123667938 Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
10070 Division of Dermatology, Temerty Faculty of Medicine, University of Toronto, Toronto, Canada.
J Cutan Med Surg. 2021 Jul-Aug;25(4):409-417. doi: 10.1177/12034754211007430. Epub 2021 Apr 13.
A lack of representation of skin of color (SoC) in dermatology curricula is well-documented across North American medical schools and may present a barrier to equitable and comprehensive undergraduate medical education.
This study aims to examine representation in dermatologic educational materials and appreciate a link between bias in dermatologic education and student diagnostic ability and self-rated confidence.
The University of Toronto Dermatology Undergraduate Medical Education curriculum was examined for the percentage photographic representation of SoC. A survey of 10 multiple-choice questions was administered to first- and third-year medical students at the University of Toronto to assess diagnostic accuracy and self-rated confidence in diagnosis of 5 common skin lesions in Fitzpatrick skin phototypes (SPT) I-III (white skin) and VI-VI (SoC).
The curriculum audit showed that <7% of all images of skin disease were in SoC. Diagnostic accuracy was fair for both first- (77.8% and 85.9%) and third-year (71.3% and 72.4%) cohorts in white skin and SoC, respectively. Students' overall self-rated confidence was significantly greater in white skin when compared to SoC, in both first- (18.75/25 and 17.78/25, respectively) and third-year students (17.75/25 and 15.79/25, respectively) ( = .0002).
This preliminary assessment identified a lack of confidence in diagnosing dermatologic conditions in SoC, a finding which may impact health outcomes of patients with SoC. This project is an important first step in diversifying curricular materials to provide comprehensive medical education.
在北美医学院校的课程中，皮肤颜色（SoC）的代表性不足已经有大量记录，这可能会成为公平和全面的本科医学教育的障碍。
本研究旨在检查皮肤科教育材料中的代表性，并认识到皮肤科教育中的偏见与学生的诊断能力和自我评估信心之间的联系。
检查了多伦多大学皮肤科本科医学教育课程中 SoC 的照片代表性百分比。对多伦多大学的一年级和三年级医学生进行了 10 道多项选择题的调查，以评估他们在 5 种常见皮肤病变（Fitzpatrick 皮肤类型 I-III [白皮肤]和 VI-VI [SoC]）的诊断准确性和自我评估诊断信心。
课程审核显示，所有皮肤疾病图像中，SoC 的比例不到 7%。在白皮肤和 SoC 中，一年级（分别为 77.8%和 85.9%）和三年级（分别为 71.3%和 72.4%）学生的诊断准确性都不错。与 SoC 相比，一年级（分别为 18.75/25 和 17.78/25）和三年级（分别为 17.75/25 和 15.79/25）学生对自己在白皮肤中诊断皮肤疾病的整体自我评估信心都明显更大（ =.0002）。
这项初步评估确定了在 SoC 中诊断皮肤科疾病的信心不足，这一发现可能会影响 SoC 患者的健康结果。该项目是使课程材料多样化以提供全面医学教育的重要第一步。
