1
|
Arya DM, Gupta S, Kapatia G, Kumari N. Commentary on "Benchtop fine needle aspirations: An untapped source of cytologic educational material". Diagn Cytopathol 2024; 52:540-541. [PMID: 38812456 DOI: 10.1002/dc.25362] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/13/2024] [Accepted: 05/20/2024] [Indexed: 05/31/2024]
Affiliation(s)
- Divyanshu Mohan Arya
- Department of Pathology and Lab Medicine, All Institute of Medical Sciences, Raebareli, India
| | - Shruti Gupta
- Department of Pathology and Lab Medicine, All Institute of Medical Sciences, Raebareli, India
| | - Gargi Kapatia
- Department of Pathology and Lab Medicine, All Institute of Medical Sciences, Bhatinda, India
| | - Niraj Kumari
- Department of Pathology and Lab Medicine, All Institute of Medical Sciences, Raebareli, India
| |
Collapse
|
2
|
Wu Y, Lepe M. Benchtop fine needle aspirations: An untapped source of cytologic educational material. Diagn Cytopathol 2024; 52:E48-E53. [PMID: 37991114 DOI: 10.1002/dc.25257] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2023] [Revised: 11/09/2023] [Accepted: 11/10/2023] [Indexed: 11/23/2023]
Abstract
Fine needle aspirations (FNAs) are a valuable tool for the diagnosis of a wide variety of lesions. However, obtaining proficiency in performing FNAs and finding simulated scenarios where one can practice specimen adequacy and slide smearing can all be challenging. Benchtop FNAs of fresh surgical specimens offer a novel training opportunity that addresses these needs. In this study, we describe the feasibility and practicality of benchtop FNAs of fresh surgical specimens as a training tool. We performed benchtop FNAs on multiple specimen types, although most were partial and radical nephrectomies. We documented this approach to cytology training and have provided examples of slides that were generated, along with the surgical pathology correlate. Our results suggest that benchtop FNAs of fresh surgical specimens can be a valuable training tool in the arsenal of today's cytopathologist. This technique offers several advantages over traditional training methods, including the ability to generate high-quality cytology slides, provide cyto-histo correlation, and practice almost immediate gross-microscopic correlation. However, there are also some disadvantages to this approach, including the need for immediate access to fresh surgical specimens and the potential for artifacts to be introduced. Overall, we believe that benchtop FNAs of fresh surgical specimens offer a promising new training tool that can maximize training opportunities, especially in institutions where the FNA volume is low.
Collapse
Affiliation(s)
- Yubo Wu
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| | - Marcos Lepe
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, Massachusetts, USA
- Harvard Medical School, Boston, Massachusetts, USA
| |
Collapse
|
3
|
Torres-Rivas HE, Fernández Fernández LM, González Gutiérrez MDLP, Berríos Hernández ML, Pérez Fontán JF, Chandra A, Caputo A, Dávila Lemos AB, Villar Zarra K. Resident training in interventional pathology: Ultrasound-guided fine-needle aspiration and rapid on site evaluation-5 years of teaching experience in a single university hospital. Cytopathology 2024. [PMID: 38197485 DOI: 10.1111/cyt.13355] [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: 11/28/2023] [Revised: 01/02/2024] [Accepted: 01/03/2024] [Indexed: 01/11/2024]
Abstract
INTRODUCTION Despite the established role of the interventional pathologist, their diagnostic performance is difficult to establish. At least in Spain training of pathology residents in ultrasound-guided interventional procedures for specimen collection is limited or absent in most institutions. We present our teaching experience in the instruction of ultrasound-guided fine-needle aspiration (FNA) to pathology residents in a tertiary-level hospital. MATERIALS AND METHODS The training of pathology residents who rotated through the interventional unit of the pathology department and the application of ultrasound-guided FNA and rapid on-site evaluation (U-ROSE) was documented over 5 years. The training period was broken down into learning phases and included the number of ultrasound-guided FNA performed, anatomical location, and their diagnostic performance, among other aspects. RESULTS Nineteen (19) pathology residents were trained in U-ROSE, and performed a total of 4003 procedures, with a mean of 211 per resident. In 53% of cases only one pass was required for an adequated sample. The specimen was diagnostic in more than 97% of cases. The most frequently sampled anatomical sites were the thyroid gland (n = 2347), followed by lymph node (n = 667), soft tissues (n = 663) and salivary glands (n = 322). CONCLUSION The results support the training programme followed by pathology residents in learning U-ROSE, which is essential to lay the foundations for the future interventional pathologist.
