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Hosseini MS, Bejnordi BE, Trinh VQH, Chan L, Hasan D, Li X, Yang S, Kim T, Zhang H, Wu T, Chinniah K, Maghsoudlou S, Zhang R, Zhu J, Khaki S, Buin A, Chaji F, Salehi A, Nguyen BN, Samaras D, Plataniotis KN. Computational pathology: A survey review and the way forward. J Pathol Inform 2024; 15:100357. [PMID: 38420608 PMCID: PMC10900832 DOI: 10.1016/j.jpi.2023.100357] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/15/2023] [Revised: 12/21/2023] [Accepted: 12/23/2023] [Indexed: 03/02/2024] Open
Abstract
Computational Pathology (CPath) is an interdisciplinary science that augments developments of computational approaches to analyze and model medical histopathology images. The main objective for CPath is to develop infrastructure and workflows of digital diagnostics as an assistive CAD system for clinical pathology, facilitating transformational changes in the diagnosis and treatment of cancer that are mainly address by CPath tools. With evergrowing developments in deep learning and computer vision algorithms, and the ease of the data flow from digital pathology, currently CPath is witnessing a paradigm shift. Despite the sheer volume of engineering and scientific works being introduced for cancer image analysis, there is still a considerable gap of adopting and integrating these algorithms in clinical practice. This raises a significant question regarding the direction and trends that are undertaken in CPath. In this article we provide a comprehensive review of more than 800 papers to address the challenges faced in problem design all-the-way to the application and implementation viewpoints. We have catalogued each paper into a model-card by examining the key works and challenges faced to layout the current landscape in CPath. We hope this helps the community to locate relevant works and facilitate understanding of the field's future directions. In a nutshell, we oversee the CPath developments in cycle of stages which are required to be cohesively linked together to address the challenges associated with such multidisciplinary science. We overview this cycle from different perspectives of data-centric, model-centric, and application-centric problems. We finally sketch remaining challenges and provide directions for future technical developments and clinical integration of CPath. For updated information on this survey review paper and accessing to the original model cards repository, please refer to GitHub. Updated version of this draft can also be found from arXiv.
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Affiliation(s)
- Mahdi S Hosseini
- Department of Computer Science and Software Engineering (CSSE), Concordia Univeristy, Montreal, QC H3H 2R9, Canada
| | | | - Vincent Quoc-Huy Trinh
- Institute for Research in Immunology and Cancer of the University of Montreal, Montreal, QC H3T 1J4, Canada
| | - Lyndon Chan
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Danial Hasan
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Xingwen Li
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Stephen Yang
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Taehyo Kim
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Haochen Zhang
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Theodore Wu
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Kajanan Chinniah
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Sina Maghsoudlou
- Department of Computer Science and Software Engineering (CSSE), Concordia Univeristy, Montreal, QC H3H 2R9, Canada
| | - Ryan Zhang
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Jiadai Zhu
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Samir Khaki
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
| | - Andrei Buin
- Huron Digitial Pathology, St. Jacobs, ON N0B 2N0, Canada
| | - Fatemeh Chaji
- Department of Computer Science and Software Engineering (CSSE), Concordia Univeristy, Montreal, QC H3H 2R9, Canada
| | - Ala Salehi
- Department of Electrical and Computer Engineering, University of New Brunswick, Fredericton, NB E3B 5A3, Canada
| | - Bich Ngoc Nguyen
- University of Montreal Hospital Center, Montreal, QC H2X 0C2, Canada
| | - Dimitris Samaras
- Department of Computer Science, Stony Brook University, Stony Brook, NY 11794, United States
| | - Konstantinos N Plataniotis
- The Edward S. Rogers Sr. Department of Electrical & Computer Engineering (ECE), University of Toronto, Toronto, ON M5S 3G4, Canada
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Demetz M, Abramovic A, Krigers A, Bauer M, Lener S, Pinggera D, Kerschbaumer J, Hartmann S, Fritsch H, Thomé C, Freyschlag CF. Cadaveric study of ergonomics and performance using a robotic exoscope with a head-mounted display in spine surgery. J Robot Surg 2024; 18:6. [PMID: 38198072 PMCID: PMC10781796 DOI: 10.1007/s11701-023-01777-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2023] [Accepted: 12/10/2023] [Indexed: 01/11/2024]
Abstract
The conventional microscope has the disadvantage of a potentially unergonomic posture for the surgeon, which can affect performance. Monitor-based exoscopes could provide a more ergonomic posture, as already shown in pre-clinical studies. The aim of this study was to test the usability and comfort of a novel head-mounted display (HMD)-based exoscope on spinal surgical approaches in a simulated OR setting. A total of 21 neurosurgeons naïve to the device were participated in this prospective trial. After a standardized training session with the device, participants were asked to perform a single-level thoracolumbar decompression surgery on human cadavers using the exoscope. Subsequently, all participants completed a comfort and safety questionnaire. For the objective evaluation of the performance, all interventions were videotaped and analyzed. Twelve men and nine women with a mean age of 34 (range: 24-57) were participating in the study. Average time for decompression was 15 min (IqR 9.6; 24.2); three participants (14%) terminated the procedure prematurely. In these dropouts, a significantly higher incidence of back/neck pain (p = 0.002 for back, p = 0.046 for neck pain) as well as an increased frequency of HMD readjustments (p = 0.045) and decreased depth perception (p = 0.03) were documented. Overall, the surgeons' satisfaction with the exoscope was 84% (IqR 75; 100). Using a standardized, pre-interventional training, it is possible for exoscope-naïve surgeons to perform sufficient spinal decompression using the HMD-based exoscope with a high satisfaction. However, inaccurate HMD setup prior to the start of the procedure may lead to discomfort and unsatisfactory results.
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Affiliation(s)
- Matthias Demetz
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Anto Abramovic
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Aleksandrs Krigers
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Marlies Bauer
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Sara Lener
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Daniel Pinggera
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Johannes Kerschbaumer
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Sebastian Hartmann
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Helga Fritsch
- Institute of Clinical and Functional Anatomy, Medical University of Innsbruck, Müllerstr. 59, 6020, Innsbruck, Austria
| | - Claudius Thomé
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria
| | - Christian F Freyschlag
- Department of Neurosurgery, Medical University of Innsbruck, Anichstr. 35, 6020, Innsbruck, Austria.
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Marahrens H, Wagener MG, Schaper E, Zintl J, Kiene F, Ganter M. Teaching clinical hematology and leukocyte differentiation in veterinary medicine using virtual patients. Front Vet Sci 2023; 10:1163927. [PMID: 37795012 PMCID: PMC10546049 DOI: 10.3389/fvets.2023.1163927] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2023] [Accepted: 08/15/2023] [Indexed: 10/06/2023] Open
Abstract
Due to contact restrictions imposed because of the COVID-19 pandemic, we created a novel digital course on the Moodle learning platform for winter term in 2020. In the clinical pathology course (CPC) with hematological content, third-year students were able to work independently on 10 extra digital cases of internal medicine involving eight different animal species as a compensation for the reduction in traditional microscopy exercises. Each case presented was initiated using an anamnesis, also the participants to generate a differential blood count based on digitized leukocytes, previously been photographed using a microscope camera. The cases were successive and increased in complexity, for example through the increase in the number of different cell types to be differentiated. The participants had the opportunity to evaluate the course through a final module to rate user-friendliness and acceptance. The total results of the participants in 2021 were analyzed descriptively, focusing on success rates, time spent on the tasks, and number of attempts. A total of 237 (= 96%) of 247 students completed all cases, each assessing 1033 photographed blood cells in sum. The mean processing time was 22.48 min for a differentiation and the students spent an average of 1.48 attempts on it. A voluntary feedback form was completed by 192 (= 78%) students, with more than 95% rating the course positively in 12 evaluation questions, and 29 of 33 comments (= 87.88%) providing positive statements in a comment box. Suggestions for improvement primarily included more explanations on erythrocyte morphologies, followed by adjusting the difficulty level and improving the presentational set-up. Slight improvements in results, time spent on processing the tasks, and the number of attempts indicated an achievement of routine and confidence during the course and were associated with an increase of competency. The positive feedback showed a high acceptance of the digital format and students evaluated the course as improving the quality of teaching when combined with practical exercises.
