Exploring Skin Tone Diversity in a Plastic Surgery Resident Education Curriculum.

Area of Science:

• Medical Education
• Plastic Surgery
• Health Equity

Background:

• Surgical education curricula often lack diverse skin tone representation in visual materials.
• This disparity can hinder equitable patient care and potentially lead to misdiagnosis.
• Ensuring representative imagery is crucial for plastic surgery residents' future practice.

Purpose of the Study:

• To assess the representation of skin tone diversity in Canadian plastic surgery resident educational materials.
• To compare the proportion of images across different Fitzpatrick skin types.
• To explore faculty and resident perceptions of diversity in educational photographs.

Main Methods:

• Analysis of 1990 images from 96 hours of plastic surgery resident lectures (May 2020-Dec 2021).
• Classification of images using the Fitzpatrick skin typing system.
• Anonymized online survey of faculty and residents regarding photographic diversity.

Main Results:

• Images predominantly featured lighter skin tones: 83.2% Fitzpatrick I-III, 13.1% IV-V, and 3.7% VI.
• A statistically significant underrepresentation of Fitzpatrick types IV-V and VI was observed (P < .01).
• While most faculty felt diversity was adequate, 46% of residents desired more diverse imagery.

Conclusions:

• Plastic surgery educational images significantly underrepresent medium and dark skin tones (Fitzpatrick IV-VI).
• Diverse visual representation is essential for developing competent and equitable surgical care.
• Prioritizing skin tone diversity in plastic surgery curricula is necessary for all programs.