Mind the Gap: a handbook of clinical signs on black and brown skin

Published: 18 June 2020

Second year medic, Malone Mukwende, has been working with Senior Lecturer in Diversity and Medical Education, Margot Turner, and Clinical Lecturer in Clinical Skills, Peter Tamony, as part of a student-staff partnership project looking at clinical teaching on black and brown skins. Malone highlighted that, as a black student, he felt alienated with the way clinical skills is currently being taught due to the lack of discussion around clinical signs on darker skin.

It was agreed that this was a very important issue and an essential part of decolonizing the curriculum. The trio have designed a booklet, which will be available shortly, to raise awareness of how symptoms and signs can present differently on darker skin as well as highlighting the different language that needs to be used in descriptors.

Malone explains, “The aim of this booklet is to educate students and essential allied health care professionals on the importance of recognising that certain clinical signs do not present the same on darker skin. This is something which is not commonly practiced in medical textbooks as there is a ‘white skin bias’. It is important that we as future healthcare professionals are aware of these differences so that we don’t compromise our care for certain groups.

“The booklet addresses many issues that have been further exacerbated during the Covid-19 pandemic, such as families being asked if potential Covid patients are ‘pale’ or if their lips ‘turned blue’. These are not useful descriptors for a black patient and, as a result, their care is compromised from the first point of contact. It is essential we begin to educate others so they are aware of such differences and the power of the clinical language we currently use. We will be hosting a training session for clinical skills peer tutors which will take place in July 2020.

“Multiple conversations are now taking place around what can be done to tackle health disparities in the UK and we would love for St George’s to be a part of that growing conversation. Recently there was a petition calling for teaching clinical skills on black and brown skins that now has over 125,000 signatures. The petition, Covid-19 pandemic and the Black Lives Matter movement all illustrate there is an urgent need for change.”

Mind the Gap is not currently published and so is not available to distribute however discussions with potential publishers are ongoing.