Collapse
Affiliation(s)
| | | | | | | | | | - Ashish Chandra
- Cellular Pathology Department, Guy's and St Thomas' NHS Foundation Trust, London, UK
| | - Alessandro Caputo
- Department of Medicine and Surgery, University of Salerno, Salerno, Italy
| | | | | |
Collapse
|
4
|
Alcaraz-Mateos E, Exposito-Afonso IJ, Labiano-Miravalles T, Pijuan L, Temprana-Salvador J, Zhao Q, Jiang XS. How do cytopathologists learn fine needle aspiration techniques? An international survey. Cytopathology 2023. [PMID: 38146771 DOI: 10.1111/cyt.13352] [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: 09/13/2023] [Revised: 12/04/2023] [Accepted: 12/15/2023] [Indexed: 12/27/2023]
Abstract
INTRODUCTION Fine needle aspiration cytology (FNAC) is a widely accepted diagnostic technique, but performance varies according to expertise. Little is known about variation in FNAC training practices worldwide. We surveyed pathologists using social media networks to determine FNAC training practices internationally. DESIGN Pathologists were surveyed on questions related to FNAC simulation training using direct messaging on the Twitter and WhatsApp platforms. Survey responses over a period of 2 weeks were collected. RESULTS In total, 149 pathologists participated (96.1% response rate). The respondents came from 24 countries and 87 institutions. The majority of the pathologists (63.8%) performed FNAC directly on patients for the first time. Only 36.2% of them had simulation instruction during their training. It was performed on food items such as fruit (64.8%), surgical specimens (37.0%), autopsies (13.0%) and others (9.3%), including commercially available phantom simulators for ultrasound-guided FNAC (US-FNAC) (two pathologists). DISCUSSION Most pathologists did not receive formal training in a simulated environment, and of the pathologists who had simulation instruction, food items were commonly used for education. A few participants used a commercial US-FNAC simulator, but since most pathologists perform FNAC by palpation, this method of simulation training is not applicable to many practices. Social media is an effective and efficient way to perform survey research, yielding a very high response rate.
Collapse
Affiliation(s)
| | | | | | - Lara Pijuan
- Pathology Department, Bellvitge University Hospital, Barcelona, Spain
| | | | - Qing Zhao
- Faculty of Medicine, Peking Union Medical College, Beijing, China
| | | |
Collapse
|
5
|
Marcos R, Fonte-Oliveira L, Santos M, Caniatti M. An immersive simulation strategy to teach cytology sample collection methods and basic diagnosis skills: A two academic center study. Vet Clin Pathol 2023; 52:722-731. [PMID: 37460418 DOI: 10.1111/vcp.13280] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/25/2023] [Revised: 04/29/2023] [Accepted: 05/25/2023] [Indexed: 12/29/2023]
Abstract
BACKGROUND Collecting cytology samples and making simple diagnoses are skills taught in veterinary universities, mostly in a passive way. Simulators enhance practical skills learning, increasing student engagement through immersive activities. These strategies have not been carefully assessed in veterinary cytology. OBJECTIVES This study aimed to describe a simulator developed for training cytology sample collection methods and assess the utility of an immersive simulation strategy to learn and practice the collection of cytology samples. METHODS A flipped classroom with a station design was followed. Students first watched video tutorials on sampling collection, listened to brief cases' clinical histories, and moved to immersive simulator stations. There, they practiced imprints, swabs, and fine-needle aspiration (FNA). Microscopic observation of the material was available through augmented reality tools. Students were evaluated by Objective Structured Clinical Examination (OSCE) tools on their ability to perform FNA on stuffed animal models. Students answered two questionnaires addressing their learning outcomes. RESULTS Second- and third-year students from two centers (n = 129) practiced cytologic collection methods in simulators which significantly changed their willingness to perform FNA in live animals after the class activities. OSCE pass rates over 90% were obtained for most steps of FNA, and students rated the activity as essential/very relevant for learning. CONCLUSIONS Immersive simulation strategies were effective at increasing student comfort with cytologic sampling techniques. This approach should be included in the veterinary curriculum as it can increase the quality of cytology samples and could potentially improve the cytologic diagnosis of a submitted sample.
