Skip to main content

Advertisement

Log in

Beyond the surface: unveiling gaps in medical education through eyes of diverse learners

  • Short Report
  • Published:
Archives of Dermatological Research Aims and scope Submit manuscript

Abstract

Inadequate education regarding disease manifestations in diverse skin colors hinders diagnosis and exacerbates health disparities. All levels of medical trainees report low confidence in accurately identifying disease in skin of color (SOC). To help further elucidate these concerns, our research aims to assess medical student confidence in recognizing cutaneous diseases in SOC and their viewpoints regarding SOC education within their institution. An eight-question, open-ended survey was provided to medical students before and after a SOC presentation. The survey assessed participants’ confidence in their diagnostic ability and perspectives on educational material. Among the 70 attendees, 58 (82.8%) and 64 (91.4%) completed the pre- and post-seminar surveys, respectively. There was a significant discrepancy in confidence levels when assessing cutaneous manifestations of internal pathology in light (Monk Skin Colors 1–5) versus dark (Monk Skin Colors 6–10) skin (p < 0.009). Notably, 78.7% (37/47) perceived the institutional learning materials as insufficient for SOC. Post-seminar reflections indicated that 87.2% (40/46) of students lacked confidence in diagnosing SOC, with 78.7% (32/46) citing inadequate curriculum coverage as the cause. An additional 8.5% (6/46) identified the predominance of white-centric medical descriptions as a hindrance. Students collectively called for improved educational approaches, including better visual representation of diseases in darker skin. Medical education must continue to strive for increased SOC representation to train competent physicians in treating a diverse patient population and reduce disparities in SOC patients.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Data availability

No datasets were generated or analysed during the current study.

Abbreviations

SOC:

skin of color

MST:

Monk Skin Tone

MedEd:

Medical Education

References

  1. Adelekun A, Onyekaba G, Lipoff JB (2021) Skin color in dermatology textbooks: an updated evaluation and analysis. J Am Acad Dermatol 84(1):194–196. https://doi.org/10.1016/j.jaad.2020.04.084

    Article  PubMed  Google Scholar 

  2. Perlman KL, Williams NM, Egbeto IA, Gao DX, Siddiquee N, Park JH (2021) Skin of color lacks representation in medical student resources: a cross-sectional study. Int J Womens Dermatol 7(2):195–196 Published 2021 Jan 8. https://doi.org/10.1016/j.ijwd.2020.12.018

    Article  PubMed  PubMed Central  Google Scholar 

  3. Jones VA, Clark KA, Shobajo MT, Cordova A, Tsoukas MM (2021) Skin of color representation in medical education: an analysis of popular preparatory materials used for United States Medical Licensing examinations. J Am Acad Dermatol 85(3):773–775. https://doi.org/10.1016/j.jaad.2020.07.112

    Article  PubMed  Google Scholar 

  4. Gupta R, Ibraheim MK, Dao H Jr, Patel AB, Koshelev M (2021) Assessing dermatology resident confidence in caring for patients with skin of color. Clin Dermatol 39(5):873–878. https://doi.org/10.1016/j.clindermatol.2021.08.019

    Article  PubMed  Google Scholar 

  5. Shango KH, Abdole FA, Gonzalez SM, Farshchian M, Moossavi M (2022) Medical Student confidence in diagnosis of dermatologic diseases in skin of Color. Clin Cosmet Investig Dermatol 15:745–750 Published 2022 Apr 23. https://doi.org/10.2147/CCID.S357743

    Article  PubMed  PubMed Central  Google Scholar 

  6. Krueger L, Hijab E, Latkowski JA, Elbuluk N (2023) Clinical decision-making bias in darker skin types: a prospective survey study identifying diagnostic bias in decision to biopsy. Int J Dermatol 62(4):e252–e253. https://doi.org/10.1111/ijd.16213

    Article  PubMed  Google Scholar 

  7. Yousuf Y, Yu JC (2021) Improving representation of skin of Color in a Medical School Preclerkship Dermatology Curriculum. Med Sci Educ 32(1):27–30 Published 2021 Nov 30. https://doi.org/10.1007/s40670-021-01473-x

    Article  PubMed  PubMed Central  Google Scholar 

  8. National Population Projections 2014–2060 Request [Internet]. wonder.cdc.gov. http://wonder.cdc.gov/population-projections-2014-2060.html

  9. Gloster HM Jr, Neal K (2006) Skin cancer in skin of color. J Am Acad Dermatol 55(5):741–764. https://doi.org/10.1016/j.jaad.2005.08.063

    Article  PubMed  Google Scholar 

  10. Monk E (2019) Monk skin tone Scale. Google htps:/skintone.google

  11. United States Census Bureau. U.S. Census Bureau QuickFacts: United States. United States Census Bureau (2021) https://www.census.gov/quickfacts/fact/table/US/PST045221

  12. CDC. Racism and Health. Centers for Disease Control and Prevention. Centers for Disease Control and Prevention (2021) https://www.cdc.gov/minorityhealth/racism-disparities/index.html

  13. Pandya AG, Alexis AF, Berger TG, Wintroub BU (2016) Increasing racial and ethnic diversity in dermatology: a call to action. J Am Acad Dermatol 74(3):584–587. https://doi.org/10.1016/j.jaad.2015.10.044

    Article  PubMed  Google Scholar 

  14. Saha S, Guiton G, Wimmers PF, Wilkerson L (2008) Student body racial and ethnic composition and diversity-related outcomes in US medical schools. JAMA 300(10):1135–1145. https://doi.org/10.1001/jama.300.10.113

    Article  CAS  PubMed  Google Scholar 

Download references

Funding

Not applicable.

Author information

Authors and Affiliations

Authors

Contributions

Conceptualization Idea - A.A.; Study Design: A.A., Z.S., A.J.; Data Curation - A.A., Z.S., C.G.; Visualization/Figures - Z.S., M.V., C.G., A.A.; Writing of Initial Draft - A.A., Z.S., C.G.; Review & Editing - All authors participated in this step.

Corresponding author

Correspondence to Alexis Arza.

Ethics declarations

Ethical approval

Determined Exempt; Study ID: 2210009475.

Patient consent

Not applicable.

Competing interests

The authors declare no competing interests.

Additional information

Publisher’s Note

Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Electronic supplementary material

Below is the link to the electronic supplementary material.

Supplementary Material 1

Supplementary Material 2

Supplementary Material 3

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Arza, A., Sejdiu, Z., Viveiros, M. et al. Beyond the surface: unveiling gaps in medical education through eyes of diverse learners. Arch Dermatol Res 316, 187 (2024). https://doi.org/10.1007/s00403-024-02963-9

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • DOI: https://doi.org/10.1007/s00403-024-02963-9

Keywords

Navigation