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Affiliation(s)
- Hannah Marahrens
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Matthias Gerhard Wagener
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Elisabeth Schaper
- Center for E-Learning, Didactics and Educational Research, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Jana Zintl
- Center for E-Learning, Didactics and Educational Research, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Frederik Kiene
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
| | - Martin Ganter
- Clinic for Swine and Small Ruminants, Forensic Medicine and Ambulatory Service, University of Veterinary Medicine Hannover, Foundation, Hannover, Germany
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Laohawetwanit T, Gonzalez RS, Bychkov A. Learning at a distance: results of an international survey on the adoption of virtual conferences and whole slide imaging by pathologists. J Clin Pathol 2023:jcp-2023-208912. [PMID: 37208158 DOI: 10.1136/jcp-2023-208912] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2023] [Accepted: 05/08/2023] [Indexed: 05/21/2023]
Abstract
AIMS This study presents the findings of a global survey of pathologists' views of online conferences and digital pathology. METHODS An online anonymous survey consisting of 11 questions focusing on pathologists' perceptions of virtual conferences and digital slides was distributed to practising pathologists and trainees across the globe using the authors' social media accounts and professional society connections. Participants were asked to rank their preference for various aspects of pathology meetings on a 5-point Likert scale. RESULTS There were 562 respondents from 79 countries. Several advantages of virtual meetings were recognised, including that they are less expensive to attend than in-person meetings (mean 4.4), more convenient to attend remotely (mean 4.3) and more efficient due to no loss of time for travel (mean 4.3). The lack of networking was reported as the main disadvantage of virtual conferences (mean 4.0). Most respondents (n=450, 80.1%) preferred hybrid or virtual meetings. About two-thirds (n=356, 63.3%) had no concern regarding the use of virtual slides for educational purposes and viewed them as an acceptable substitute for glass slides. CONCLUSIONS Online meetings and whole slide imaging are viewed as valuable tools in pathology education. Virtual conferences allow affordable registration fees and flexibility for participants. However, networking opportunities are limited, meaning in-person meetings cannot be entirely replaced by virtual conferences. Hybrid meetings may be a solution to maximise the benefits of both virtual and in-person meetings.
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Affiliation(s)
- Thiyaphat Laohawetwanit
- Division of Pathology, Chulabhorn International College of Medicine, Thammasat University, Pathum Thani, Thailand
| | - Raul S Gonzalez
- Department of Pathology and Laboratory Medicine, Emory University, Atlanta, Georgia, USA
| | - Andrey Bychkov
- Department of Pathology, Kameda Medical Center, Kamogawa, Chiba, Japan
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Hortsch M. Histology as a paradigm for a science-based learning experience: Visits by histology education spirits of past, present, and future. ANATOMICAL SCIENCES EDUCATION 2023; 16:372-383. [PMID: 36453080 DOI: 10.1002/ase.2235] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/25/2022] [Revised: 10/31/2022] [Accepted: 11/17/2022] [Indexed: 05/11/2023]
Abstract
The term "histology" was coined a little over 200 years ago and the subject has always relied on microscopy as its defining technology. Microscopy was and still is an essential approach for the description of cellular components and their arrangements in living organisms. For more than a century and a half, histology or microanatomy has also been part of the basic science education for biomedical students. Traditionally, it has been taught in two major components, a didactic transfer of information, either in a lecture or self-learning format, and in active-learning laboratory sessions. These two modes of histology instruction conform with the dual-processing theory of learning, one being more automatic and depending mainly on rote memorization, whereas the other is analytical, requiring more advanced reasoning skills. However, these two components of histology education are not separate and independent, but rather complementary and part of a multi-step learning process that encourages a scientific analysis of visual information and involves higher-level learning skills. Conventional, as well as modern electronic instruction methods (e-learning) have been used in complementary ways to support the integrated succession of individual learning steps as outlined in this manuscript. However, as recent curricular reforms have curtailed instructional time, this traditional format of teaching histology is no longer sustainable and a reflective reassessment of the role of histology in modern biomedical education is a timely necessity.
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Affiliation(s)
- Michael Hortsch
- Department of Cell and Developmental Biology, University of Michigan Medical School, Michigan, Ann Arbor, USA
- Department of Learning Health Sciences, University of Michigan Medical School, Michigan, Ann Arbor, USA
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Maity S, Nauhria S, Nayak N, Nauhria S, Coffin T, Wray J, Haerianardakani S, Sah R, Spruce A, Jeong Y, Maj MC, Sharma A, Okpara N, Ike CJ, Nath R, Nelson J, Parwani AV. Virtual Versus Light Microscopy Usage among Students: A Systematic Review and Meta-Analytic Evidence in Medical Education. Diagnostics (Basel) 2023; 13:diagnostics13030558. [PMID: 36766660 PMCID: PMC9914930 DOI: 10.3390/diagnostics13030558] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2022] [Revised: 01/26/2023] [Accepted: 01/30/2023] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND The usage of whole-slide images has recently been gaining a foothold in medical education, training, and diagnosis. OBJECTIVES The first objective of the current study was to compare academic performance on virtual microscopy (VM) and light microscopy (LM) for learning pathology, anatomy, and histology in medical and dental students during the COVID-19 period. The second objective was to gather insight into various applications and usage of such technology for medical education. MATERIALS AND METHODS Using the keywords "virtual microscopy" or "light microscopy" or "digital microscopy" and "medical" and "dental" students, databases (PubMed, Embase, Scopus, Cochrane, CINAHL, and Google Scholar) were searched. Hand searching and snowballing were also employed for article searching. After extracting the relevant data based on inclusion and execution criteria, the qualitative data were used for the systematic review and quantitative data were used for meta-analysis. The Newcastle Ottawa Scale (NOS) scale was used to assess the quality of the included studies. Additionally, we registered our systematic review protocol in the prospective register of systematic reviews (PROSPERO) with registration number CRD42020205583. RESULTS A total of 39 studies met the criteria to be included in the systematic review. Overall, results indicated a preference for this technology and better academic scores. Qualitative analyses reported improved academic scores, ease of use, and enhanced collaboration amongst students as the top advantages, whereas technical issues were a disadvantage. The performance comparison of virtual versus light microscopy meta-analysis included 19 studies. Most (10/39) studies were from medical universities in the USA. VM was mainly used for teaching pathology courses (25/39) at medical schools (30/39). Dental schools (10/39) have also reported using VM for teaching microscopy. The COVID-19 pandemic was responsible for the transition to VM use in 17/39 studies. The pooled effect size of 19 studies significantly demonstrated higher exam performance (SMD: 1.36 [95% CI: 0.75, 1.96], p < 0.001) among the students who used VM for their learning. Students in the VM group demonstrated significantly higher exam performance than LM in pathology (SMD: 0.85 [95% CI: 0.26, 1.44], p < 0.01) and histopathology (SMD: 1.25 [95% CI: 0.71, 1.78], p < 0.001). For histology (SMD: 1.67 [95% CI: -0.05, 3.40], p = 0.06), the result was insignificant. The overall analysis of 15 studies assessing exam performance showed significantly higher performance for both medical (SMD: 1.42 [95% CI: 0.59, 2.25], p < 0.001) and dental students (SMD: 0.58 [95% CI: 0.58, 0.79], p < 0.001). CONCLUSIONS The results of qualitative and quantitative analyses show that VM technology and digitization of glass slides enhance the teaching and learning of microscopic aspects of disease. Additionally, the COVID-19 global health crisis has produced many challenges to overcome from a macroscopic to microscopic scale, for which modern virtual technology is the solution. Therefore, medical educators worldwide should incorporate newer teaching technologies in the curriculum for the success of the coming generation of health-care professionals.
