Danny Clegg, is an Associate Professor of Digital Pedagogy and Inclusive Practice, in the Institute of Health & Social Care (HSC), London South Bank University (LSBU). This blog presents a summary of the author’s experiences during creation of the “Diverse Dermatology” Learning Programme, ranging from challenges and opportunities during the project planning stages, developing broader awareness of racism in historical and current healthcare curricula, and delivering an “Antiracist Healthcare” learning programme that was appraised, highly commended, and subsequently integrated into curriculum by a panel of antiracist curriculum reviewers.
They said… “Hey Danny, I heard your healthcare ‘spot diagnosis’ teaching content and CPD focuses on inclusion of diverse skin types? We are looking for someone who could advise on teaching human skin biology through an antiracist lens. Any chance you would be interested in writing an outline of what you do, for our antiracist curriculum project?”
I heard… “Hey Danny, do you fancy building an innovative learning resource, upskilling in 7 new creative software packages, becoming a graphic designer, creating antiracist methods to produce animations and audio, coming close to starting a fight with a world-leading software provider, and generally tumbling down a rabbit hole that may never end?”
After a decade of teaching spot diagnosis and triage for service users, centring human skin as “the window to pathology”, and striving to ensure I sourced diverse images (often with “risky” copyright practices), being given an opportunity to consolidate my work into something publishable was exciting!
With my decolonising lens fully focused, I began by attempting to deconstruct the issues of racism in skin health curriculum, research, and in practice. The aim was to produce a learning programme that also challenges the existing deficit models still prevalent in curricula and public information.
At every stage of developing the content I started with excitement, gradually started to feel battered, (almost) beaten, and reduced to tears for more reasons and on more occasions than I care to admit! What started out as enthusiasm to produce an innovative learning programme rapidly developed into an unending (and almost always unsuccessful) series of pleas to the owners of crucially relevant images, and in a moment of desperation, asking an AI to create an anatomically accurate image of the first homo sapiens: “Please produce an image of the first Homo Sapiens, ensuring you integrate the evidence-based depiction of their highly pigmented skin”
I must have rephrased that instruction no fewer than 20 times, and this was perhaps the moment I realised that there isn’t just a history of racism, but the rapid evolution of AI-technology is not just replicating racism in healthcare, but it has a strong and palpable risk of perpetuating end exacerbating it. The images produced by the software AI were horrifying. Not just because of their inaccuracies, not even because the AI repeatedly ignored the “highly pigmented” skin element, but most horrifying of all was being presented with several images that strongly resembled the pre-1988 company motif of an infamous ‘jam & preserve’ company…
Next came the anatomical models, and whilst it was fantastic to see how the hair and cosmetics industry have produced images and videos to depict diverse human hair types, along with the relative hair follicle morphology and associated skin types, another challenge arose when none of these images existed in tandem with the general skin anatomy models used in skin health curriculum. The only “diverse” anatomical models depicting highly pigmented skin, still contained all the elements of the “Caucasian” skin anatomy models that form the basis of skin health anatomy in curriculum. In fact, most of the images containing “boasts” about diversity within their subtext, looked suspiciously like the “Caucasian” image counterparts, with no more than a quick “shade” of the dermis layer having been performed to “create diversity”!
Thus the “Diverse Dermatology” skin anatomy model was created, and all subsequent learning content driven by the ethos of “we need to fix this at every level of healthcare curriculum, research, and practice”.
What was initially intended to be a 1-lesson programme in skin biology, evolved into a programme of learning that has been integrated into key stage 3 curriculum in Wales, is being accessed by level 3-7 students on healthcare programmes at LSBU, and is even being accessed by some academics on healthcare programmes. The personal experiences and reframing of many of my own perspectives throughout the project, have had a resounding impact on me as a healthcare educator, learning programme and content developer, and as a human.
Follow this link to the Diverse Dermatology content (so far!)
© DVC Productions. (Artist: Danny Clegg)