Clinical photography processes (ClinPhoto) study for photo diversity.

Although clinical photography serves an important role in the education of clinicians, there is still a disparity of darker skin tones in the photographs used for medical education. This disparity results in a skill deficit for clinicians because the differences in skin pigmentation change the appearance of visible diseases so that it is essential for students and trainees to have examples of clinical photographs on varying skin tones. To effectively address the problem, we need to understand the complex sociotechnical processes involved in clinical photography, which is more than simply the act of taking a photograph. Therefore, we conducted semi-structured interviews on clinical photography with 10 clinicians, 1 medical photographer, and 1 clinical administrator at a tertiary academic medical centre. The interviews revealed 5 deductive themes based on the questions and 19 inductive codes within those themes on how clinical photography is conducted. Analysis of the themes through a lens of critical theory showed how simple awareness of the disparity has not led to interventions for the poor representation of varying skin tones in photographs for medical education and also suggests initial next steps.

Visualizing diversity: the Oregon Health & Science University Educational Use Photo Diversity Repository.

BACKGROUND: Health science education needs images that represent both the diversity of patients served and the diversity of its students and clinicians. To begin to address this need, a nurse educator and librarian collaborated to launch the Oregon Health & Science University (OHSU) Educational Use Photo Diversity Repository. This online resource provides educators of health professional students with access to photos of pathophysiological conditions in skin of various colors so their students can increase their awareness of issues related to health and diversity and prepare themselves for more effective clinical work with their future patients. CASE PRESENTATION: The OHSU Educational Use Photo Diversity Repository became a university-wide project, leveraging the thoughts of an image advisory board, clinicians, faculty members, administrators, and students. Key considerations were given to the workflows used to submit photos as well as the controlled vocabulary for submitting images. The repository was started with photos already in existence, with future plans to have images taken specifically for the repository. CONCLUSIONS: This repository is playing an important role as OHSU and the health sciences in general reflect on the role of systemic racism in health care and clinical education. Negotiating issues of consent, patient health information, and privacy around using different technologies to take photos is a complex and ongoing process. The repository provides opportunities for closely examining these processes and creating improvements that result in more equitable education.

Depression coping self-efficacy as a predictor of relapse 1 and 2 years following psychiatric hospital-based treatment.

This longitudinal study involved 1 - and 2-year follow-up assessments of participants who received inpatient (n = 25) or partial hospital program (PHP) (n = 24) treatment for depression. The purposes of this study were to (a) compare 2-year follow-up depressive symptom and depression coping self-efficacy scores with posttreatment scores, (b) examine depression coping self-efficacy scores as a predictor of health care visit frequencies following treatment, and (c) examine differences in 2-year depressive symptom and depression coping self-efficacy scores between original treatment groups. Participant (n = 49) health records were reviewed for frequencies and types of health care visits at 1-year posttreatment. Twenty-six (52% response rate) participants completed the Depression Coping Self-Efficacy Scale, Center for Epidemiologic Studies Depression Scale, and Two-Year Follow-Up Questionnaire at 2-years posttreatment. One-year findings indicated posttreatment depression coping self-efficacy scores were associated with frequencies of psychiatric episodes of care. Relapse rates (> 25%) were consistent with previous reports. Despite maintenance of improvements in depressive symptom and depression coping self-efficacy scores, depressive symptom scores remained above cutoff levels at 2 years posttreatment. Two-year findings did not differ based on original treatment type. Findings support further research examining the DCSES as a predictor of relapse and a target for treatment.