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Affiliation(s)
- Sabyasachi Maity
- Department of Physiology, Neuroscience, and Behavioral Sciences, St. George’s University School of Medicine, St. George’s, Grenada
| | - Samal Nauhria
- Department of Pathology, St. Matthews University School of Medicine, Georgetown P.O. Box 30992, Cayman Islands
- Correspondence:
| | - Narendra Nayak
- Department of Microbiology, St. Matthews University School of Medicine, Georgetown P.O. Box 30992, Cayman Islands
| | - Shreya Nauhria
- Department of Psychology, University of Leicester, Leicester LE1 7RH, UK
| | - Tamara Coffin
- Medical Student Research Institute, St. George’s University School of Medicine, St. George’s, Grenada
| | - Jadzia Wray
- Medical Student Research Institute, St. George’s University School of Medicine, St. George’s, Grenada
| | - Sepehr Haerianardakani
- Medical Student Research Institute, St. George’s University School of Medicine, St. George’s, Grenada
| | - Ramsagar Sah
- Department of Public Health, Torrens University, Ultimo, Sydney, NSW 2007, Australia
| | - Andrew Spruce
- Department of Pathology, St. Matthews University School of Medicine, Georgetown P.O. Box 30992, Cayman Islands
| | - Yujin Jeong
- Department of Clinical Medicine, American University of Antigua, St. John’s, Antigua and Barbuda
| | - Mary C. Maj
- Department of Biochemistry, St. George’s University School of Medicine, St. George’s, Grenada
| | - Abhimanyu Sharma
- Department of Pathology, Government Medical College, Jammu 180001, India
| | - Nicole Okpara
- Department of Pathology, St. Matthews University School of Medicine, Georgetown P.O. Box 30992, Cayman Islands
| | - Chidubem J. Ike
- Department of Clinical Medicine, American University of Antigua, St. John’s, Antigua and Barbuda
| | - Reetuparna Nath
- Department of Education Service, St. George’s University, St. George’s, Grenada
| | - Jack Nelson
- Medical Illustrator, The Centre for Biomedical Visualization, St. George’s University, St. George’s, Grenada
| | - Anil V. Parwani
- Department of Pathology, Wexner Medical Center, The Ohio State University, Cooperative Human Tissue Network (CHTN) Midwestern Division, Columbus, OH 43210, USA
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Sakthi-Velavan S, Zahl S. Integration of virtual microscopy podcasts in the histology discipline in osteopathic medical school: Learning outcomes. ANATOMICAL SCIENCES EDUCATION 2023; 16:157-170. [PMID: 35366372 DOI: 10.1002/ase.2181] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/20/2021] [Revised: 03/25/2022] [Accepted: 03/27/2022] [Indexed: 06/14/2023]
Abstract
Virtual microscopy podcasts (VMPs) are narrative recordings of digital histology images. This study evaluated the outcomes of integrating the VMPs into teaching histology to osteopathic medical students. The hypothesis was that incorporating virtual microscopy podcasts as supplementary histology resources to the curriculum would have a positive impact on student performance and satisfaction. Sixty-one podcasts of dynamic microscopic images were created using screen recordings of the digital slides. The VMPs were integrated as supplementary histology resources in multiple courses during the first and second years of the medical curriculum for three classes, a total of 477 osteopathic medical students. A voluntary and anonymous survey was obtained from the students using a questionnaire that included two open-ended questions. The overall performance of the three classes on the histology content of the preclinical course examinations was compared to historical controls of the previous two classes that did not have access to the VMPs. Most students indicated that the podcasts enabled more efficient study time and improved their confidence in the histology content on examinations. The findings indicated a positive association between podcast viewing and efficient study time utilization and class performance. The class average scores of the three consecutive cohorts that used the VMPs progressively increased by 7.69%, 14.88%, and 14.91% compared to the controls. A summary of students' feedback and academic performance supported that integration of the VMPs into Histology teaching improved the learning experience. The findings align with previous studies on the effectiveness of multimedia-based teaching in histology laboratory modules.
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Affiliation(s)
- Sumathilatha Sakthi-Velavan
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
| | - Sarah Zahl
- Division of Biomedical Sciences, Marian University College of Osteopathic Medicine, Indianapolis, Indiana, USA
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Hortsch M, Koney NKK, Oommen AM, Yohannan DG, Li Y, de Melo Leite ACR, Girão-Carmona VCC. Virtual Microscopy Goes Global: The Images Are Virtual and the Problems Are Real. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1421:79-124. [PMID: 37524985 DOI: 10.1007/978-3-031-30379-1_5] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 08/02/2023]
Abstract
For the last two centuries, the scholarly education of histology and pathology has been based on technology, initially on the availability of low-cost, high-quality light microscopes, and more recently on the introduction of computers and e-learning approaches to biomedical education. Consequently, virtual microscopy (VM) is replacing glass slides and the traditional light microscope as the main instruments of instruction in histology and pathology laboratories. However, as with most educational changes, there are advantages and disadvantages associated with a new technology. The use of VM for the teaching of histology and pathology requires an extensive infrastructure and the availability of computing devices to all learners, both posing a considerable financial strain on schools and students. Furthermore, there may be valid reasons for practicing healthcare professionals to maintain competency in using light microscopes. In addition, some educators may be reluctant to embrace new technologies. These are some of the reasons why the introduction of VM as an integral part of histology and pathology instruction has been globally uneven. This paper compares the teaching of histology and pathology using traditional or VM in five different countries and their adjacent regions, representing developed, as well as developing areas of the globe. We identify general and local roadblocks to the introduction of this still-emerging didactic technology and outline solutions for overcoming these barriers.
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Affiliation(s)
- Michael Hortsch
- Departments of Cell and Developmental Biology and of Learning Health Sciences, University of Michigan, Ann Arbor, MI, USA.
| | - Nii Koney-Kwaku Koney
- Department of Anatomy, University of Ghana Medical School, University of Ghana, Korle Bu, Accra, Ghana
| | - Aswathy Maria Oommen
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Doris George Yohannan
- Government Medical College Thiruvananthapuram, Thiruvananthapuram, Kerala, India
- Kerala University of Health Sciences, Thrissur, Kerala, India
| | - Yan Li
- Department of Anatomy, Histology and Embryology, Fudan University, Shanghai, China
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Jones-Hall YL, Skelton JM, Adams LG. Implementing Digital Pathology into Veterinary Academics and Research. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:547-555. [PMID: 34460355 DOI: 10.3138/jvme-2021-0068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/13/2023]
Abstract
The advantages of digital pathology (DP) have been recognized as early as 1963, but only within the last decade or so have the advancements of slide scanners and viewing software made the use and implementation of DP feasible in the classroom and in research. Several factors must be considered prior to undertaking the project of implementing the DP workflow in any setting, but particularly in an academic environment. Sustained and open dialogue with information technology (IT) is critical to the success of this enterprise. In addition to IT, there is a multitude of criteria to consider when determining the best hardware and software to purchase to support the project. The goals and limitations of the laboratory and the requirements of its users (students, instructors, and researchers) will ultimately direct these decisions. The objectives of this article are to provide an overview of the opportunities and challenges associated with the integration of DP in education and research, to highlight some important IT considerations, and to discuss some of the requirements and functionalities of some hardware and software options.
