General surgery textbooks and surgical disparities

Area of Science:

• Medical Education
• Surgical Textbooks
• Health Disparities Research

Background:

• Academic textbooks have perpetuated simplistic or incorrect ideas about race.
• This can lead to disparities in care for minority patients in General Surgery.
• Current General Surgery textbooks may not adequately address racial disparities.

Purpose of the Study:

• To evaluate the depth of understanding of racial disparities in General Surgery textbooks.
• To identify how these textbooks discuss medical differences among racial and ethnic groups.

Main Methods:

• Analysis of 13 General Surgery textbooks from Doody's list.
• Extraction and classification of 511 passages on racial/ethnic medical differences.
• Assessment of passages for discussion of interventions, environmental factors, racism, and causal language.

Main Results:

• Only 2.9% of passages linked race causally to medical differences; two discussed racism.
• Most passages (72.3%) received a low score (0) on a heuristic scale for depth of understanding.
• The mean score was 0.24, showing no improvement over time.

Conclusions:

• General Surgery textbooks lack a scientifically thorough understanding of health disparities.
• Incorporating systemic causes and racism is crucial to prevent negative associations with minority patients.
• Future textbook editions should feature dedicated, comprehensive sections on health disparities.