Collapse
Affiliation(s)
- Ricardo Marcos
- Cytology and Hematology Diagnostic Services, Laboratory of Histology and Embryology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Luísa Fonte-Oliveira
- Cytology and Hematology Diagnostic Services, Laboratory of Histology and Embryology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Marta Santos
- Cytology and Hematology Diagnostic Services, Laboratory of Histology and Embryology, School of Medicine and Biomedical Sciences (ICBAS), University of Porto, Porto, Portugal
| | - Mario Caniatti
- Dipartimento di Medicina Veterinaria e Scienze Animali (DIVAS), Università degli Studi di Milano, Milan, Italy
| |
Collapse
|
6
|
Zhao X, Ersoy E, Ng DL. Comparison of low-cost phantoms for ultrasound-guided fine-needle aspiration biopsy training. J Am Soc Cytopathol 2023; 12:275-283. [PMID: 37085429 PMCID: PMC10330098 DOI: 10.1016/j.jasc.2023.03.005] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2023] [Revised: 03/20/2023] [Accepted: 03/22/2023] [Indexed: 04/23/2023]
Abstract
INTRODUCTION Phantoms and simulators are widely accepted methods to gain valuable experience and confidence for inexperienced trainees prior to seeing their patient and for refining their skills. A phantom model that is durable, simple, and inexpensive to produce and use would be ideal to train practitioners in ultrasound-guided fine-needle aspiration biopsy (USFNA) technique. MATERIALS AND METHODS In this study, we systematically compared several low-cost phantom models including gelatin, extra firm tofu, canned cooked pork, ballistics gel, and chicken breast for their haptic properties, echogenicity, teaching utility, and overall performance based on a Likert scale (1-5; 5 = best). Nine cytopathologists and cytopathology fellows who perform FNA regularly evaluated these models and completed the survey. RESULTS The gelatin phantom, with a gelatin to water ratio of 1:8 by weight, was found to be the best for USFNA practice and overall performance, followed by the 1:10 gelatin phantom. Tofu and chicken breast phantoms were also good low-cost alternatives that needed only a few minutes of total preparation time. CONCLUSIONS Low-cost, homemade phantoms can serve as excellent alternatives to commercial phantoms for practicing and teaching USFNA.
Collapse
Affiliation(s)
- Xiaofeng Zhao
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Esma Ersoy
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York
| | - Dianna L Ng
- Department of Pathology, Memorial Sloan Kettering Cancer Center, New York, New York.
| |
Collapse
|
7
|
Buléon C, Mattatia L, Minehart RD, Rudolph JW, Lois FJ, Guillouet E, Philippon AL, Brissaud O, Lefevre-Scelles A, Benhamou D, Lecomte F, group TSAWS, Bellot A, Crublé I, Philippot G, Vanderlinden T, Batrancourt S, Boithias-Guerot C, Bréaud J, de Vries P, Sibert L, Sécheresse T, Boulant V, Delamarre L, Grillet L, Jund M, Mathurin C, Berthod J, Debien B, Gacia O, Der Sahakian G, Boet S, Oriot D, Chabot JM. Simulation-based summative assessment in healthcare: an overview of key principles for practice. ADVANCES IN SIMULATION (LONDON, ENGLAND) 2022; 7:42. [PMID: 36578052 PMCID: PMC9795938 DOI: 10.1186/s41077-022-00238-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/02/2022] [Accepted: 11/30/2022] [Indexed: 12/29/2022]
Abstract
BACKGROUND Healthcare curricula need summative assessments relevant to and representative of clinical situations to best select and train learners. Simulation provides multiple benefits with a growing literature base proving its utility for training in a formative context. Advancing to the next step, "the use of simulation for summative assessment" requires rigorous and evidence-based development because any summative assessment is high stakes for participants, trainers, and programs. The first step of this process is to identify the baseline from which we can start. METHODS First, using a modified nominal group technique, a task force of 34 panelists defined topics to clarify the why, how, what, when, and who for using simulation-based