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Gellisch M, Wolf OT, Minkley N, Kirchner WH, Brüne M, Brand-Saberi B. Decreased sympathetic cardiovascular influences and hormone-physiological changes in response to Covid-19-related adaptations under different learning environments. ANATOMICAL SCIENCES EDUCATION 2022; 15:811-826. [PMID: 35968688 DOI: 10.1002/ase.2213] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2022] [Revised: 07/07/2022] [Accepted: 07/26/2022] [Indexed: 06/15/2023]
Abstract
To examine the implications of the transition from face-to-face to online learning from a psychobiological perspective, this study investigated potential differences in physiological stress parameters of students engaged in online or face-to-face learning and determined whether these can be identified as possible mediators between learning experience and achievement emotions. In a randomized experimental field study, medical students (n = 82) attended either regular face-to-face classes of the microscopic anatomy course or the same practical course online using Zoom videoconferencing platform. The present study investigated Heart Rate Variability (HRV) and salivary cortisol concentration as stress correlates, within the contexts of online and face-to-face learning and compared these parameters with a control group that was measured at rest. Additionally, participants completed a standardized questionnaire about their experienced emotions in relation to task achievement and subjective stress levels. A significant reduction in HRV was found in face-to-face learning, suggesting stronger stress responses in the face-to-face learning environment (η2 = 0.421, P < 0.001). Furthermore, participants engaged in face-to-face learning showed significantly higher cortisol concentrations (η2 = 0.115, P = 0.032). Additionally, increased sympathetic activation correlated with the discrete positive emotion of enjoyment exclusively within the face-to-face condition (r = 0.365, P = 0.043). These results indicate that the transfer of a face-to-face practical course in microscopic anatomy to an online learning environment is associated with decreased sympathetic and enhanced vagal cardiovascular influences, together with lower cortisol concentrations in healthy medical students.
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Affiliation(s)
- Morris Gellisch
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
| | - Oliver T Wolf
- Department of Cognitive Psychology, Faculty of Psychology, Ruhr University Bochum, Bochum, Germany
| | - Nina Minkley
- Behavioral Biology and Biology Education, Faculty of Biology and Biotechnology, Ruhr University Bochum, Bochum, Germany
| | - Wolfgang H Kirchner
- Behavioral Biology and Biology Education, Faculty of Biology and Biotechnology, Ruhr University Bochum, Bochum, Germany
| | - Martin Brüne
- Department of Cognitive Neuropsychiatry and Psychiatric Preventive Medicine, Landschaftsverband Westfalen-Lippe (LWL) University Hospital of Ruhr University Bochum, Bochum, Germany
| | - Beate Brand-Saberi
- Department of Anatomy and Molecular Embryology, Institute of Anatomy, Medical Faculty, Ruhr University Bochum, Bochum, Germany
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11
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Gribbin W, Wilson EA, McTaggart S, Hortsch M. Histology education in an integrated, time-restricted medical curriculum: Academic outcomes and students' study adaptations. ANATOMICAL SCIENCES EDUCATION 2022; 15:671-684. [PMID: 34363740 DOI: 10.1002/ase.2127] [Citation(s) in RCA: 8] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/03/2021] [Revised: 08/02/2021] [Accepted: 08/04/2021] [Indexed: 06/13/2023]
Abstract
In an ever-changing medical curricular environment, time dedicated for anatomical education has been progressively reduced. This happened at the University of Michigan Medical School starting in 2016-2017 when preclinical medical education was condensed to one year. Histology instruction remained integrated in organ system courses but reduced to a lecture-only format without scheduling time for laboratory exercises, requiring students to study virtual histology slides on their own time. In accordance with the shortened instructional time, the number of histology examination questions was reduced more than twofold. This study analyzed students' histology examination results and assessed their motivation to learn histology and use of educational opportunities before and after these curricular changes were implemented. Students' motivation to learn histology and their evaluation of histology lectures increased in the new curriculum. However, students devoted less study time to studying histology. Students' cumulative histology examination scores were significantly lower in the new curriculum and the number of students with overall scores <75%, defined as a substandard performance, increased more than 15-fold. Academically weaker students' histology scores were disproportionately more affected. As medical educational strategies, priorities, and curricular frameworks continue to evolve, traditional didactic topics like histology will need to adapt to continue providing educational value to future health care providers.
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Affiliation(s)
- William Gribbin
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Eric A Wilson
- University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Suzy McTaggart
- Office of Medical Student Education, University of Michigan Medical School, Ann Arbor, Michigan, USA
| | - Michael Hortsch
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan, USA
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan, USA
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12
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Ishak A, AlRawashdeh MM, Meletiou-Mavrotheris M, Nikas IP. Virtual Pathology Education in Medical Schools Worldwide during the COVID-19 Pandemic: Advantages, Challenges Faced, and Perspectives. Diagnostics (Basel) 2022; 12:diagnostics12071578. [PMID: 35885484 PMCID: PMC9321717 DOI: 10.3390/diagnostics12071578] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Revised: 06/22/2022] [Accepted: 06/27/2022] [Indexed: 11/20/2022] Open
Abstract
The COVID-19 pandemic shifted pathology education in medical schools worldwide towards online delivery. To achieve this goal, various innovative platforms were used by pathology educators and medical students, facilitating both synchronous and asynchronous learning. The aim of this study was to review the published evidence regarding remote pathology teaching at the medical school level during this period, present our own experience, and provide some perspectives regarding the best mode of pathology teaching post-pandemic. Among its advantages, virtual pathology education was considered among students and educators as convenient, flexible, and engaging, while learning outcomes were met and students’ academic performance was in general satisfactory. However, several challenges were faced. For instance, suboptimal internet connection compromised the flow of classes and was even associated with a lower academic performance. The lack of hands-on laboratory activities, such as operating the light microscope and tissue grossing, and the reduced student interactions among themselves and their instructors, were also pointed out as significant drawbacks of remote pathology education. Whereas online education has multiple advantages, experiencing the physical university environment, in-person interactions and teamwork, exposure to the “hidden curriculum”, and hands-on activities are vital for medical school education and future student development. In conclusion, the implementation of a blended approach in pathology education—where online and face-to-face sessions are jointly used to promote students’ engagement, interaction with their instructors and peers, and learning—could be the most optimal approach to pathology teaching in medical schools post-pandemic.
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Affiliation(s)
- Angela Ishak
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (M.M.A.)
| | - Mousa M. AlRawashdeh
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (M.M.A.)
| | | | - Ilias P. Nikas
- School of Medicine, European University Cyprus, Nicosia 2404, Cyprus; (A.I.); (M.M.A.)
- Correspondence:
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13
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Norman HH, Hadie SNH, Yaacob NM, Kasim F. The Association Between Preclinical Medical Students' Perceptions of the Anatomy Education Environment and Their Learning Approaches. MEDICAL SCIENCE EDUCATOR 2022; 32:399-409. [PMID: 35528310 PMCID: PMC9055004 DOI: 10.1007/s40670-022-01517-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/28/2022] [Indexed: 06/14/2023]
Abstract
This study aimed to measure medical students' perceptions of the anatomy education environment and determine its association with their learning approaches. First- and second-year undergraduate medical students (N = 234) completed the Anatomy Education Environment Measurement Inventory and the Approaches and Study Skills Inventory for Students. Results revealed that the students' perceptions of all the factors in the anatomy education environment were positive except for two areas-the anatomy learning resources and quality of histology learning facilities. The majority of students in the first year (62.3%) and second year (43.7%) adopted a deep learning approach. There was no significant association between most of the factors in the anatomy education environment and the students' learning approaches, except for the students' intrinsic interest in learning anatomy factor (p = 0.032). The anatomy education environment was positive for the medical students, and there was a prevalence of a deep learning approach among them. However, most of the factors in the anatomy education environment did not influence the students' learning approach. Given that the students' learning approach is a multifactorial construct, investigating the relationship between these two variables in longitudinal time points would provide better insight into the association between the anatomy educational climate and students' learning approaches.
