Does Skin Color Influence Differential Diagnosis Generation in a Simulated Cardiac Arrest?

Homer’s epic opens with a plague sent by Apollo, not only decimating the Greek army but igniting a bitter conflict between its leaders. In a similar vein, the COVID-19 Pandemic not only posed an unprecedented threat to global health but also exposed deep divisions in public opinion. Among the most visible signs of this division was the emergence of strong anti-vaccine sentiment, often underpinned by conspiracy theories that question the safety, efficacy, or necessity of vaccination itself. Although conspiracy beliefs are associated with broader political and ideological orientations, increasing attention has also been directed toward the role of media-related informational environments, including selective exposure and media scepticism. They are frequently associated with populist attitudes characterised by distrust toward political elites, scientific institutions, and mainstream media. Research has shown that individuals with such orientations are more likely to endorse conspiratorial narratives as alternative explanations that align with their anti-establishment perspectives. Although these studies point to multiple psychological and ideological foundations of conspiracy beliefs, the present study focuses specifically on the role of media-related informational environments, particularly media scepticism and patterns of media exposure, in shaping vaccine-related conspiracy beliefs. Within this broader literature, research on digital media environments has highlighted the importance of informational exposure processes in the spread and persistence of conspiracy beliefs. The digital media environment also plays a crucial role in shaping the spread and entrenchment of conspiracy beliefs. Social media platforms often facilitate selective exposure to ideologically congruent content through algorithmic curation and personalization. This process reinforces preexisting beliefs and insulates users from countervailing information. Scholars refer to this phenomenon as the “echo chamber effect”. Moreover, the amplification of fringe content by recommendation algorithms and the influence of automated bot accounts can further distort perceptions of consensus and credibility online. These structural features of digital platforms do not merely transmit misinformation but actively shape the information ecosystem in which conspiracy theories thrive. Therefore, to better understand the persistence and diffusion of vaccine-related conspiracy beliefs, researchers should examine differences in media-related informational environments, including patterns of mass and social media exposure. Much existing research on conspiracy beliefs has focused on highly polarised Western media environments, particularly the United States, where partisan media ecosystems and ideological fragmentation are especially pronounced. By contrast, the Japanese media environment has traditionally been characterised by comparatively strong normative expectations of political neutrality in news reporting. Previous research has also demonstrated substantial audience overlap among major Japanese media outlets and relatively limited ideology-based fragmentation in online news consumption. Although some recent studies have suggested increasing political polarisation in specific domains, Japan nevertheless remains less characterised by highly segmented partisan media environments than many Western democracies. Despite this comparatively consensus-oriented media environment, conspiracy beliefs concerning COVID-19 still emerged and circulated during the pandemic. Examining conspiracy beliefs in Japan, therefore, provides an opportunity to investigate how conspiratorial thinking develops even in a media environment where overt partisan division and highly segmented information ecosystems are comparatively less pronounced. This context is particularly valuable for clarifying how media scepticism, subjective media literacy, and patterns of media exposure relate to conspiracy beliefs.