summative assessment (SBSA). Second, each topic was explored by a group of panelists based on state-of-the-art literature reviews technique with a snowball method to identify further references. Our goal was to identify current knowledge and potential recommendations for future directions. Results were cross-checked among groups and reviewed by an independent expert committee. RESULTS Seven topics were selected by the task force: "What can be assessed in simulation?", "Assessment tools for SBSA", "Consequences of undergoing the SBSA process", "Scenarios for SBSA", "Debriefing, video, and research for SBSA", "Trainers for SBSA", and "Implementation of SBSA in healthcare". Together, these seven explorations provide an overview of what is known and can be done with relative certainty, and what is unknown and probably needs further investigation. Based on this work, we highlighted the trustworthiness of different summative assessment-related conclusions, the remaining important problems and questions, and their consequences for participants and institutions of how SBSA is conducted. CONCLUSION Our results identified among the seven topics one area with robust evidence in the literature ("What can be assessed in simulation?"), three areas with evidence that require guidance by expert opinion ("Assessment tools for SBSA", "Scenarios for SBSA", "Implementation of SBSA in healthcare"), and three areas with weak or emerging evidence ("Consequences of undergoing the SBSA process", "Debriefing for SBSA", "Trainers for SBSA"). Using SBSA holds much promise, with increasing demand for this application. Due to the important stakes involved, it must be rigorously conducted and supervised. Guidelines for good practice should be formalized to help with conduct and implementation. We believe this baseline can direct future investigation and the development of guidelines.
Collapse
Affiliation(s)
- Clément Buléon
- grid.460771.30000 0004 1785 9671Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, 6th Floor, Caen, France ,grid.412043.00000 0001 2186 4076Medical School, University of Caen Normandy, Caen, France ,grid.419998.40000 0004 0452 5971Center for Medical Simulation, Boston, MA USA
| | - Laurent Mattatia
- grid.411165.60000 0004 0593 8241Department of Anesthesiology, Intensive Care and Perioperative Medicine, Nîmes University Hospital, Nîmes, France
| | - Rebecca D. Minehart
- grid.419998.40000 0004 0452 5971Center for Medical Simulation, Boston, MA USA ,grid.32224.350000 0004 0386 9924Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Jenny W. Rudolph
- grid.419998.40000 0004 0452 5971Center for Medical Simulation, Boston, MA USA ,grid.32224.350000 0004 0386 9924Department of Anesthesia, Critical Care and Pain Medicine, Massachusetts General Hospital, Boston, MA USA ,grid.38142.3c000000041936754XHarvard Medical School, Boston, MA USA
| | - Fernande J. Lois
- grid.4861.b0000 0001 0805 7253Department of Anesthesiology, Intensive Care and Perioperative Medicine, Liège University Hospital, Liège, Belgique
| | - Erwan Guillouet
- grid.460771.30000 0004 1785 9671Department of Anesthesiology, Intensive Care and Perioperative Medicine, Caen Normandy University Hospital, 6th Floor, Caen, France ,grid.412043.00000 0001 2186 4076Medical School, University of Caen Normandy, Caen, France
| | - Anne-Laure Philippon
- grid.411439.a0000 0001 2150 9058Department of Emergency Medicine, Pitié Salpêtrière University Hospital, APHP, Paris, France
| | - Olivier Brissaud
- grid.42399.350000 0004 0593 7118Department of Pediatric Intensive Care, Pellegrin University Hospital, Bordeaux, France
| | - Antoine Lefevre-Scelles
- grid.41724.340000 0001 2296 5231Department of Emergency Medicine, Rouen University Hospital, Rouen, France
| | - Dan Benhamou
- grid.413784.d0000 0001 2181 7253Department of Anesthesiology, Intensive Care and Perioperative Medicine, Kremlin Bicêtre University Hospital, APHP, Paris, France
| | - François Lecomte
- grid.411784.f0000 0001 0274 3893Department of Emergency Medicine, Cochin University Hospital, APHP, Paris, France
| | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | | |
Collapse
|
8
|
Olvera-Cortés HE, Hernández-Gutiérrez LS, Scherer-Castanedo E, Ramírez-Arias JD, Argueta Muñoz FD, Gutiérrez-Barreto SE. Who Can Debriefing Assessment for Simulation in Healthcare? Different Perspectives on Teledebriefing Assessments. Simul Healthc 2022; 17:308-312. [PMID: 35136006 DOI: 10.1097/sih.0000000000000642] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
INTRODUCTION Virtual debriefing is a cardinal element to achieve the effectiveness of telesimulation. There are different instruments to assess face-to-face debriefing to determine the degree of effectiveness of debriefing; Debriefing Assessment for Simulation in Healthcare (DASH) instrument is one of them. This study aims to describe and compare the evaluation of raters, instructors, and students during a virtual debriefing using the DASH. METHODS A cross-sectional study was performed evaluating the virtual debriefing of 30 instructors after a heart failure telesimulation scenario. The evaluation was conducted by 30 instructors, 338 undergraduate students in the seventh semester, and 7 simulation raters. The 3 versions of the DASH instrument in Spanish were applied, respectively. RESULTS Two comparisons were made, student versus instructor and rater versus instructor. Cronbach α was 0.97 for each version. The averages of the results on the DASH instrument were: 6.61 (3.34-7.0), 5.95 (4.65-7.0), and 4.84 (2.68-6.02) for student, rater, and instructor versions, respectively. The size effect between student and debriefer perspectives was 0.42. In contrast, the size effect between instructor and rater was 0.72. All differences were significant. CONCLUSIONS There are different rates between the persons who use the DASH. In this study, from the perspective of the instructor and rater, the difference was 1 point with a wide range, in contrast with the difference between instructor and student, which is relatively minor. It is necessary to consider the perspectives of experts in the subject to achieve a virtual debriefing of high quality and improve a debriefing by using the DASH.
Collapse
Affiliation(s)
- Hugo E Olvera-Cortés
- From the Department of Integration of Medical Sciences, Faculty of Medicine, National Autonomous University of Mexico, Mexico City, Mexico
| | | | | | | | | | | |
Collapse
|
9
|
Stowe DM, Fiebrandt KE, Druley GE, Taylor AJ. Implementation of a Fine Needle Aspirate Simulation Model. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:432-436. [PMID: 34003730 DOI: 10.3138/jvme-2020-0157] [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: 06/12/2023]
Abstract
Being able to appropriately perform fine needle aspiration (FNA) collecting techniques and sample preparation is essential in obtaining a diagnostic sample, which is a critical skill for veterinary practitioners. Collection and preparation of cytologic samples are skills gained through practice. Experience leads to refinement of technique and improved diagnostic quality. Using live patients for mass skills training is not feasible; therefore, an aspiration simulation model and laboratory session was developed to reinforce physical exam skills, appropriate selection of sample collection supplies, and collection technique. Materials for the models include Ping-Pong balls, silicone, instant vanilla pudding mix, water, and stuffed animals. The laboratory session allows veterinary students to practice lesion identification, isolation, aspiration, and successful preparation. Subsequent submission of the collected sample involves being able to expel and spread the sample on a slide and proper labeling. While the simulation experience was initially developed for a short course with 12 students, it has recently been incorporated into the required clinical pathology clinical year rotation for up to 100 fourth-year veterinary students. The model is inexpensive and efficient and allows for technique development and immediate instructor assessment and feedback.
