Editor’s Note: This article is based on “Using a reverse diversity audit approach to evaluate a dermatology collection in an academic health sciences library: A case presentation” published in the Journal of Academic Librarianship. 

Our study arose out of an interest to answer one question: How well does our collection represent the existing research on diversity in dermatology? Many areas of health sciences could do better in terms of representation, including dermatology, where patients are often underrepresented despite the differences in presentation that can occur across skin tones (Gupta et al., 2021; Marchetti et al., 2021; Thomley et al., 2021). As an academic health sciences library that supports evidence-informed education, we wanted to ensure that diversity is represented in the materials that we make available to our learners. This was the goal that led us to develop and complete a reverse diversity audit of our dermatology collection. 

We began by investigating different methods of assessing diversity in a collection. A standard diversity audit involves reviewing each item in a collection and assessing for diversity. While useful, this approach can be time-consuming and does not account for materials outside of the collection (Ciszek & Young, 2010; Emerson & Lehman, 2022). Instead, we decided to try a reverse diversity audit approach, which involves four steps: (1) selecting an area of focus, (2) creating a list of titles in the chosen subject area that support equity, diversity, and inclusion, (3) checking the existing collection for the titles on the curated list, and (4) purchasing any missing titles if applicable (Jensen, 2018). 

Following the decision to focus our audit on books and clinical materials in dermatology, we proceeded to step two. We used several approaches to ensure that we were identifying the full scope of available content. These methods included conducting a basic literature review, consulting with librarian and faculty member stakeholders, and performing a gray literature search focused on resource guides and webpages. We determined that our list was complete once we no longer found or received any new suggestions. 

Generating an authoritative list can potentially be a lengthy process, depending on the topic of focus and the amount of content published in the topic area. In our case, we identified a relatively narrow set of 55 titles, which confirmed that more work in diversifying the field of dermatology was needed. We then completed step three and found that our dermatology collection, which comprises over 1000 books and journals, already contained 43 of the 55 titles on the list. The final step was to fill the gap by purchasing the available materials. 

This approach has some limitations to be aware of. Firstly, a reverse diversity audit works best when investigating a focused subject area as opposed to an entire collection. We also want to acknowledge that the step of identifying the authoritative list of titles is subject to some individual bias in terms of what is considered scholarly, reputable, or appropriate for a collection. While we wanted to keep the list as comprehensive as possible, we removed two titles after reading reviews suggesting that the information was inaccurate or not at an appropriate level for a post-secondary context. We recognize that these decisions can be subject to individual interpretations. 

We also found several strengths in this approach. Conducting this project enabled us to become more familiar with our own collection and gain an understanding of the gaps that exist in the topic area. We believe that we were able to improve representation in our collection by identifying and purchasing to fill the gaps that we identified. We also found the approach to be achievable in a reasonable time frame (about six months from start to finish). 

There is always more work to be done to improve diversity in health sciences collections, and we hope to stay informed of developments in the topic area and continue to build our collection as more items become available. We encourage other libraries to experiment with this method and hope to repeat it for additional topic areas, such as Indigenous health. 

References  

Ciszek, M. P., & Young, C. L. (2010 Jan 1). Diversity collection assessment in large academic libraries. Collection Building, 29(4), 154–161. 

Emerson, M. E., & Lehman, L. G. (2022 May 1). Who are we missing? Conducting a diversity audit in a liberal arts college library. The Journal of Academic Librarianship, 48(3), Article 102517.  

Gupta, R., Ibraheim, M. K., Dao, H., Patel, A. B., & Koshelev, M. (2021 Sep 1). Assessing dermatology resident confidence in caring for patients with skin of color. Clinics in Dermatology, 39(5), 873–878. 

Jensen, K. (2018). Library journal’s equity in action: Doing a diversity audit [Internet] [cited 2022 Jul 14]. Available from: Teen Librarian Toolbox https://teenlibrariantoolbox. com/2018/10/24/library-journals-equity-in-action-doing-a-diversity-audit/. 

Marchetti, M. A., Adamson, A. S., & Halpern, A. C. (2021 Sep 1). Melanoma and racial health disparities in black individuals—Facts, fallacies, and fixes. JAMA Dermatology, 157(9), 1031–1032. 

Thomley, M. E., Roland, D. L., Noble, C. A., Sharma, M., Shipley, S. R., & Nahar, V. K. (2021 Apr). Skin cancer in skin of color: The importance of expanding education and prevention efforts to include this community. Journal of the Dermatology Nurses’ Association, 13(2), 106–109.