University of Pittsburgh School of Medicine, Pittsburgh, PA.
Department of Medicine, University of Pittsburgh, Pittsburgh, PA.
Fam Med. 2023 Jun;55(6):375-380. doi: 10.22454/FamMed.2023.766642. Epub 2023 Mar 13.
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.
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.
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).
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.
视觉学习公平是一项健康公正努力，旨在应对医学教育中缺乏棕色和黑色皮肤图像的代表性。这种缺乏代表性会造成知识差距，并降低提供者在少数族裔人群中管理皮肤疾病的能力。在此，我们旨在创建一个标准化的课程审核系统，以评估医学教育中棕色和黑色皮肤图像的使用情况。
我们对一所美国医学院 2020-2021 年的临床前课程进行了横断面分析。对学习材料中的所有人类图像进行了分析。使用 Massey-Martin 新移民调查肤色量表将肤色分为浅色/白色、中等/棕色和深色/黑色。
我们的分析包括 1660 张独特的图像；71.3%（n=1183）为浅色/白色，16.1%（n=267）为中等/棕色，12.7%（n=210）为深色/黑色。皮肤、毛发、指甲或黏膜疾病的皮肤科图像占图像的 62.1%（n=1031），其中 68.1%（n=702）为浅色/白色。肺部课程呈现出最高比例的浅色/白色皮肤（88.0%，n=44/50），而皮肤科课程呈现出最低比例的浅色/白色皮肤（59.0%，n=301/510）。传染病的图像更常出现在较深的肤色中（χ2[2]=15.46，P<.001）。
浅色/白色皮肤是该机构医学院课程中视觉学习图像的标准。作者概述了执行课程审核和使医学课程多样化的步骤，以确保下一代医生接受教育，为所有患者提供护理。
