1
|
Başer A, Büyük B. Bridging the gap in medical education: comparing analysis of light microscopy and virtual microscopy in histology. PeerJ 2024; 12:e17695. [PMID: 39026537 PMCID: PMC11257044 DOI: 10.7717/peerj.17695] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/01/2024] [Accepted: 06/14/2024] [Indexed: 07/20/2024] Open
Abstract
This study aims to investigate the impact of virtual microscopy (VM) and light microscopy (LM) on the satisfaction of second-year medical students and how they affect student performance in different educational settings. The research involved 94 second-year students from Izmir Democracy University's School of Medicine, with criteria requiring enrollment in the 2021-2022 academic year and attendance of at least 80% in histology practical course. A paired two-tailed t-test was used for comparison, with a researcher-designed questionnaire for data collection. Cronbach's alpha was 0.894 for the LM questionnaire, and 0.918 for the VM questionnaire, indicating high level of reliability. LM scored higher in the questionnaire (p = 0.010), but VM showed higher exam averages (p = 0.013). The study found VM more effective in exams, with students showing high satisfaction with LM. VM's accessibility to histological preparations and its impact on learning levels and board exam success rates were noted. The study concludes that while VM is becoming essential in histology education due to its positive impact on exam performance and accessibility, LM remains highly valued by students for its hands-on experience and satisfaction levels.
Collapse
Affiliation(s)
- Aysel Başer
- Department of Medical Education, Faculty of Medicine, Izmir Democracy University, İzmir, Konak, Turkey
| | - Başak Büyük
- Department of Histology and Embryology, Faculty of Medicine, Izmir Democracy University, İzmir, Konak, Turkey
| |
Collapse
|
2
|
Cai C, Zhou Y, Jiao Y, Li L, Xu J. Prognostic Analysis Combining Histopathological Features and Clinical Information to Predict Colorectal Cancer Survival from Whole-Slide Images. Dig Dis Sci 2024:10.1007/s10620-024-08501-x. [PMID: 38837111 DOI: 10.1007/s10620-024-08501-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/09/2024] [Accepted: 05/13/2024] [Indexed: 06/06/2024]
Abstract
BACKGROUND Colorectal cancer (CRC) is a malignant tumor within the digestive tract with both a high incidence rate and mortality. Early detection and intervention could improve patient clinical outcomes and survival. METHODS This study computationally investigates a set of prognostic tissue and cell features from diagnostic tissue slides. With the combination of clinical prognostic variables, the pathological image features could predict the prognosis in CRC patients. Our CRC prognosis prediction pipeline sequentially consisted of three modules: (1) A MultiTissue Net to delineate outlines of different tissue types within the WSI of CRC for further ROI selection by pathologists. (2) Development of three-level quantitative image metrics related to tissue compositions, cell shape, and hidden features from a deep network. (3) Fusion of multi-level features to build a prognostic CRC model for predicting survival for CRC. RESULTS Experimental results suggest that each group of features has a particular relationship with the prognosis of patients in the independent test set. In the fusion features combination experiment, the accuracy rate of predicting patients' prognosis and survival status is 81.52%, and the AUC value is 0.77. CONCLUSION This paper constructs a model that can predict the postoperative survival of patients by using image features and clinical information. Some features were found to be associated with the prognosis and survival of patients.
Collapse
Affiliation(s)
- Chengfei Cai
- School of Automation, Nanjing University of Information Science and Technology, Nanjing, 210044, China.
- College of Information Engineering, Taizhou University, Taizhou, 225300, China.
- Institute for AI in Medicine, School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing, 210044, China.