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Affiliation(s)
- Haziq Hazman Norman
- Anatomy Unit, Management and Science University, University Drive, Off Persiaran Olahraga, Seksyen 13, Shah Alam, Selangor 40100 Malaysia
| | - Siti Nurma Hanim Hadie
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan 16150 Malaysia
| | - Najib Majdi Yaacob
- Biostatistics and Research Methodology Unit, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan Malaysia
| | - Fazlina Kasim
- Department of Anatomy, School of Medical Sciences, Health Campus, Universiti Sains Malaysia, Kubang Kerian, Kota Bharu, Kelantan 16150 Malaysia
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14
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Nikas IP, Lamnisos D, Meletiou‐Mavrotheris M, Themistocleous S, Pieridi C, Mytilinaios DG, Michaelides C, Johnson EO. Shift to emergency remote preclinical medical education amidst the Covid-19 pandemic: A single-institution study. ANATOMICAL SCIENCES EDUCATION 2022; 15:27-41. [PMID: 34854255 PMCID: PMC9011537 DOI: 10.1002/ase.2159] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/31/2021] [Revised: 08/09/2021] [Accepted: 11/29/2021] [Indexed: 05/22/2023]
Abstract
The Covid-19 pandemic disrupted medical education, shifting it towards emergency remote delivery. This cross-sectional study aimed to assess the impact of the pandemic on preclinical medical education and identify predictors of the virtual learning experience and perceived stress. An anonymous survey was delivered electronically to the students of the authors' medical school that attended either histology or pathology. This survey contained two scales, the virtual learning experience (VLE) and the perceived stress scale-10 (PSS-10). A total of 173/255 (68%) responded, showing a positive perception towards the remote delivery of both courses. An exploratory factor analysis was performed on the VLE scale items and four new dimensions were formed: "course quality and learning outcomes", "student motivation", virtual against F2F learning", and "virtual laboratory sessions". The following significant predictors of enhanced VLE, in at least one dimension, were identified: female gender, pathology course, final examination grade >80%, lower perceived stress levels, studying in home country, and holding of another degree before medical school. In addition, the following predictors were significantly associated with higher levels of student perceived stress: female gender, pathology course, studying away from home, and suboptimal internet connection. Notably, the quality of internet connection was significantly associated with the students' final examination performance. Concerning the best mode for future delivery of both courses, most students proposed a blended, rather than an entirely on-campus or online approach. In conclusion, despite its problems, a high-quality remote preclinical medical education was possible in the authors' school and offered tremendous opportunities for future improvement.
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Affiliation(s)
- Ilias P. Nikas
- School of MedicineEuropean University CyprusNicosiaCyprus
| | - Demetris Lamnisos
- Department of Health SciencesEuropean University CyprusNicosiaCyprus
| | | | | | - Chryso Pieridi
- School of MedicineEuropean University CyprusNicosiaCyprus
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15
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Joaquim DC, Hortsch M, Silva ASRD, David PB, Leite ACRDM, Girão-Carmona VCC. Digital information and communication technologies on histology learning: What to expect?-An integrative review. Anat Histol Embryol 2021; 51:180-188. [PMID: 34921436 DOI: 10.1111/ahe.12776] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Revised: 11/19/2021] [Accepted: 12/08/2021] [Indexed: 11/26/2022]
Abstract
This integrative review summarizes the scientific evidence about the use of information and communication technologies in the teaching of histology and discusses its implications. The authors used the descriptors 'Educational Technology', 'Information Technology', 'Histology', 'Teaching', 'Learning', and their corresponding Portuguese translation for a comprehensive search of the published literature. This research was performed in May 2020 and targeted the PubMed, SciELO, LILACS, WOS, and SCOPUS databases. Studies published between 2010 and 2020 in Portuguese, English, and Spanish were included in the analysis. After excluding dissertations, reports, and duplicate reviews, 11 articles were identified for an in-depth analysis, which discussed the use of different technologies, such as digital platforms, mobile apps, virtual microscopy, and video classes for the teaching of histology. All studies concluded that these technologies could have a considerable impact, both positive and negative, on academic performance, the correct interpretation of histological structures, as well as students' motivation and satisfaction. The authors' analysis indicates that the use of the above-mentioned technologies in combination with traditional methods has the potential of transforming the teaching and learning process for histology. However, how such technologies impact students' learning success needs to be carefully considered.
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Affiliation(s)
- Davide Carlos Joaquim
- Department of Morphology, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
| | - Michael Hortsch
- Departments of Cell and Developmental Biology and of Learning Health Sciences, University of Michigan, Ann Arbor, Michigan, USA
| | | | - Priscila Barros David
- Department of Physiotherapy, Faculty of Medicine, Federal University of Ceará (UFC), Fortaleza, CE, Brazil
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16
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Kolinko Y, Malečková A, Kochová P, Grajciarová M, Blassová T, Kural T, Trailin A, Červenková L, Havránková J, Vištejnová L, Tonarová P, Moulisová V, Jiřík M, Zavaďáková A, Tichánek F, Liška V, Králíčková M, Witter K, Tonar Z. Using virtual microscopy for the development of sampling strategies in quantitative histology and design-based stereology. Anat Histol Embryol 2021; 51:3-22. [PMID: 34806204 DOI: 10.1111/ahe.12765] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/29/2021] [Accepted: 10/31/2021] [Indexed: 02/03/2023]
Abstract
Only a fraction of specimens under study are usually selected for quantification in histology. Multilevel sampling or tissue probes, slides and fields of view (FOVs) in the regions of interest (ROIs) are required. In general, all parts of the organs under study should be given the same probability to be taken into account; that is, the sampling should be unbiased on all levels. The objective of our study was to provide an overview of the use of virtual microscopy in the context of developing sampling strategies of FOVs for stereological quantification. We elaborated this idea on 18 examples from multiple fields of histology, including quantification of extracellular matrix and muscle tissue, quantification of organ and tumour microvessels and tumour-infiltrating lymphocytes, assessing osseointegration of bone implants, healing of intestine anastomoses and osteochondral defects, counting brain neurons, counting nuclei in vitro cell cultures and others. We provided practical implications for the most common situations, such as exhaustive sampling of ROIs, sampling ROIs of different sizes, sampling the same ROIs for multiple histological methods, sampling more ROIs with variable intensities or using various objectives, multistage sampling and virtual sampling. Recommendations were provided for pilot studies on systematic uniform random sampling of FOVs as a part of optimizing the efficiency of histological quantification to prevent over- or undersampling. We critically discussed the pros and cons of using virtual sections for sampling FOVs from whole scanned sections. Our review demonstrated that whole slide scans of histological sections facilitate the design of sampling strategies for quantitative histology.
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Affiliation(s)
- Yaroslav Kolinko
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Anna Malečková
- Faculty of Applied Sciences, European Centre of Excellence NTIS, University of West Bohemia, Pilsen, Czech Republic
| | - Petra Kochová
- Faculty of Applied Sciences, European Centre of Excellence NTIS, University of West Bohemia, Pilsen, Czech Republic
| | - Martina Grajciarová
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Tereza Blassová
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Tomáš Kural
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Andriy Trailin
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Lenka Červenková
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic.,Department of Pathology, Third Faculty of Medicine, Charles University, Prague, Czech Republic
| | - Jiřina Havránková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Lucie Vištejnová
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Pavla Tonarová
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Vladimíra Moulisová
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Miroslav Jiřík
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic.,Faculty of Applied Sciences, European Centre of Excellence NTIS, University of West Bohemia, Pilsen, Czech Republic
| | - Anna Zavaďáková
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Filip Tichánek
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic.,Department of Pathological Physiology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Václav Liška
- Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic.,Department of Surgery and Biomedical Center, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic
| | - Milena Králíčková
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
| | - Kirsti Witter
- Institute of Morphology, Department of Pathobiology, University of Veterinary Medicine Vienna, Vienna, Austria
| | - Zbyněk Tonar
- Department of Histology and Embryology, Faculty of Medicine in Pilsen, Charles University, Pilsen, Czech Republic.,Faculty of Medicine in Pilsen, Biomedical Center, Charles University, Pilsen, Czech Republic
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17
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Lee HN, Seo HD, Kim EM, Han BS, Kang JS. Classification of Mouse Lung Metastatic Tumor with Deep Learning. Biomol Ther (Seoul) 2021; 30:179-183. [PMID: 34725310 PMCID: PMC8902456 DOI: 10.4062/biomolther.2021.130] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2021] [Revised: 08/31/2021] [Accepted: 09/13/2021] [Indexed: 11/26/2022] Open
Abstract
Traditionally, pathologists microscopically examine tissue sections to detect pathological lesions; the many slides that must be evaluated impose severe work burdens. Also, diagnostic accuracy varies by pathologist training and experience; better diagnostic tools are required. Given the rapid development of computer vision, automated deep learning is now used to classify microscopic images, including medical images. Here, we used a Inception-v3 deep learning model to detect mouse lung metastatic tumors via whole slide imaging (WSI); we cropped the images to 151 by 151 pixels. The images were divided into training (53.8%) and test (46.2%) sets (21,017 and 18,016 images, respectively). When images from lung tissue containing tumor tissues were evaluated, the model accuracy was 98.76%. When images from normal lung tissue were evaluated, the model accuracy (“no tumor”) was 99.87%. Thus, the deep learning model distinguished metastatic lesions from normal lung tissue. Our approach will allow the rapid and accurate analysis of various tissues.
