Abstract
Background: There are concerns that teaching skin assessment is focused on people with light skin tones yet skin tones cause variances in the presentation of visual skin changes[1]. This study aims to explore real-world experiences of teaching skin assessment and considers the barriers and facilitators to including skin tone diversity in teaching nurses and student nurses.
Methods: An online survey was carried out in February 2023. Questions were based on the Theoretical Domains Framework of behavioural change[2] to determine areas to be modified or enhanced as part of a stepped approach to changing clinical behaviour. Invitations to participate were shared on social media and via email to universities teaching nursing. Ethical Clearance Reference: MRA-22/23-35171
Results: 61 registered nurses completed the survey (62.3% from university: 37.7% from practice). Most respondents included skin tone diversity in their teaching (63.9%) and had one of the two lightest skin tones (77.0%). Only 42.6% felt confident that skin tone diversity would be taught by other members of staff.
Participants completing the survey often recognised the importance of teaching skin assessment across diverse skin tones to prevent miss- or delayed diagnosis (32.8%) and prevent poor care or poor patient outcomes (57.4%). However, the proportion of participants certain of how to assess skin in people with dark skin tones was lower than assessing people with light skin tones for all skin conditions. Among those who remained certain of steps to include, confidence reduced when assessing people with dark skin tones.
In classroom-based teaching and simulation, 50% of participants included patients with dark skin tones “always” or “often” however, the availability of good quality photographs for classroom-based teaching may be preventing further inclusion. In direct patient care situations, the skin tone characteristics of patients needing an assessment determined what was taught.
Conclusion: Findings indicate there is some awareness of the importance of including diverse skin tones in teaching, but further education and resources are needed (For example, good quality photographs, and evidence-based guidance on clinical presentations for non-specialists). There may be a need to actively include patients with dark skin tones in areas with predominately light skin tones.
References:
Wounds UK (2021) Best Practice Statement: Addressing skin tone bias in wound care: assessing signs and symptoms in people with dark skin tones. Wounds UK, London. Available to download from: https://link.edgepilot.com/s/91dba6af/EMfXUtZEQ0_cwnW4jWZC5w?u=http://www.wounds-uk.com/
Atkins, L., Francis, J., Islam, R. et al. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Sci 12, 77 (2017). https://link.edgepilot.com/s/0ef60ff1/anJ2GYRTeEq4sYz-lrXUZw?u=https://doi.org/10.1186/s13012-017-0605-9
Methods: An online survey was carried out in February 2023. Questions were based on the Theoretical Domains Framework of behavioural change[2] to determine areas to be modified or enhanced as part of a stepped approach to changing clinical behaviour. Invitations to participate were shared on social media and via email to universities teaching nursing. Ethical Clearance Reference: MRA-22/23-35171
Results: 61 registered nurses completed the survey (62.3% from university: 37.7% from practice). Most respondents included skin tone diversity in their teaching (63.9%) and had one of the two lightest skin tones (77.0%). Only 42.6% felt confident that skin tone diversity would be taught by other members of staff.
Participants completing the survey often recognised the importance of teaching skin assessment across diverse skin tones to prevent miss- or delayed diagnosis (32.8%) and prevent poor care or poor patient outcomes (57.4%). However, the proportion of participants certain of how to assess skin in people with dark skin tones was lower than assessing people with light skin tones for all skin conditions. Among those who remained certain of steps to include, confidence reduced when assessing people with dark skin tones.
In classroom-based teaching and simulation, 50% of participants included patients with dark skin tones “always” or “often” however, the availability of good quality photographs for classroom-based teaching may be preventing further inclusion. In direct patient care situations, the skin tone characteristics of patients needing an assessment determined what was taught.
Conclusion: Findings indicate there is some awareness of the importance of including diverse skin tones in teaching, but further education and resources are needed (For example, good quality photographs, and evidence-based guidance on clinical presentations for non-specialists). There may be a need to actively include patients with dark skin tones in areas with predominately light skin tones.
References:
Wounds UK (2021) Best Practice Statement: Addressing skin tone bias in wound care: assessing signs and symptoms in people with dark skin tones. Wounds UK, London. Available to download from: https://link.edgepilot.com/s/91dba6af/EMfXUtZEQ0_cwnW4jWZC5w?u=http://www.wounds-uk.com/
Atkins, L., Francis, J., Islam, R. et al. A guide to using the Theoretical Domains Framework of behaviour change to investigate implementation problems. Implementation Sci 12, 77 (2017). https://link.edgepilot.com/s/0ef60ff1/anJ2GYRTeEq4sYz-lrXUZw?u=https://doi.org/10.1186/s13012-017-0605-9
| Original language | English |
|---|---|
| Title of host publication | 2023 conference programme |
| Publication status | Published - 26 Apr 2023 |
| Event | Society of tissue viability annual conference : Solving skin & wound challenges together - Peterbrough, United Kingdom Duration: 26 Apr 2023 → 27 Apr 2023 https://societyoftissueviability.org/our-annual-conference/2023-conference-programme/ |
Conference
| Conference | Society of tissue viability annual conference |
|---|---|
| Country/Territory | United Kingdom |
| Period | 26/04/2023 → 27/04/2023 |
| Internet address |