Does Skin Color Influence Differential Diagnosis Generation in a Simulated Cardiac Arrest?

Area of Science:

• Medical Education
• Emergency Medicine
• Health Equity

Background:

• Skin color bias in medical diagnosis is a growing concern.
• The impact of patient race on diagnostic reasoning is not fully understood.
• Substance use is an underdiagnosed cause of cardiac arrest.

Purpose of the Study:

• To investigate if the skin color of a simulated cardiac arrest patient influences medical students' inclusion of substance use in their differential diagnoses.
• To assess potential racial bias in diagnostic reasoning among emergency medicine students.

Main Methods:

• Fourth-year medical students participated in a manikin-based cardiac arrest simulation.
• Manikins of light and dark skin tones were used alternately.
• Differential diagnoses, including the consideration of substance use, were documented and analyzed in relation to manikin skin color.

Main Results:

• No statistically significant difference was found in the inclusion of substance use on the differential diagnosis based on manikin skin color (P = 1.00).
• Only 20% of students considered substance use as a potential cause of cardiac arrest, regardless of the manikin's skin tone.
• A very low percentage of students listed substance use as the leading diagnosis.

Conclusions:

• Manikin skin color did not correlate with medical students' consideration of substance use in simulated cardiac arrest cases.
• The overall low inclusion of substance use suggests a need for enhanced medical education on this topic.
• Further research is needed to address potential biases in medical students' diagnostic reasoning.