Gaps in medical education curricula on skin of color in medical school, residency, and beyond: Part 1

Syder, Nicole; McKenzie, Shanice A; Omar, Deega; Brown-Korsah, Jessica; Taylor, Susan C.; Elbuluk, Nada

doi:10.1016/j.jaad.2022.03.053

Cited by 12 publications

(1 citation statement)

References 30 publications

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“…To score the skin color of the images, we used the Massey-Martin New Immigrant Survey (NIS) Skin Color Scale. 14 While most studies have used Fitzpatrick Skin Types as a proxy for skin color, 15 this is a phototyping measurement that categorizes a person's response to ultraviolet light, which cannot be determined from images. Instead, the NIS Skin Color Scale is a tool developed to assess the skin color of research participants.…”

Section: Measurementsmentioning

confidence: 99%

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education

Lamb

Stone

Davis

et al. 2023

Fam Med

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Background and Objectives: Visual learning equity is a health justice effort in response to the lack of representation of brown and black skin images in medical education. This paucity creates a knowledge gap and decreases providers’ competence in managing skin disease in minoritized populations. Herein, we aimed to create a standardized course auditing system to assess the use of brown and black skin images in medical education. Methods: We performed a cross-sectional analysis of the 2020-2021 preclinical curriculum at one US medical school. All human images in the learning material were analyzed. Skin color was categorized as light/white, medium/brown, and dark/black using the Massey-Martin New Immigrant Survey Skin Color Scale. Results: We included 1,660 unique images in our analysis; 71.3%, (n=1,183) were light/white, 16.1% (n=267) were medium/brown and 12.7% (n=210) were dark/black. Dermatologic images of skin, hair, nails, or mucosal disease made up 62.1% (n=1,031) of the images and 68.1% (n=702) were light/white. The pulmonary course presented the highest proportion of light/white skin (88.0%, n=44/50) and the dermatology course presented the lowest proportion of light/white skin (59.0%, n=301/510). Images of infectious diseases were more frequently presented in darker skin colors (χ2 [2]=15.46, P<.001). Conclusions: Light/white skin was the standard used for visual learning images in the medical school curriculum at this institution. The authors outline steps to perform a curriculum audit and diversify medical curricula to ensure the next generation of physicians are educated to care for all patients.

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Section: Measurementsmentioning

confidence: 99%

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education

Lamb

Stone

Davis

et al. 2023

Fam Med

View full text Add to dashboard Cite

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Understanding disparities in hidradenitis suppurativa through social and structural determinants of health

Polaskey,

Chovatiya

2024

JEADV Clinical Practice

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disorder with a global prevalence and presentation that varies widely and is influenced by both intrinsic and extrinsic factors. While research into disease heterogeneity and burden has traditionally focused on biological and genetic differences (i.e., intrinsic factors), emerging evidence suggests that social determinants of health (SDOH) and structural determinants of health (StDOH) (i.e., extrinsic factors) play a pivotal role in the disparities observed in HS. This narrative review consolidates insights on the influence of SDOH and StDOH on HS incidence, severity, and health disparities. We highlight the importance of SDOH, including economic stability, education quality and access, healthcare quality and access, neighbourhood environment, and social/community context in shaping HS outcomes. Furthermore, we emphasize the overarching role of StDOH, including government processes, economic policies, social/public policies, and cultural and societal values in determining health outcomes. Addressing these determinants is crucial for devising effective interventions and enhancing patient outcomes. Future research should focus on a holistic understanding of HS, moving beyond a purely biological perspective to consider the intricate interplay of social and structural determinants.

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Cutaneous presentations of systemic sclerosis in skin of colour: A systematic review

Podwojniak,

Tan,

Leiter

et al. 2024

JEADV Clinical Practice

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Systemic sclerosis (SSc), a rheumatologic autoimmune disease, can present diversely, especially in patients with skin of colour (SOC). Differences in clinical manifestations among SOC individuals compared to predominantly White populations require a comprehensive examination to optimize diagnosis and treatment. This systematic review aims to explore the differences in SSc manifestations among individuals with SOC, identifying variations in disease severity, clinical features and psychosocial impacts. A systematic review of the literature was conducted following PRISMA guidelines. Databases searched included PubMed, SCOPUS, Cochrane and Web of Science, focusing on studies published within the last 10 years. Nine studies were selected and qualitatively analysed due to the heterogeneity of study types. Key findings highlight significant variations in disease severity and cutaneous clinical features among SOC cohorts compared to predominantly White populations. Raynaud's phenomenon was prevalent across all ethnicities; however, SOC groups exhibited fewer hallmark features of scleroderma, such as telangiectasias, calcinosis and digital swelling, which complicates diagnosis. SOC individuals showed a higher propensity for severe pulmonary complications and increased mortality rates. Atypical cutaneous presentations in SOC were associated with disease progression. Psychosocial impacts were more pronounced in SOC individuals, with greater awareness and dissatisfaction over cutaneous symptoms. Recognizing the atypical presentations of SSc in SOC is critical for early diagnosis and optimizing patient outcomes. The study underscores the need for further research to determine if observed differences are due to variations in prevalence, genetic factors or insufficient training in recognizing cutaneous manifestations in SOC. Enhanced awareness and targeted training for healthcare providers are essential to address these diagnostic challenges and improve care for SOC patients with SSc.

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Gaps in medical education curricula on skin of color in medical school, residency, and beyond: Part 1

Cited by 12 publications

References 30 publications

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education

Visual Learning Equity: A Course Auditing System of Skin Color in Preclinical Medical Education

Understanding disparities in hidradenitis suppurativa through social and structural determinants of health

Cutaneous presentations of systemic sclerosis in skin of colour: A systematic review

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