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Affiliation(s)
- Ha Neul Lee
- Department of Biomedical, Laboratory Science, Namseoul University, Cheonan 31020, Republic of Korea
| | - Hong-Deok Seo
- Department of Industrial Promotion, Spatial Information Industry Promotion Agency, Seongnam 13487, Republic of Korea
| | - Eui-Myoung Kim
- Department of Spatial Information Engineering, Namseoul University, Cheonan 31020, Republic of Korea
| | - Beom Seok Han
- Department of Pharmaceutical Engineering, Hoseo University, Asan 31499, Republic of Korea
| | - Jin Seok Kang
- Department of Biomedical, Laboratory Science, Namseoul University, Cheonan 31020, Republic of Korea
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18
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Somera Dos Santos F, Osako MK, Perdoná GDSC, Alves MG, Sales KU. Virtual Microscopy as a Learning Tool in Brazilian Medical Education. ANATOMICAL SCIENCES EDUCATION 2021; 14:408-416. [PMID: 33720510 DOI: 10.1002/ase.2072] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 05/29/2020] [Revised: 01/19/2021] [Accepted: 03/10/2021] [Indexed: 06/12/2023]
Abstract
Virtual microscopy (VM) is a widely used teaching method in Medical Education in many developed countries. In Brazil, however, this is not the case for most medical schools, considering Brazilian social inequality and uneven access to technology. Recently, the Covid-19 pandemic has also challenged Universities to seek and make a transition toward more effective methods of full-time online education. Thus, the main goal of this work was to verify student's perception and academic performance, assessed upon VM implementation in a Brazilian Medical School. Ribeirao Preto Medical School students answered a 26-question survey with regards to optical microscopy (OM) and VM. Academic performance was compared between participants that were (year of 2019) or were not (year of 2015) exposed to VM. Taken the results together, subjective impressions such as handling, suitability, learning effectiveness, and pleasure using the tools, have shown a higher score for virtual microscopy (median = 29), when compared to optical microscopy (median = 24) with a P-value < 0.001 by Wilcoxon rank test, upon measurement using an ordinal scale. Regarding academic performance, no statistically significant differences were found between groups (P-value = 0.38, Cohen's d = 0.19). Therefore, VM proved to be adequate to the Brazilian medical education in light of Brazilian social contexts and Covid-19 pandemic.
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Affiliation(s)
- Fernanda Somera Dos Santos
- Obstetrics and Gynecology Residency Program, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Mariana Kiomy Osako
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | | | - Márcia Gaião Alves
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
| | - Katiuchia Uzzun Sales
- Department of Cell and Molecular Biology and Pathogenic Bioagents, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, Brazil
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19
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Salinas-Alvarez Y, Quiroga-Garza A, Martinez-Garza JH, Jacobo-Baca G, Zarate-Garza PP, Rodríguez-Alanís KV, Guzman-Lopez S, Elizondo-Omaña RE. Mexican Educators Survey on Anatomical Sciences Education and a Review of World Tendencies. ANATOMICAL SCIENCES EDUCATION 2021; 14:471-481. [PMID: 32902143 DOI: 10.1002/ase.2017] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/04/2019] [Revised: 08/12/2020] [Accepted: 09/01/2020] [Indexed: 06/11/2023]
Abstract
Anatomical sciences curricula have been under constant reform over the years, with many countries having to reduce course hours while trying to preserve laboratory time. In Mexico, schools have historically been autonomous and unregulated, and data regarding structure and methods are still lacking. A national survey was sent by the Mexican Society of Anatomy to 110 anatomical sciences educators. The questionnaire consisted of 50 items (open and multiple choice) for gross anatomy, microscopic anatomy, neuroanatomy, and embryology courses in medical schools across Mexico. A clinical approach was the most common course approach in all disciplines. Contact course hours and laboratory hours were higher in Mexican anatomy education compared to other countries, with the highest reported contact hours for embryology (133.4 ± 44.1) and histology (125 ± 33.2). There were similar contact hours to other countries for gross anatomy (228.5 ± 60.5). Neuroanatomy course hours (43.9 ± 13.1) were less than reported by the United States and similar to Saudi Arabia and higher than the United Kingdom. Dissection and microscopy with histological slides predominate as the most common laboratory activities. Traditional methods prevail in most of the courses in Mexico and only a few educators have implemented innovative and technological tools. Implementation of new methods, approaches, and curricular changes are needed to enhance anatomical sciences education in Mexico.
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Affiliation(s)
- Yolanda Salinas-Alvarez
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | - Alejandro Quiroga-Garza
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | - Guillermo Jacobo-Baca
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
| | | | | | - Santos Guzman-Lopez
- Department of Human Anatomy, School of Medicine, Universidad Autónoma de Nuevo León, Monterrey, México
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20
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Darici D, Reissner C, Brockhaus J, Missler M. Implementation of a fully digital histology course in the anatomical teaching curriculum during COVID-19 pandemic. Ann Anat 2021; 236:151718. [PMID: 33675948 PMCID: PMC8739541 DOI: 10.1016/j.aanat.2021.151718] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/06/2020] [Revised: 02/11/2021] [Accepted: 02/11/2021] [Indexed: 02/07/2023]
Affiliation(s)
- D Darici
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany.
| | - C Reissner
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany
| | - J Brockhaus
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany
| | - M Missler
- Institute of Anatomy and Molecular Neurobiology, Westfälische-Wilhelms-University, Vesaliusweg 2-4, 48149 Münster, Germany.
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21
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Guiter GE, Sapia S, Wright AI, Hutchins GGA, Arayssi T. Development of a Remote Online Collaborative Medical School Pathology Curriculum with Clinical Correlations, across Several International Sites, through the Covid-19 Pandemic. MEDICAL SCIENCE EDUCATOR 2021; 31:549-556. [PMID: 33495717 PMCID: PMC7815444 DOI: 10.1007/s40670-021-01212-2] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 01/08/2021] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Due to the Covid-19 social distancing restrictions, in March 2020, Weill Cornell Medicine-Qatar decided to replace students' clinical instruction with novel online electives. Hence, we implemented an innovative online and remote pathology curriculum, anchored on virtual microscopy and Zoom videoconferencing: ideal tools to support online teaching. OBJECTIVE To assess a new curriculum implementation at Weill Cornell Medicine-Qatar. MATERIALS AND METHODS This for-credit, 2-week elective included 6 synchronous Zoom sessions where complex clinicopathological cases were discussed in small groups. We used open access digital microscopy slides from the University of Leeds' Virtual Pathology Library (http://www.virtualpathology.leeds.ac.uk/slides/library/). Students independently prepared for these sessions by reviewing cases, slides, readings, and questions in advance (asynchronous self-directed learning anchored on a flipped classroom model), and wrote a final review of a case. An assessment and feedback were given to each student. RESULTS Four elective iterations were offered to a total of 29 students, with learners and faculty spread over 4 countries. During the Zoom sessions, students controlled the digital slides and offered their own diagnoses, followed by group discussions to strengthen autonomy and confidence. We surveyed learners about the elective's performance (program evaluation). Students conveyed high levels of satisfaction about the elective's overall quality, their pathology learning and online interactions, with minimal challenges related to the remote nature of the course. DISCUSSION AND CONCLUSIONS Technological innovations mitigate sudden disruptions in medical education. A remote curriculum allows instruction at any distance, at any time, from anywhere, enhancing educational exchanges, flexibility and globalization in medical education.
