Cultural competency toolkit for derms
Compilation of training resources and educational materials now available, with plans for further growth (1,300 words, 6 minutes)
The Dermatology Industry Taskforce on Diversity, Inclusiveness & Equity (DiTiDE) has developed a Diversity & Inclusion Cultural Competency toolkit for dermatologists. The toolkit is designed to support best practices and to make recommendations to physicians working with people with diverse skin tones to help fill resource gaps.
DiTiDE is a volunteer committee of Canadian life sciences managers and executives, physicians, and allied parties.
“We feel that medical practitioners need to be aware of resources that exist and to improve their skills on being culturally competent,” said DiTiDE executive committee member Matthew Page, National Medical Relations Manager at L’Oréal Canada, in an interview with Skin Spectrum Weekly. He said that physicians having these resources and learning opportunities is especially important in Canada “with the culture being so diverse and with many new immigrants.”
“Everyone in healthcare needs to have the ability to understand where patients are coming from, what they might be experiencing, and how to help them.”
The Toolkit contains links to cultural competency training materials, resources such as checklists for working with immigrant children, and articles on the history and impact of bias in healthcare.
Developing the Toolkit was a collaborative effort between the members of the DiTiDE committee, supported by consultations with Canadian dermatologists involved in diversity, equity, and inclusion activities, said Page.
The dermatologists provided examples of where they access information on cultural matters and what resources they were aware of.
“From that, we came up with a fairly comprehensive list,” Page said. “There are always more articles to add and other interesting resources. We are looking to grow [the Toolkit] as well. As we start to promote it externally, we want to get feedback and refine it and update it as we go.”
While the Toolkit links physicians with valuable resources, Page said that DiTiDE hopes to produce and host more information on the Toolkit site itself.
“We'd be looking for anyone in the dermatology community or in the healthcare industry that has resources or information that we can publicize or include on the site,” he said.
“In the long term, we could have recorded webinars or talks as well.”
Bottom line: DiTiDE has developed a diversity and inclusion toolkit intended to be a one-stop shop for key resources that doctors, residents, and medical students can access to understand what they need to consider when providing care to patients, hiring staff, or working collaboratively in a diverse population.
From the literature on cultural competency in medicine
A roadmap for the development of a diverse and inclusive medical student dermatologic curriculum
The authors of this paper note there is an increasing need for diversification in dermatology. They write that there has been a need for more emphasis on diversity and inclusion in medical education, though there have been recent articles supporting diversity.
In this paper, they outline a “roadmap” for developing a diverse and inclusive medical student dermatology curriculum.
Perception of culturally competent care among a national sample of skin cancer patients
This study aimed to characterize the perception of culturally competent care among skin cancer patients in the United States. The authors used data from the 2017 National Health Interview Survey (NHIS) to identify a sample of patients with skin cancer.
The researchers analyzed responses to two following questions: “How important is it for providers to understand or share your culture?” and “How often are you able to see healthcare providers that understand or share your culture?”
Overall, 31% (95% confidence interval (CI) 27-35%) of skin cancer patients responded that it was very or somewhat important for providers to share or understand their culture. Patients with income below 200% of the federal poverty level (adjusted odds ratio (aOR) 1.52; 95% CI 1.02-2.25), foreign-born patients (aOR 3.33; 95% CI 1.25-8.88) and patients with no education past a high school diploma (aOR 1.50; 95% CI 1.08-2.09), all had increased odds of reporting that sharing or understanding culture was important.
Some 20% of patients had access to culturally competent care only some or none of the time.
An ethnographic investigation of medical students' cultural competence development in clinical placements
This U.K.-based ethnographic case study combined participant observation with interviews and a focus group to understand the views and experiences of students in developing their cultural competence during clinical placements.
The authors found that student development of cultural competence varied based on four learning avenues:
Immersion in a diverse healthcare environment contributed to student development of cultural awareness and knowledge;
Observation of culturally appropriate or inappropriate practices allowed students to enhance their practical skills and critical reflection;
Interaction with other clinical professionals, patients, and their family members enabled student engagement within the busy clinical practice; and
Reflection helped students to actively think about the impact of culture on health and internalize the importance of cultural competence.
