Our goal was to have SOC featured in a minimum of 35% of photographs, mirroring the patient population served in metro Atlanta. Only 3/16 lectures reviewed met this goal. Lectures that fell below the 35% target were flagged and sent to lecturers for diversification. Resources were made available to lecturers (Figure 1). These goals were shared with medical students in our course learning objectives.
The third step is to integrate cultural humility as well as diseases that disproportionately affect SOC populations into the curriculum. To accomplish this, we encouraged lecturers to incorporate concepts such as disease incidence across populations, variability in disease presentation across skin types, and bias in diagnosis/treatment. To reflect the top reasons SOC patients seek dermatologic care, we added vitiligo, melasma, acne, and alopecia to our curriculum, highlighting the intersection of culture and disease when appropriate.3,4
We recommend collecting feedback as the fourth step. An optional, anonymous pre- and post-lecture survey was administered to medical students following the lecture on cultural humility and diseases that disproportionately affect SOC populations. 88/107 and 49/107 students completed the pre and post-test, respectively. Medical students agreed that the course incorporated themes of diversity, inclusion, and cultural competency (P<0.001). Following the lecture, students were more likely to view dermatology as a specialty that emphasized the importance of cultural competency (P<0.001) and to recognize the role of culture in dermatologic conditions (P=0.0022). Furthermore, medical students’ interest in dermatology as a career increased following the lecture (P=0.048). Additional end-of-course feedback was solicited and overall, students reported a preference for learning about variation of disease prevalence/presentations across populations and diseases disproportionately affecting SOC.