| | - Yangshu Zhou
- Department of Pathology, Zhujiang Hospital of Southern Medical University, Guangzhou, 510280, China
| | - Yiping Jiao
- Institute for AI in Medicine, School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| | - Liang Li
- Department of Pathology, Nanfang Hospital of Southern Medical University, Guangzhou, 510515, China
| | - Jun Xu
- Institute for AI in Medicine, School of Artificial Intelligence, Nanjing University of Information Science and Technology, Nanjing, 210044, China
| |
Collapse
|
3
|
Williams BJ. Practical guide to the use of digital slides in histopathology education. J Clin Pathol 2024; 77:366-371. [PMID: 38548321 PMCID: PMC11103283 DOI: 10.1136/jcp-2024-209415] [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: 01/19/2024] [Accepted: 01/20/2024] [Indexed: 05/19/2024]
Abstract
Digital pathology (the technology whereby glass histology slides are scanned at high resolution, digitised, stored and shared with pathologists, who can view them using microscopy software on a screen) is transforming the delivery of clinical diagnostic pathology services around the world. In addition to adding value to clinical histopathology practice, digital histology slides provide a versatile medium to achieve the educational needs of a variety of learners including undergraduate students, postgraduate doctors in training and those pursuing continuing professional development portfolios. In this guide, we will review the principal use cases for digital slides in training and education and I will share tips for successful use of digital pathology to support a range of learners based on experience gathered at Leeds Teaching Hospitals National Health Service Trust and the National Pathology Imaging Co-Operative during the last 5 years of digital slide usage.
Collapse
Affiliation(s)
- Bethany Jill Williams
- National Pathology Imaging Co-Operative, Leeds Teaching Hospitals NHS Trust, Leeds, UK
- University of Leeds, Leeds, UK
| |
Collapse
|
4
|
Cima L, Bussola N, Hassell LA, Kiehl TR, Schukow C, Zerbe N, Munari E, Torresani E, Barbareschi M, Cecchini MJ, Cirielli V, Pagliuca F, Ahsan M, Mohanty SK, Arbitrio E, Hughes G, Mirza KM. Evolving educational landscape in pathology: a comprehensive bibliometric and visual analysis including digital teaching and learning resources. J Clin Pathol 2024; 77:87-95. [PMID: 38123966 DOI: 10.1136/jcp-2023-209203] [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: 09/20/2023] [Accepted: 12/01/2023] [Indexed: 12/23/2023]
Abstract
AIMS Pathology education is a core component of medical training, and its literature is critical for refining educational modalities. We performed a cross-sectional bibliometric analysis to explore publications on pathology education, focusing on new medical education technologies. METHODS The analysis identified 64 pathology journals and 53 keywords. Relevant articles were collected using a web application, PaperScraper, developed to accelerate literature search. Citation data were collected from multiple sources. Descriptive statistics, with time period analysis, were performed using Microsoft Excel and visualised with Flourish Studio. Two article groups were further investigated with a bibliometric software, VOSViewer, to establish co-authorship and keyword relationships. RESULTS 8946 citations were retrieved from 905 selected articles. Most articles were published in the last decade (447, 49.4%). The top journals were Archives of Pathology & Laboratory Medicine (184), Human Pathology (122) and the American Journal of Clinical Pathology (117). The highest number of citations was found for Human Pathology (2120), followed by Archives of Pathology & Laboratory Medicine (2098) and American Journal of Clinical Pathology (1142). Authors with different backgrounds had the greatest number of articles and citations. 12 co-authorship, 3 keyword and 8 co-citation clusters were found for the social media/online resources group, 8 co-authorship, 4 keyword and 7 co-citation clusters for the digital pathology/virtual microscopy/mobile technologies group. CONCLUSIONS The analysis revealed a significant increase in publications over time. The emergence of digital teaching and learning resources played a major role in this growth. Overall, these findings underscore the transformative potential of technology in pathology education.
