Mind the Gap: Essential Reading for Every Paramedic



A revolutionary new handbook called Mind the Gap which looks at how clinical signs and symptoms can differ on black and brown skin is now available to download for free on the College of Paramedics website.

The booklet was developed by Malone Mukwende, a second year medical student at St George’s, University of London, Margot Turner, Senior Lecturer in Diversity and Medical Education, and Dr Peter Tamony, Clinical Lecturer in Clinical Skills.

It came about after Malone recognised that the images being shown during his clinical skills sessions were not representative of people with darker skin tones. Working in partnership with Margot Turner and Dr Tamony, Malone wanted to devise a handbook which would educate medical and allied health professional students on the importance of understanding that certain clinical signs present differently on darker skin. As Malone explained: “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.”

A case in point would be when a call taker asks a caller if the patient’s skin is pale or if their lips are turning blue. On a patient with dark skin, neither of these descriptors would prove useful, and consequently their care could be compromised from the get-go. With the help of this handbook, many of those differences will now be highlighted, as will the need for change when it comes to the clinical language we currently use..

These are key areas of our learning where there is undoubtedly room for improvement and the College is working with all HEIs with paramedic programmes, supporting them in their commitment to ‘decolonise’ their curricula, to ensure that learning experiences include and reflect the diversity of ethnicity within the UK population, equipping student paramedics with the knowledge and skills to safely and effectively assess all patients, no matter their skin colour.
We are also working with a smaller group of paramedic lecturers and students to produce a whole system approach to increasing diversity across all stands within UK paramedic programmes that HEIs and their students can benefit from in the future. We hope to be able to tell you more on this in spring of 2021.

The College of Paramedics encourages all its members to download this handbook and use it in their practice, their learning and the education of others. Click here to download.

Read more about the background of the Mind the Gap project here.

Read more about how the Mind the Gap project is developing here.

Malone has set up a website to continue gathering pictures and information on the presentation of conditions in people with black and brown skin, as well as their stories of health care. Malone and his team are asking for submissions to increase their collection here