The authors integrated their results and generated a theoretical model of the development of cultural competence by medical students in clinical placements.
Implicit racial bias, healthcare provider attitudes, and perceptions of health care quality among African American college students in Georgia, USA
This study examined biased racial attitudes of health care providers in Georgia, and students' perceptions of the quality of health care they receive from providers. The investigators also examined the effects of care and student recommendations for the way forward.
The cross-sectional study collected data from 63 African American students from the Georgia State University School of Public Health.
Students identified three main implicit racial attitudes: a medical provider brushing off patient concerns (29.9%), stereotyping (26.9%), and a lack of communication during medical care (25.4%).
Some students reported the quality of medical care they had received led them to be reluctant to use healthcare services (28.4%), distrust doctors of a different race than themselves (34.3%), not adhere to treatment (19.4%), or prefer to use home remedies (28.4%) when ill.
Students recommended cultural competency training, holding healthcare providers accountable for their actions, and increasing African American healthcare providers in Georgia as ways to address healthcare provider attitudes and quality of care.
VIDEO: 2022 HeLa Diversity, Equity and Inclusion Conference, New York Medical College
At the intersection of skin and society
In a recent episode of the Canadian Bar Association’s (CBA) Modern Law podcast, law professor Tuma Young, KC, discusses what the revitalization of Indigenous law in Canada means.
Young, a past CEO of the Eskasoni First Nation, is an Assistant Professor of Political Science & Indigenous Studies at Cape Breton University in Sydney, N.S. and Past President of the Nova Scotia Barristers' Society.
The episode is a conversation between Young and podcast host Yves Faguy, editor-in-chief of CBA National Magazine about court rulings and initiatives by bodies such as the Truth and Reconciliation Committee over the last 10 years that have changed the landscape of Indigenous law in Canada. Topics covered include what revitalizing Indigenous law means conceptually and how that can be at odds with some people's understanding of legal pluralism.
The two men also discuss how Indigenous and non-Indigenous legal orders in Canada can interact across vastly different conceptions of governance.
This week
Nov. 29 is National Day of Giving in Canada
Dec. 3 is International Day of Persons with Disabilities
The first week in December is National Handwashing Awareness Week in the U.S.
Something to think about in the week ahead…
Next week
The Dermatology Industry Taskforce on Diversity, Inclusiveness & Equity (DiTiDE) is developing an image library of dermatologic conditions that will focus on the diversity of skin tones across Canada.
This image library is being created as an educational resource database of photos collected through voluntary user submission.
DiTiDE is a volunteer committee of Canadian life sciences managers and executives, physicians, and allied parties.
The next edition of Skin Spectrum Weekly will include details about the image library, its development and planned features, and how interested dermatologists can contribute images to the database.
If you like Skin Spectrum Weekly, why not check out our other publications, podcasts, and portal?
Established in 1995, The Chronicle of Skin & Allergy is a scientific newspaper providing news and information on practical therapeutics and clinical progress in dermatologic medicine. The latest issue features:
Dr. Lyn Guenther (London, Ont.) discusses the benefit a fixed-dose combination calcipotriol/betamethasone dipropionate (Cal/BD) foam can have at alleviating psoriasis-related impairment of work productivity and activity
A review of recent literature on acne treatments, featuring interviews with Dr. Michelle Pratt (St. John’s, NL), Dr. Ben Barankin (Toronto), Dr. Maha Dutil (Toronto), and Dr. Yuka Asai (Kingston, Ont.)
Plus regular features, including the popular column “Vender on Psoriasis” by Hamilton, Ont. dermatologist Dr. Ron Vender
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The Women in Dermatology e-newsletter updates new findings concerning dermatologic issues that affect women and the female dermatologists who care for them. Read the current issue here.
Season two of the Shear Listening Pleasure podcast with Dr. Neil Shear has started. Listen to the first episode here, where Dr. Shear speaks with Dr. Kucy Pon about specializing in aesthetic dermatology, treating skin of colour, and the credibility of information about cosmetic procedures on social media.
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