Skin of Colour Education Initiatives Among Dermatology Residents: A Narrative Review

Abstract

Background:

Achieving comprehensive education in skin of colour (SoC) dermatology presents a multifaceted challenge for dermatology trainees. Exposure to diverse skin tones in didactic curricula and clinical encounters varies greatly based on geographic location and institution and, as a whole, remains disparate. While SoC education initiatives for medical students and residents have increased in recent years, the characteristics and outcomes of initiatives specifically tailored to dermatology residents have not been summarized.

Objectives:

(1) Outline the demographic features of participants; (2) summarize intervention characteristics and the metrics by which educational impact was defined.

Methods:

MEDLINE, Embase, and PubMed were searched for SoC education interventions aimed at dermatology trainees.

Results:

Five studies were selected for inclusion. Two hundred thirty-seven dermatology residents participated from institutions across the United States, United Kingdom, Australia, and Botswana. Most interventions were didactics based, assessed changes in subjective confidence, and employed identical pre- and posttest questions. Confidence increased for didactic-only interventions, decreased with multimodal interventions, and was incongruent with objective knowledge or diagnostic scores. Single-format interventions or assessments with identical pre- and posttest questions may provide an inflated sense of confidence through recall bias or other heuristics. Conversely, the cognitive synthesis afforded by multimodal interventions or new (but equivalent) assessment questions may lead to low confidence ratings despite improved knowledge scores.

Conclusions:

When designing SoC learning initiatives in postgraduate dermatology education, multimodal formats, and paired objective and subjective assessments that employ both identical and different pre- and post-intervention questions may give a more relevant and accurate reflection of impact in clinical practice settings.