and gender integration in the grants management database. The application was the unit of analysis. Trends in sex and gender uptake in applications were plotted over time, stratified by research area. Univariate logistic regression was used to assess associations between the sex of the applicant and the uptake of sex and gender, and the latter with funding success. Qualitative review of the quality and appropriateness of evaluators' comments informed the development of discipline-specific training to peer review committee members. Feedback was compiled from a subset of evaluators on the perceived usefulness of the educational materials using a brief questionnaire.

RESULTS

Since 2011, 39,390 applications were submitted. The proportion that reported integration of sex rose from 22 to 83%, and gender from 12 to 33%. Population health research applications paid the greatest attention to gender (82%). Across every competition, applications with female principal investigators were more likely to integrate sex (odds ratio [OR] 1.60, 95% confidence interval [CI] 1.50-1.63) and gender (OR 2.40, 95% CI 2.29-2.51) than those who identified as male. Since 2018, applications that scored highly for the integration of sex (OR 1.92, 95% CI 1.50-2.50) and gender (OR 2.53, 95% CI 1.83-3.50) were more likely to be funded. Qualitative observations revealed persistent conflation of the terms sex and gender. Eighty-six percent of evaluators appreciated the tailored discipline-specific coaching.

CONCLUSIONS

A number of policy interventions improved sex and gender uptake in grant applications, with higher success rates observed over time for applications that integrated sex and gender. Other funders' action plans around sex and gender integration may be informed from our experiences of the timing, type and targets of the different interventions, specifically those directed at evaluators.

Sex bias and omission in neuroscience research is influenced by research model and journal, but not reported NIH funding

Neuroscience research has historically demonstrated sex bias that favors male over female research subjects, as well as sex omission, which is the lack of reporting sex. Here we analyzed the status of sex bias and omission in neuroscience research published across six different journals in 2017. Regarding sex omission, 16% of articles did not report sex. Regarding sex bias, 52% of neuroscience articles reported using both males and females, albeit only 15% of articles using both males and females reported assessing sex as an experimental variable. Overrepresentation of the sole use of males compared to females persisted (26% versus 5%, respectively). Sex bias and omission differed across research models, but not by reported NIH funding status. Sex omission differed across journals. These findings represent the latest information regarding the complex status of sex in neuroscience research and illustrate the continued need for thoughtful and informed action to enhance scientific discovery.

The promises and pitfalls of sex difference research

Funding agencies in North America and Europe are recognizing the importance of the integration of sex differences into basic and clinical research. Although these mandates are in place to improve our knowledge of health for both men and women, there have been a number of implementation issues that require vigilance on the part of funders and the research community. Here we discuss issues on simple inclusion of both sexes in studies to specialisation of sex differences with attention paid to statistics and the need for sex-specific treatments. We suggest differing mandates need to be considered regarding simple integration versus the need for studies in the specialisation of sex differences and/or the need for research that recognises the importance of male-specific or female-specific factors that influence subsequent health such as menstruation, menopause or pregnancy.