Collapse
Affiliation(s)
- Luca Cima
- Department of Laboratory Medicine, Pathology Unit, Santa Chiara University Hospital, APSS, Trento, Italy
| | - Nicole Bussola
- Department of Psychiatry, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Lewis A Hassell
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, Oklahoma, USA
| | - Tim-Rasmus Kiehl
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Casey Schukow
- Department of Pathology, Corewell Health's Beaumont Hospital, Royal Oak, Michigan, USA
| | - Norman Zerbe
- Charité-Universitätsmedizin Berlin, Corporate Member of Freie Universität Berlin and Humboldt-Universität zu Berlin, Institute of Pathology, Berlin, Germany
| | - Enrico Munari
- Department of Molecular and Translational Medicine, Pathology Unit, University of Brescia, Brescia, Italy
| | - Evelin Torresani
- Department of Laboratory Medicine, Pathology Unit, Santa Chiara University Hospital, APSS, Trento, Italy
| | - Mattia Barbareschi
- Department of Laboratory Medicine, Pathology Unit, Santa Chiara University Hospital, APSS, Trento, Italy
- CISMED, Centro Interdipartimentale di Scienze Mediche, University of Trento, Trento, Italy
| | - Matthew J Cecchini
- Department of Pathology and Laboratory Medicine, University of Western Ontario, London, Ontario, Canada
| | - Vito Cirielli
- Department of Prevention, Legal Medicine Unit, Azienda ULSS 8 Berica, Vicenza, Italy
| | - Francesca Pagliuca
- Department of Mental and Physical Health and Preventive Medicine, Pathology Unit, University of Campania 'Luigi Vanvitelli', Naples, Italy
| | - Muhammad Ahsan
- Histopathology Department, Chughtai Institute of Pathology, Lahore, Pakistan
| | - Sambit K Mohanty
- Department of Pathology and Laboratory Medicine, CORE Diagnostics, Gurgaon, Delhi, India
| | | | - Griffin Hughes
- Office of Medical Student Research, Oklahoma State University Center for Health Sciences, Tulsa, Oklahoma, USA
| | - Kamran M Mirza
- Department of Pathology and Laboratory Medicine, Loyola University Chicago Stritch School of Medicine, Maywood, Illinois, USA
| |
Collapse
|
5
|
Deng S, Li Z, Ma X, Wei Y, Lyu P, Fan Y. Evaluation of Atlas-Based Mobile Application in Undergraduate Teaching in Oral Histopathology. Healthcare (Basel) 2023; 11:2087. [PMID: 37510528 PMCID: PMC10379324 DOI: 10.3390/healthcare11142087] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 07/17/2023] [Accepted: 07/18/2023] [Indexed: 07/30/2023] Open
Abstract
The utilization of mobile devices in education is a growing trend in various subjects. We developed the Dental and Maxillofacial Development Teaching Atlas App, and applied it to the learning process of oral histopathology. The aim of the current study was to investigate the educational effects of atlas-based mobile-assisted teaching in the field of dental medicine, and to suggest relevant improvements. The Dental and Maxillofacial Development Teaching Atlas App encompasses a wide range of atlases. It harbors various features, such as terminology definitions, student communications, and teacher-student interactions. By conducting questionnaires (70 students) and a quiz (68 students), we obtained students' feedback, to evaluate the effects and application prospects of the WeChat applet. The questionnaire results indicate that students experienced a high level of satisfaction and support. Additionally, students participated in the quiz, with the experimental group exhibiting significantly higher average scores than the control group. The fill-in-the-blank questions, image recognition questions, and the total score all demonstrated statistically significant differences, while the terminology definition questions did not. The Dental and Maxillofacial Development Teaching Atlas App facilitates students' utilization of fragmented time for learning, and demonstrates positive effects in enhancing students' learning interests and proactiveness. It also holds promising potential for applications in other disciplines in the field of dental education.
Collapse
Affiliation(s)
- Shuangshan Deng
- Department of Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Zucen Li
- Department of Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Xinyu Ma
- Department of Stomatology, West China School of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yali Wei
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Ping Lyu
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| | - Yi Fan
- State Key Laboratory of Oral Diseases, National Clinical Research Center for Oral Diseases, Department of Cariology and Endodontics, West China Hospital of Stomatology, Sichuan University, Chengdu 610041, China
| |
Collapse
|
6
|
Meyer GT. Online, Interactive, Digital Visualisation Resources that Enhance Histology Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1421:125-160. [PMID: 37524986 DOI: 10.1007/978-3-031-30379-1_6] [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
Teaching histology is expensive, particularly in some universities with limited or ageing resources such as microscope equipment and inadequate histological slide collections. Increasing numbers of student enrolments have required duplications of laboratory classes. Such practical classes are staff intensive and so teaching hours are increased. Technology can now solve many of these issues but perhaps, more importantly, can also cater to the self-directed and independent learning needs of today's learners.This chapter will describe and evaluate distinct innovations available on a global scale, utilising both technology-enhanced and interactive learning strategies to revolutionise histology teaching via successful online delivery of learning resources. Histology students can access these innovations to maximise their learning and enable them to complete all learning outcomes away from the traditional classroom environment (i.e., online). Most appropriately, all of these innovations address and help solve cognitive challenges that students experience in histology learning.Lecture recording platforms with engaging functionalities have enabled students to view lectures online. Using new innovative histology resources has eliminated the need for students to attend practical histology laboratory sessions. Instead, students can now study histology successfully and enjoyably in their own time. Learners can interact with unlimited numbers of high-quality images and click on hyperlinked text to identify key features of histological structures. Students can now use virtual microscopy to view digitised histological sections (virtual microscopy) at increasing levels of magnification. Consequently, there is no requirement for academic staff to be present when directing students through their learning objectives, which therefore eliminates formal, scheduled practical classes. The learning platforms offer a variety of formative assessment formats. On completion of a quiz, instant feedback can be provided for students, which makes histology learning efficient and can significantly improve student performance in examinations.However, there remains the issue that three-dimensional (3D) interpretation from traditional two-dimensional (2D) representations of cell, tissue, and organ structure can be cognitively challenging for many students. The popularity of using animations and 3D reconstructions to help learners understand and remember information has greatly increased since the advent of powerful graphics-oriented computers. This technology allows animations to be produced much more easily and cheaply than in previous years, whilst Cinema 4D technology has enhanced a new paradigm shift in teaching histology. 3D reconstruction and animations can meet the educational need and solve the dilemma.