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Affiliation(s)
- Gerardo E. Guiter
- Division of Medical Education, Weill Cornell Medicine-Qatar, 445 East 69 Street, RM 432, New York, NY 10021 USA
| | - Sandra Sapia
- Division of Medical Education, Weill Cornell Medicine- Qatar, Qatar Foundation - Education City, P.O. Box 24144, Doha, Qatar
| | - Alexander I. Wright
- Section of Pathology, Leeds Institute of Medical Research, University of Leeds, 4.11 Wellcome Trust Brenner Building, St James’s University Hospital, Beckett Street, Leeds, LS9 7TF UK
| | - Gordon G. A. Hutchins
- Leeds Teaching Hospitals NHS Trust/University of Leeds. Histopathology and Molecular Pathology, St James’ University Hospital, Beckett Street, Leeds, LS9 7TF UK
| | - Thurayya Arayssi
- Division of Medical Education, Weill Cornell Medicine-Qatar, 445 East 69 Street, RM 432, New York, NY 10021 USA
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22
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Lee BC, Hsieh ST, Chang YL, Tseng FY, Lin YJ, Chen YL, Wang SH, Chang YF, Ho YL, Ni YH, Chang SC. A Web-Based Virtual Microscopy Platform for Improving Academic Performance in Histology and Pathology Laboratory Courses: A Pilot Study. ANATOMICAL SCIENCES EDUCATION 2020; 13:743-758. [PMID: 31883209 DOI: 10.1002/ase.1940] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/05/2019] [Revised: 12/20/2019] [Accepted: 12/21/2019] [Indexed: 06/10/2023]
Abstract
Virtual microscopy (VM) has been utilized to improve students' learning experience in microscope laboratory sessions, but minimal attention has been given to determining how to use VM more effectively. The study examined the influence of VM on academic performance and teacher and student perceptions and compared laboratory test scores before and after VM incorporation. A total of 662 third-year students studying histology and 651 fourth-year students studying pathology were divided into two groups. The light microscopy (LM) group used a light microscope in 2014 and 2015, while the LM + VM group used the VM platform and a light microscope in 2016 and 2017. Four factors positively predict laboratory scores (R square, 0.323; P < 0.001): (i) the pathology course and test-enhanced learning, (ii) the VM platform and experience, (iii) medical students and lecture scores, and (iv) female students. The LM + VM group exhibited less score variability on laboratory examinations relative to their mean than the LM group. The LM + VM group was also associated with fewer failing grades (F grade; odds ratio, 0.336; P < 0.001) and higher scores (A grade; odds ratio, 2.084; P < 0.001) after controlling for sex, school, course, and lecture grades. The positive effect of the VM platform on laboratory test grades was associated with prior experience using the VM platform and was synergistic with more interim tests. Both teachers and students agreed that the VM platform enhanced laboratory learning. The incorporation of the VM platform in the context of test-enhanced learning may help more students to master microscopic laboratory content.
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Affiliation(s)
- Bai-Chin Lee
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Sung-Tsang Hsieh
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yih-Leong Chang
- Department of Pathology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Fen-Yu Tseng
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Jung Lin
- Center of Faculty Development, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yuh-Lien Chen
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shu-Huei Wang
- Department of Anatomy and Cell Biology, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yu-Fong Chang
- School of Dentistry, National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yi-Lwun Ho
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Yen-Hsuan Ni
- Department of Pediatrics, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
| | - Shan-Chwen Chang
- Department of Internal Medicine, National Taiwan University Hospital and National Taiwan University College of Medicine, Taipei, Taiwan
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23
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Elmore JG, Shucard H, Lee AC, Wang PC, Kerr KF, Carney PA, Drew T, Brunyé TT, Weaver DL. Pathology Trainees' Experience and Attitudes on Use of Digital Whole Slide Images. Acad Pathol 2020; 7:2374289520951922. [PMID: 33088907 PMCID: PMC7545516 DOI: 10.1177/2374289520951922] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2020] [Revised: 06/22/2020] [Accepted: 06/30/2020] [Indexed: 11/15/2022] Open
Abstract
Digital whole slide images are Food and Drug Administration approved for clinical diagnostic use in pathology; however, integration is nascent. Trainees from 9 pathology training programs completed an online survey to ascertain attitudes toward and experiences with whole slide images for pathological interpretations. Respondents (n = 76) reported attending 63 unique medical schools (45 United States, 18 international). While 63% reported medical school exposure to whole slide images, most reported ≤ 5 hours. Those who began training more recently were more likely to report at least some exposure to digital whole slide image training in medical school compared to those who began training earlier: 75% of respondents beginning training in 2017 or 2018 reported exposure to whole slide images compared to 54% for trainees beginning earlier. Trainees exposed to whole slide images in medical school were more likely to agree they were comfortable using whole slide images for interpretation compared to those not exposed (29% vs 12%; P = .06). Most trainees agreed that accurate diagnoses can be made using whole slide images for primary diagnosis (92%; 95% CI: 86-98) and that whole slide images are useful for obtaining second opinions (93%; 95% CI: 88-99). Trainees reporting whole slide image experience during training, compared to those with no experience, were more likely to agree they would use whole slide images in 5 years for primary diagnosis (64% vs 50%; P = .3) and second opinions (86% vs 76%; P = .4). In conclusion, although exposure to whole slide images in medical school has increased, overall exposure is limited. Positive attitudes toward future whole slide image diagnostic use were associated with exposure to this technology during medical training. Curricular integration may promote adoption.
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Affiliation(s)
- Joann G Elmore
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Hannah Shucard
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Annie C Lee
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Pin-Chieh Wang
- Department of Medicine, University of California, Los Angeles, Los Angeles, CA, USA
| | - Kathleen F Kerr
- Department of Biostatistics, University of Washington, Seattle, WA, USA
| | - Patricia A Carney
- Department of Family Medicine, Oregon Health and Science University, Portland, OR, USA
| | - Trafton Drew
- Department of Psychology, University of Utah, Salt Lake City, UT, USA
| | - Tad T Brunyé
- Department of Psychology, Tufts University, Medford, MA, USA
| | - Donald L Weaver
- Department of Pathology and Laboratory Medicine, University of Vermont, Larner College of Medicine, Burlington, VT, USA
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24
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Rodrigues-Fernandes CI, Speight PM, Khurram SA, Araújo ALD, Perez DEDC, Fonseca FP, Lopes MA, de Almeida OP, Vargas PA, Santos-Silva AR. The use of digital microscopy as a teaching method for human pathology: a systematic review. Virchows Arch 2020; 477:475-486. [PMID: 32833038 DOI: 10.1007/s00428-020-02908-3] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/26/2019] [Revised: 07/24/2020] [Accepted: 08/10/2020] [Indexed: 11/24/2022]
Abstract
Since digital microscopy (DM) has become a useful alternative to conventional light microscopy (CLM), several approaches have been used to evaluate students' performance and perception. This systematic review aimed to integrate data regarding the use of DM for education in human pathology, determining whether this technology can be an adequate learning tool, and an appropriate method to evaluate students' performance. Following a specific search strategy and eligibility criteria, three electronic databases were searched and several articles were screened. Eight studies involving medical and dental students were included. The test of performance comprised diagnostic and microscopic description, clinical features, differential, and final diagnoses of the specimens. The students' achievements were equivalent, similar or higher using DM in comparison with CLM in four studies. All publications employed question surveys to assess the students' perceptions, especially regarding the easiness of equipment use, quality of images, and preference for one method. Seven studies (87.5%) indicated the students' support of DM as an appropriate method for learning. The quality assessment categorized most studies as having a low bias risk (75%). This study presents the efficacy of DM for human pathology education, although the high heterogeneity of the included articles did not permit outlining a specific method of performance evaluation.
