Department of Dermatology, University of Utah School of Medicine, Salt Lake City.
Department of Dermatology, University of Virginia School of Medicine, Charlottesville.
JAMA Dermatol. 2022 Aug 1;158(8):928-932. doi: 10.1001/jamadermatol.2022.2104.
From its debut in 1935 until its discontinuation in 2009, Eastman Kodak Company's Kodachrome color reversal film was a cornerstone for dermatologic teaching innovations that transformed 20th century medical education. This Special Communication examines Kodachrome's contributions to the field of dermatology, as well as its lessons for improving inclusive representation of patients of all skin tones in 21st century dermatologic curricula.
Kodachrome's color quality, its slide transparency format, and its broad commercial availability democratized the creation, sharing, and teaching of visual information about skin disease in the 20th century. Kodachrome's usefulness as a complement to bedside teaching modernized medical school curricula, dermatologic conferences, and the American Board of Dermatology certifying examination, which inspired the Kodachrome-style of didactic that remains central to dermatologic training programs today. However, Kodachrome film was also the product of a prejudiced era when color film technology and photographic best practices were optimized for white skin. These biases are still evident in industry standards, photographic techniques, and the historically unjust representation of skin of color in educational resources.
Kodachrome film contributed substantially to shaping 20th-century medical education; however, its legacy is a reminder that diverse and inclusive image representation in dermatologic curricula is vital to counteracting implicit biases, correcting assumptions about disease epidemiology, and providing high-quality care for patients of all skin tones. Historical biases that have harmed representations of racial and ethnic minorities in dermatologic curricula are being addressed through improvements in digital photographic technologies, photographic best practices that serve a broader range of skin tones, inclusive skin color representation in contemporary educational resources, and skin-of-color specific curriculum for learners.
从 1935 年首次推出到 2009 年停产，伊士曼柯达公司的柯达克罗姆彩色反转片是皮肤科教学创新的基石，这些创新改变了 20 世纪的医学教育。本专题通讯探讨了柯达克罗姆对皮肤科的贡献，以及它为改善 21 世纪皮肤科课程中所有肤色患者的包容性代表性提供的经验教训。
柯达克罗姆的色彩质量、幻灯片透明格式及其广泛的商业可用性使 20 世纪有关皮肤疾病的视觉信息的创建、共享和教学民主化。柯达克罗姆作为床边教学的补充，使医学院课程、皮肤科会议和美国皮肤病学会认证考试现代化，这激发了柯达克罗姆式的教学法，至今仍是皮肤科培训项目的核心。然而，柯达克罗姆胶卷也是一个有偏见的时代的产物，当时彩色胶卷技术和摄影最佳实践是为白色皮肤优化的。这些偏见在行业标准、摄影技术以及历史上有色人种皮肤的不公正代表性在教育资源中仍然明显存在。
柯达克罗姆胶卷对塑造 20 世纪医学教育做出了重大贡献；然而，它的遗产提醒人们，在皮肤科课程中，多样化和包容性的图像代表对于消除隐性偏见、纠正关于疾病流行病学的假设以及为所有肤色的患者提供高质量的护理至关重要。在皮肤科课程中，历史上对少数族裔和族裔代表性的偏见通过改进数字摄影技术、为更广泛的肤色服务的摄影最佳实践、当代教育资源中包容性的肤色代表以及针对学习者的特定肤色课程得到了解决。