Collapse
|
10
|
Alcaraz-Mateos E, Mirza KM, Molina-Valverde S, Togkaridou M, Caballero-Alemán F, Poblet E. The utility of a gross dissection anatomical model for simulation-based learning in pathology. REVISTA ESPANOLA DE PATOLOGIA : PUBLICACION OFICIAL DE LA SOCIEDAD ESPANOLA DE ANATOMIA PATOLOGICA Y DE LA SOCIEDAD ESPANOLA DE CITOLOGIA 2022; 55:149-155. [PMID: 35779880 DOI: 10.1016/j.patol.2022.02.001] [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: 01/28/2022] [Revised: 02/11/2022] [Accepted: 02/14/2022] [Indexed: 06/15/2023]
Abstract
INTRODUCTION The examination of morphological alterations in tissues is fundamental in Pathology. Traditional training in gross dissection has several limitations, including the risk of transmissible diseases, formaldehyde exposure and limited specimen availability. We describe a teaching method using anatomical simulators. METHODS Liquid silicone-based artisan neoplastic anatomical models were used in conjunction with clinical scenarios. Eighty-five medical students participated in a gross dissection experience and were asked to complete a feedback questionnaire. Additionally, a workshop was organized for students to compare three different teaching methods. The first one used still images (Group1-G1), the second a video explanation (Group2-G2), and the third directly observed a pathologist while grossing (Group3-G3). RESULTS The knowledge acquisition questionnaire showed an average value of 4.4 out of 5 (1-5) (range 3.4-4.7, σ0.89). The categories 'knowledge of resection margins' and 'macroscopic diagnosis' received the highest values (4.8, σ0.11 and 4.7, σ0.32, respectively), followed by 'understanding of handling and gross examination of the surgical specimen' (4.5, σ0.49), 'prognosis' (4.3, σ0.67) and 'understanding of a tumor resection' (3.9, σ0.96) (p<0.05). Regarding teaching methods, G3 spent less time than G2 and G1 with mean times of 15'39″ (σ2'12″), 16'50″ (σ3'45″), and 17'52″ (σ2'12″), respectively (p<0.05). Gross dissection marks (0-5) showed statistically significant differences (p<0.05). G2 obtained better results (3.7;σ0.54) than G3 (3.4;σ0.94) or G1 (3.1;σ0.8). CONCLUSIONS This preliminary study demonstrates that it is possible to implement a gross dissection simulation module at medical school and thus enable the acquisition of skills in a secure environment.
Collapse
Affiliation(s)
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University, Chicago, USA
| | - Sara Molina-Valverde
- Internal Medicine Department, Virgen de la Arrixaca University Hospital, Murcia, Spain
| | | | | | - Enrique Poblet
- Department of Pathology, Reina Sofía University Hospital, Murcia, Spain; Faculty of Medicine, University of Murcia, Spain
| |
Collapse
|
11
|
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.
Collapse
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:
| |
Collapse
|
12
|
Pires JL, Payo P, Marcos R. A utilização de simuladores para o ensino da punção de agulha fina em medicina veterinária. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:138-143. [PMID: 35120303 DOI: 10.3138/jvme-2020-0036.pt] [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: 06/14/2023]
Abstract
A punção de agulha fina (PAF) é amplamente utilizada por veterinários, sendo ensinada maioritariamente por observação. Atualmente, considera-se que a utilização de simuladores melhora a aprendizagem de procedimentos práticos. No entanto, simuladores de PAF ainda não foram avaliados em Medicina Veterinária. Cinquenta e um estudantes de Veterinária sem experiência prévia em Citologia foram distribuídos aleatoriamente em dois grupos que usaram um simulador (caixa com nódulos artificiais) e uma peça de fruta (banana). Foi utilizado um desenho de aula invertida com estações: primeiramente, os estudantes observaram um vídeo tutorial sobre a PAF, utilizando em seguida o simulador ou a peça de fruta durante um máximo de 15 minutos. Depois, os estudantes efetuaram o procedimento num modelo animal realista, realizando-se uma avaliação clínica objetiva estruturada (ACOE). A aprendizagem através dos modelos foi comparada por meio de questionários, taxa de aprovação em ACOE e qualidade dos esfregaços obtidos. Após observar o vídeo tutorial, nenhum estudante manifestou ser capaz de fazer a PAF num animal vivo. Por oposição, a maioria revelou ser capaz após a simulação. Os estudantes praticaram mais tempo na caixa (14,8 ± 0,8 min) do que na peça de fruta (8,5 ± 2,2 min). Na avaliação, os primeiros tinham maior precisão na PAF. Ainda assim, não existiram diferenças na taxa de aprovação em ACOE. Portanto, os dois modelos são eficazes para a aprendizagem da PAF, mas a caixa tem vantagens quanto à repetição autónoma da prática. Essa repetição parece ter efeitos positivos na precisão da PAF, o que tem relevância do ponto de vista clínico.