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Affiliation(s)
- Carla Isabelly Rodrigues-Fernandes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Paul M Speight
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Syed Ali Khurram
- Unit of Oral & Maxillofacial Pathology, School of Clinical Dentistry, University of Sheffield, Sheffield, UK
| | - Anna Luíza Damaceno Araújo
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Danyel Elias da Cruz Perez
- Department of Clinical and Preventive Dentistry, School of Dentistry, Universidade Federal de Pernambuco, Recife, Pernambuco, Brazil
| | - Felipe Paiva Fonseca
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil.,Department of Oral Surgery and Pathology, School of Dentistry, Universidade Federal de Minas Gerais, Belo Horizonte, Minas Gerais, Brazil.,Department of Oral Pathology and Oral biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Márcio Ajudarte Lopes
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Oslei Paes de Almeida
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil
| | - Pablo Agustin Vargas
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil.,Department of Oral Pathology and Oral biology, School of Dentistry, University of Pretoria, Pretoria, South Africa
| | - Alan Roger Santos-Silva
- Oral Diagnosis Department, Semiology and Oral Pathology Areas, Piracicaba Dental School, University of Campinas (UNICAMP), Av. Limeira, 901, Bairro Areão, Piracicaba, São Paulo, 13414-903, Brazil.
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25
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Loeffler AG, Smith M, Way E, Stoffel M, Kurtycz DFI. A Taxonomic Index for Retrieval of Digitized Whole Slide Images from an Electronic Database for Medical School and Pathology Residency Education. J Pathol Inform 2019; 10:33. [PMID: 31799019 PMCID: PMC6883480 DOI: 10.4103/jpi.jpi_34_19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/31/2019] [Revised: 07/29/2019] [Accepted: 09/27/2019] [Indexed: 11/04/2022] Open
Abstract
Since the advent of whole slide imaging, the utility of digitized slides for education in medical school and residency has been amply documented. Pathology departments at most major academic medical centers have made digitized slides available to pathology residents for study, even before the use of digitized slides for clinical purposes (i.e., primary diagnosis) has become commonplace. This article describes the experience of one academic medical center with the storage and indexing of large volumes of digitized slides. Our goal was to be able to retrieve scanned slides for a variety of educational applications and thereby maximize the heuristic value of the slides. This posed a formidable challenge in terms of development and deployment of an index system that would allow exemplary slides to be identified and retrieved irrespective of the purpose for which the slide was scanned. We used the structure inherent in Aperio's image management software (eSlide Manager) to build an educational database that allowed each image to be appended with a unique taxonomic identifier so that the individual files could be retrieved in a flexible and utilitarian manner.
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Affiliation(s)
- Agnes G Loeffler
- Department of Pathology, Metrohealth Medical Center, Cleveland, OH, USA
| | - Mark Smith
- School of Medicine and Public Health, Madison, WI, USA
| | - Elizabeth Way
- School of Medicine and Public Health, Madison, WI, USA
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26
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3D image analysis reveals differences of CD30 positive cells and network formation in reactive and malignant human lymphoid tissue (classical Hodgkin Lymphoma). PLoS One 2019; 14:e0224156. [PMID: 31648255 PMCID: PMC6812863 DOI: 10.1371/journal.pone.0224156] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/03/2019] [Accepted: 10/07/2019] [Indexed: 02/06/2023] Open
Abstract
AIMS The examination of histological sections is still the gold standard in diagnostic pathology. Important histopathological diagnostic criteria are nuclear shapes and chromatin distribution as well as nucleus-cytoplasm relation and immunohistochemical properties of surface and intracellular proteins. The aim of this investigation was to evaluate the benefits and drawbacks of three-dimensional imaging of CD30+ cells in classical Hodgkin Lymphoma (cHL) in comparison to CD30+ lymphoid cells in reactive lymphoid tissues. MATERIALS AND RESULTS Using immunoflourescence confocal microscopy and computer-based analysis, we compared CD30+ neoplastic cells in Nodular Sclerosis cHL (NScCHL), Mixed Cellularity cHL (MCcHL), with reactive CD30+ cells in Adenoids (AD) and Lymphadenitis (LAD). We confirmed that the percentage of CD30+ cell volume can be calculated. The amount in lymphadenitis was approx. 1.5%, in adenoids around 2%, in MCcHL up to 4,5% whereas the values for NScHL rose to more than 8% of the total cell cytoplasm. In addition, CD30+ tumour cells (HRS-cells) in cHL had larger volumes, and more protrusions compared to CD30+ reactive cells. Furthermore, the formation of large cell networks turned out to be a typical characteristic of NScHL. CONCLUSION In contrast to 2D histology, 3D laser scanning offers a visualisation of complete cells, their network interaction and spatial distribution in the tissue. The possibility to differentiate cells in regards to volume, surface, shape, and cluster formation enables a new view on further diagnostic and biological questions. 3D includes an increased amount of information as a basis of bioinformatical calculations.
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Browning L, Colling R, Rittscher J, Winter L, McEntyre N, Verrill C. Implementation of digital pathology into diagnostic practice: perceptions and opinions of histopathology trainees and implications for training. J Clin Pathol 2019; 73:223-227. [PMID: 31597682 DOI: 10.1136/jclinpath-2019-206137] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/02/2019] [Revised: 09/13/2019] [Accepted: 09/19/2019] [Indexed: 11/04/2022]
Abstract
There is increasing interest in the utility of digital pathology in the diagnostic setting. Successful transition requires guidance and training, but additionally an understanding of opinions and attitudes of histopathologists to ensure that potential barriers are addressed. Histopathology trainees as a group are likely to be at the forefront of this revolution, and have specific and as yet largely neglected training needs in this context. We designed an online survey for trainees within our region to capture their opinions and attitudes to digital pathology in the diagnostic setting, and to assess their perceived training needs. This survey indicates overall that these trainees have similar aspirations with regard to the predicted utility of digital pathology and the challenges faced as have been recognised among consultant histopathologists. While their training needs are also largely similar, there are specific additional considerations based around training in multiple centres with varying exposure to digital pathology.
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Affiliation(s)
- Lisa Browning
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Richard Colling
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Jens Rittscher
- Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK.,Big Data Institute, Oxford University, Oxford, UK
| | - Lucinda Winter
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Nicholas McEntyre
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Clare Verrill
- Department of Cellular Pathology, Oxford University Hospitals NHS Foundation Trust, Oxford, UK.,Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
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28
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Cracolici V, Judd R, Golden D, Cipriani NA. Art as a Learning Tool: Medical Student Perspectives on Implementing Visual Art into Histology Education. Cureus 2019; 11:e5207. [PMID: 31565612 PMCID: PMC6758967 DOI: 10.7759/cureus.5207] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Creating visual art to teach and learn histologic concepts is uncommon. A pilot visual art program was developed for use in first-year medical student courses that include histology with the hypothesis that creating visual art would subjectively improve the learning process and lead to learner-based personal incorporation of art into in future learning. Prior to the term, volunteers (n=25) were recruited from 89 first-year medical students. The volunteer group was given art supplies and encouraged to draw histologic images in a free-form setting without restrictions. The control group (n=64) consisted of non-volunteers. Pre- and post-term surveys were distributed to all students, of which 72% and 45% completed the surveys, respectively. Regardless of participation, a majority of students viewed art as a valuable tool to learn medicine prior to and following the term (73% and 82.5%, respectively), however less than half admitted to using art to learn medical concepts (42% and 40%, respectively). In the post-term survey, a higher percentage of students in the experimental group stated they will use art to learn medical concepts in the future (75% vs 40.6%). Most students considered art to be a valuable resource to learn concepts in medicine, including all the students who participated in the art program. Based on the number of students who reported intent to change behavior, the initial hypothesis is supported. Many students favor incorporation of visual art into medical education, we believe that creating visual art may be a worthwhile adjunct tool for histology education.
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Affiliation(s)
| | - Ryan Judd
- Medical Education, The University of Chicago Pritzker School of Medicine, Chicago, USA
| | - Daniel Golden
- Radiation and Cellular Oncology, University of Chicago Medical Center, Chicago, USA
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