# Bridging the Gap: A Pre- and Post-evaluation of an Online Skin of Colour Dermatology Lecture Series for Medical Students

## TL;DR

A student-led online lecture series improved medical students' confidence in diagnosing skin conditions in darker skin tones, narrowing the gap compared to fairer skin tones.

## Contribution

A student-led online lecture series effectively increased confidence in dermatology for skin of colour among medical students.

## Key findings

- Student confidence in diagnosing dermatological conditions in darker skin tones improved significantly after the lecture series.
- The gap in confidence between diagnosing in fairer and darker skin tones narrowed following the series.
- Almost all students supported including skin of colour teaching in the undergraduate curriculum.

## Abstract

Background

Medical students often report limited teaching on dermatology in skin of colour (SoC), which may contribute to lower confidence and risk of health inequalities.

Objective

The objective of this study is to evaluate a pilot student-led lecture series designed to bridge the gap in confidence between recognising dermatological conditions in fairer skin tones (Fitzpatrick I-III) and darker skin tones (Fitzpatrick IV-VI).

Methods

A nine-lecture online series was delivered to medical students. Students completed pre- and post-series surveys measuring self-reported confidence in diagnosing general dermatological (GenDerm) and SoC dermatological conditions on a five-point Likert scale. Changes in confidence scores were assessed with the Wilcoxon signed-rank test, and effect sizes were calculated. For dichotomised outcomes (high confidence ≥ quite confident), McNemar’s test with odds ratios (ORs) and 95% confidence intervals (CIs) was applied.

Results

A total of 44 students completed both surveys. Before the series, 88% (39/44) had not received formal SoC teaching; 30/44 (68.2%) felt more confident diagnosing in lighter vs darker skin. Most began the series with low confidence, particularly in SoC, where over half rated themselves 'not at all confident.' After the teaching, many moved into the somewhat confident or quite confident categories, and no students remained 'not at all confident.'

In GenDerm, confidence rose from a median of slightly confident to somewhat confident (Wilcoxon z = 4.13, p < 0.001, r = 0.69). In SoC, the improvement was greater, with the median shifting from not at all confident to somewhat confident (Wilcoxon z = 5.11, p < 0.001, r = 0.84). Both represent large effects, showing that the programme had a strong impact on student confidence. Although overall confidence rose sharply, fewer students crossed into the 'high confidence' category, reflecting the short duration of the programme. Support for including SoC teaching in the undergraduate curriculum was almost universal (>95%).

Conclusions

This pilot shows that a student-led lecture series was associated with improved student confidence in SoC. The aim was not to create experts in a short space of time, but to bring confidence with SoC more in line with confidence in GenDerm. By the end of the series, that gap had narrowed, suggesting that focused teaching can help to close the gap. Whilst these findings sit within Kirkpatrick levels 1 and 2 (reaction and self-reported learning), the series was associated with large improvements in student confidence. Larger, multi-centre studies using validated assessments are needed to see how this translates into diagnostic skills and patient care.