Through a Different Lens: Assessing Patient and Clinician Diversity in Medical Education Clinical Practice Media

Background: As demands grow for inclusivity and representation in the workplace, schools, and various other settings, an increased focus has been placed on the lack of diversity in health multimedia. Specifically, textbooks utilized in medical school curriculum often lack photos that depict diverse skin tones, body shapes, sexes, and genders. However, past studies did not analyze the most recent clinical textbooks or emerging clinical video databases. This research focuses on examining patient and clinician clinical diversity in two clinical education resources: Bates’ Guide to Physical Examination and History Taking 13th edition (2021 e-text) and Bates’ Visual Guide to Physical Examination (video series). Methods: We developed a coding scheme for photos and videos based on previous literature that analyzes age, gender, sex, health state, skin tone, hair texture, body composition, SES, and the presence of tattoos and/or piercings. The coding scheme underwent 2 rounds of testing and subsequent modifications with a smaller sample. The final validated scheme was used to assess 576 photos and videos. Results: Of the photos and videos, only 18% exhibited individuals with curly or wavy hair, 1% included individuals with a darker skin tone, and 0.3% of individuals had a larger body type. There were no intersex or nonbinary individuals included. None of the individuals had tattoos, and all the piercings displayed were earlobe piercings, with all but 1 of the individuals being female. Conclusions/Implications: These findings reflect conclusions from previous studies, demonstrating that diversity and representation in medical textbooks can still be improved. Although there was some diversity in the photos and videos, several of the same models were used throughout the sources, which limits the application of such images to a range of diverse individuals. By advancing the diversity of medical school curriculum materials, students can provide more competent and compassionate care.