Collapse
|
13
|
Luís Pires J, Payo P, Marcos R. The Use of Simulators for Teaching Fine Needle Aspiration Cytology in Veterinary Medicine. JOURNAL OF VETERINARY MEDICAL EDUCATION 2022; 49:39-44. [PMID: 34003735 DOI: 10.3138/jvme-2020-0036] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/12/2023]
Abstract
Fine needle aspiration (FNA) is widely used by veterinary practitioners, being taught mostly by observation. Simulators are known to enhance students' learning of practice skills, but to our knowledge, FNA simulators have never been assessed in veterinary medicine. Fifty-one undergraduate students with no prior experience in cytology were randomly assigned to two groups that practiced on either a box simulator (with artificial nodules) or a fruit (banana). An in-class flip was followed, in which students first observed a FNA video tutorial and then used their assigned simulator for 15 minutes maximum. Students then attempted a FNA on an animal model and were evaluated through an objective structured clinical examination (OSCE). Learning outcomes of each model was compared through questionnaires, OSCE pass rates, and quality of produced smears. After observing the video, no student reported being able to conduct a FNA on a live animal, whereas most assured that they would be able to do so after using a simulator. Students practiced more on the box model (14.8 ± 0.8 min) than on the fruit (8.5 ± 2.2 min). At evaluation, students who had practiced on the box had more puncturing accuracy than those who had practiced on the fruit. Still, no differences in OSCE pass rates existed. Simulation models thus were effective for learning FNA, but the box simulator seemed to be more successful than the fruit in terms of deliberate practice. This appears to have a positive effect on students' puncturing accuracy, which has clinical relevance.
Collapse
|
14
|
Jiang X“S, Foo WC. Teaching interventional cytopathology. Semin Diagn Pathol 2022; 39:405-409. [DOI: 10.1053/j.semdp.2022.01.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/05/2021] [Accepted: 01/12/2022] [Indexed: 11/11/2022]
|
15
|
Poblet E. [Teaching/learning innovation of Anatomic Pathology at the Medical School]. REVISTA ESPAÑOLA DE PATOLOGÍA : PUBLICACIÓN OFICIAL DE LA SOCIEDAD ESPAÑOLA DE ANATOMÍA PATOLÓGICA Y DE LA SOCIEDAD ESPAÑOLA DE CITOLOGÍA 2021; 54:217-219. [PMID: 34544551 DOI: 10.1016/j.patol.2021.06.001] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/07/2021] [Accepted: 06/08/2021] [Indexed: 10/21/2022]
Affiliation(s)
- Enrique Poblet
- Catedrático de Anatomía Patológica, Hospital General Universitario Reina Sofía y Universidad de Murcia, Murcia, España.
| |
Collapse
|
16
|
Kebe Radulović M, Vivoda Tomšič M, Cimerman D, Gutnik H, Strojan Fležar M. A novel combined animal tissue model for freehand and ultrasound-guided fine needle aspiration biopsy and smear preparation techniques training. Diagn Cytopathol 2020; 49:39-45. [PMID: 32822083 DOI: 10.1002/dc.24578] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Revised: 07/06/2020] [Accepted: 07/20/2020] [Indexed: 11/10/2022]
Abstract
OBJECTIVE A variety of models are used for fine needle aspiration biopsy (FNAB) and smear preparation techniques training: human, animal and silicon models or combined models. We present fresh animal tissues as models for freehand and ultrasound (US)-guided FNAB technique training, enabling an integrated approach from tumour detection to smear evaluation. METHODS We introduced a novel combined animal tissue model using dietary animal meat with covering skin as a substrate. Animal liver tissue of various sizes, representing tumour, was inserted into the various layers of the substrate (subcutaneous fat, muscle tissue, proximity of bone). Freehand and US-guided FNAB smear preparation, including fixation, was then performed and assessed. RESULTS The use of a combined animal tissue model for 6 freehand and 3 US-guided FNAB sessions showed a statistically significant improvement in the US-guided FNAB retrieval of liver tissue (Fisher's exact test, p = .0216), in smear preparation technique reflected in a decrease in the number of too thick smears after freehand FNAB (Fisher's exact test, p = .0070), in the overall number of smears satisfactory for evaluation by US-guided FNAB (Fisher's exact test, p = .0206) and in the number of flawless smears obtained in the freehand FNAB training sessions (Fisher's exact test, p = .0020). CONCLUSIONS A unique advantage of the presented model encompassing various layers of animal tissues with covering skin, offers an integrated approach for FNAB training from "tumour" detection, puncture precision, to smear preparation and cytological evaluation for a wider audience and does not compromise patient safety.
Collapse
Affiliation(s)
- Maja Kebe Radulović
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | | - Damjana Cimerman
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Helena Gutnik
- Institute of Pathology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | | |
Collapse
|