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Training Medical Students/Medical Practitioners to Diagnose Dermatologic Conditions in Skin of Color: A Systematic
Andy D Lee1, Amrit Thandi1, Jinny Choi1
1Temerty Faculty of Medicine, University of Toronto, Toronto, ON, Canada.
Abstract:
Despite increasing recognition of the importance of skin-of-color (SOC) representation in dermatology education, significant gaps persist in training medical students to diagnose dermatologic conditions across diverse skin tones. This systematic review analyzed educational interventions aimed at improving SOC diagnostic competency among medical trainees. A comprehensive search of MEDLINE, Embase, APA PsycInfo, and Scopus identified 8 studies comprising 667 participants, revealing categories: didactic teaching (33.1%), seminar-style expert-led teaching (32.4%), workshop-based learning (25.8%), and simulation-based learning (8.7%). Preintervention assessments consistently showed significantly lower confidence in diagnosing conditions in darker skin tones, with 64% to 69% of students reporting no SOC training at undergraduate level. All interventions produced statistically significant improvements in self-assessed knowledge and confidence, though 87.2% of students still lacked confidence postintervention. The most promising approach was Hardin's two-week combined training protocol, which mitigated initial diagnostic bias between light and dark skin diagnoses (P = .007). Critical limitations include predominantly single-session interventions, reliance on self-reported confidence measures, absence of long-term retention data, and persistent condition-specific diagnostic challenges, particularly for melanoma in darker skin. Addressing these educational gaps represents both an imperative for medical education reform and a crucial step toward achieving health equity in dermatologic care.
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