Does clinical exposure to different skin tones during training improve diagnostic ability?

Area of Science:

• Medical Education
• Dermatology
• Health Equity

Background:

• Medical students show lower diagnostic accuracy for skin of colour (SOC) compared to white skin (WS).
• This diagnostic disparity may perpetuate existing racial inequities in healthcare.
• Understanding the reasons for this difference is critical.

Purpose of the Study:

• To investigate if clinical exposure to a predominant patient skin colour impacts diagnostic ability in both WS and SOC.
• To compare diagnostic performance between groups with different predominant patient demographics.

Main Methods:

• International medical graduates and students were divided into groups based on predominant patient skin colour exposure (white patients vs. non-white patients).
• Participants completed a dermatology quiz with 22 image-based vignettes (11 conditions, each in WS and SOC).
• Diagnostic ability in WS and SOC was compared between the two exposure groups.

Main Results:

• 411 participants were analyzed; 187 predominantly saw white patients (WP) and 224 predominantly saw non-white patients (NWP).
• Both groups performed significantly better diagnosing WS pathology than SOC pathology (p < 0.01).
• No significant difference in diagnostic ability for WS or SOC was found between the WP-exposed and NWP-exposed groups (p = 0.731).

Conclusions:

• Clinicians are less adept at diagnosing pathology in SOC, irrespective of their patient demographic exposure.
• Clinical exposure alone does not improve diagnostic ability in SOC.
• Medical education resources need greater diversity in skin tones to enhance familiarity with SOC pathology and reduce misdiagnosis risk.