ABSTRACT
Background: The current nursing shortage is expected to worsen in the coming years. While this shortage has in part been attributed to challenging working conditions, which were exacerbated during the COVID-19 pandemic, there are other factors. Although recruiting a more diverse health care workforce might help to reduce this shortage, little is known about how to do so effectively. This study explored how online images of health care workers vary by gender and skin tone and considered how those representations might impact recruitment.
Methods: This was a prospective pragmatic study. Using a popular image search engine, we obtained and evaluated images (photographs, drawings, and cartoons) of people representing different genders and a range of skin tones. The search terms used were student, nurse, and physician. The search took place during a single day and stopped once 50 images for each term had been retrieved. Images were included if they depicted at least one human. Each image was evaluated independently by two raters regarding gender (male or female) and skin tone (using a version of the 10-point Monk Skin Tone Scale).
Results: The final sample comprised 150 images that depicted 259 faces. Compared with the general population, nurses were overrepresented as being female (84.1%) and having lighter skin tones (85.2%). Physicians were overrepresented as being male (58.7%) and having lighter skin tones (63.5%). Compared with physicians or students, nurses were more likely to be represented as female and as having lighter skin tones.
Conclusions: The findings show a significant lack of diversity in gender and skin tone regarding how nurses are depicted in online images found via a popular image search engine. This lack of diversity may discourage people in some population groups from entering the health care field and could further contribute to the nursing shortage.