Modderkolk L, Van den Hurk L, Oertelt-Prigione S
Gender Unit, Department of Primary and Community Care, Radboudumc, Radboud University Medical Center, Geert Grooteplein 21, Nijmegen, 6500 HB, Netherlands.
AG 10 Sex- and Gender-Sensitive Medicine, Medical Faculty OWL, University of Bielefeld, Morgenbreede 1, Bielefeld, 33519, Germany.
BMC Public Health. 2025 Jul 2;25(1):2222. doi: 10.1186/s12889-025-23444-2.
There is growing focus on sex- and gender-sensitive medicine (SGSM) in the field of medical education, yet only few medical schools worldwide have successfully integrated SGSM content into their curricula. The topic is highly relevant, but it can be challenging due to its identity-related nature that can trigger questions about safe learning spaces. In this study we aimed at investigating the multilayered impact of safety on SGSM teaching.
We employed a multimethod qualitative approach to investigate perceptions and experiences of safety in studying SGSM and the implications for curriculum design. In the setting of a week-long summer school on SGSM we performed participant observation, a creative assignment, a focus group, and semi-structured interviews with participants to achieve a multi-dimensional framing of the concept of safety.
The study highlights the interrelation of psychological, social, and cultural safety and a hierarchy in their exploration by the learners in the context of SGSM. If social safety is not guaranteed, learners do not proceed to explore psychological and eventually cultural safety. Learners often conflated safety with comfort and avoidance of conflict. Placing an explicit focus on safety can, thus, have a paradoxical effect, with learners avoiding learning about sensitive topics because of a heightened attention to safety.
Conflation of safety with conflict avoidance can hinder learning in the field of SGSM as it might hinder deep engagement with the topic. Lecturers are responsible for the generation of safe learning spaces focused on social, psychological and cultural safety, yet need to encourage exploration and discussion within this framework. Hence, lecturers need appropriate training to support safety, in-depth engagement and critical reflection in class, in order to promote personal growth while acquiring professional skills in SGSM.
医学教育领域对性别敏感医学（SGSM）的关注日益增加，但全球只有少数医学院成功地将SGSM内容纳入其课程。该主题高度相关，但由于其与身份相关的性质可能引发关于安全学习空间的问题，因此具有挑战性。在本研究中，我们旨在调查安全对SGSM教学的多层次影响。
我们采用多方法定性方法来调查学习SGSM时对安全的认知和体验以及对课程设计的影响。在为期一周的SGSM暑期学校中，我们进行了参与观察、创意作业、焦点小组讨论以及与参与者的半结构化访谈，以实现对安全概念的多维框架构建。
该研究强调了心理、社会和文化安全之间的相互关系以及学习者在SGSM背景下探索这些安全时的层次结构。如果社会安全得不到保障，学习者就不会继续探索心理安全，最终也不会探索文化安全。学习者常常将安全与舒适和避免冲突混为一谈。因此，明确关注安全可能会产生自相矛盾的效果，即学习者由于对安全的高度关注而避免学习敏感话题。
将安全与避免冲突混为一谈可能会阻碍SGSM领域的学习，因为这可能会阻碍对该主题的深入参与。讲师负责营造注重社会、心理和文化安全的安全学习空间，但需要在这个框架内鼓励探索和讨论。因此，讲师需要适当的培训，以支持课堂上的安全、深入参与和批判性反思，从而在获得SGSM专业技能的同时促进个人成长。
