Teaching in Monochrome: Skin Tone Bias in Medical Training Resources- A Scoping Review

Background: Medical training resources demonstrate substantial under-representation of darker skin tones across textbooks, curricula, and educational materials globally. This representational gap may contribute to reduced diagnostic confidence among healthcare providers when assessing patients with diverse skin tones.

Objective: To evaluate the adequacy of skin diversity representation in medical training resources and assess its relationship to healthcare provider diagnostic confidence across different skin tones.

Methods: A review of studies examining skin diversity representation in medical education and provider confidence in diagnosing conditions across varied skin tones. Studies will be identified through comprehensive database searches, including PubMed and Cochrane, and screened for relevance to medical training and skin diversity.

Results: While results are currently pending, we believe consistent under-representation of darker skin tones will be identified across general medical textbooks, dermatology curricula, and institutional teaching materials. The diversity of training resources is the strongest modifiable predictor of diagnostic confidence, with providers using diverse materials reporting substantially higher confidence levels. Geographic location and clinical experience also influenced confidence levels.

Conclusions: We believe current medical training resources inadequately represent skin diversity, contributing to diagnostic confidence gaps that may impact patient care quality. Increasing diversity in educational materials and clinical exposure represents a promising target for intervention, though rigorous evaluation of specific interventions remains limited.