Collapse
Affiliation(s)
- Geoffrey T Meyer
- School of Human Sciences, The University of Western Australia, Perth, WA, Australia.
| |
Collapse
|
7
|
Then SM, Kokolski M, Mbaki Y, Merrick D, Anderson S. An international collaborative approach to learning histology using a virtual microscope. Anat Histol Embryol 2023; 52:21-30. [PMID: 36373558 PMCID: PMC10099614 DOI: 10.1111/ahe.12888] [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: 06/07/2022] [Revised: 10/24/2022] [Accepted: 10/31/2022] [Indexed: 11/16/2022]
Abstract
Histology is often taught in higher education settings using online virtual microscopes (VM). This study aimed to develop and evaluate the use of VM in teaching on a BSc degree at the University of Nottingham by surveying students and staff. A key development was the use of an e-workbook so that students were actively engaged in creating their own bespoke revision material. Subsequently, this approach was used in a second study evaluating the use of VM in teaching the histology and pathology of the gastrointestinal (GI) tract via group work with students from two BSc courses at the University of Nottingham; one based at Derby (RDHC) and the other in Malaysia (UNMC). Students worked together in groups to complete an e-workbook, develop a presentation, and decide how to collaborate and communicate. An evaluation of these activities revealed advantages in developing transferrable skills, and good engagement with both the histology topic and group work. Analysis of assessment of the module at UNMC showed that student performance improved in the histology-based module after the intervention (p < 0.01) and that this improvement was not evident in other modules taken by the cohort. Furthermore, when interrogating the questions from the examination paper that asked students to identify features from histological images, fewer questions were seen as 'difficult' (p < 0.001) and more were seen as 'average' (p < 0.01). This study demonstrates that the use of VM in histology combined with active learning in creating a revision resource enhances engagement and depth of learning. When further combined with collaborative active group work, students developed a range of histology knowledge and transferrable skills, with notable improvement in examination performance relative to other contemporaneous modules.
Collapse
Affiliation(s)
- Sue-Mian Then
- Division of Biomedical Sciences, University of Nottingham, Malaysia
| | | | - Yvonne Mbaki
- School of Life Sciences, University of Nottingham, UK
| | | | | |
Collapse
|
8
|
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.
Collapse
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
| | | | | |
Collapse
|
9
|
Yang J. Technology-Enhanced Preclinical Medical Education (Anatomy, Histology and Occasionally, Biochemistry): A Practical Guide. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2023; 1431:65-93. [PMID: 37644288 DOI: 10.1007/978-3-031-36727-4_4] [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: 08/31/2023]
Abstract
The recent explosion of technological innovations in mobile technology, virtual reality (VR), digital dissection, online learning platform, 3D printing, and augmented reality (AR) has provided new avenues for improving preclinical education, particularly in anatomy and histology education. Anatomy and histology are fundamental components of medical education that teach students the essential knowledge of human body structure and organization. However, these subjects are widely considered to be some of the most difficult disciplines for healthcare students. Students often face challenges in areas such as the complexity and overwhelming volume of knowledge, difficulties in visualizing body structures, navigating and identifying tissue specimens, limited exposure to learning materials, and lack of clinical relevance. The COVID-19 pandemic has further exacerbated the situation by reducing face-to-face teaching opportunities and affecting the availability of body donations for medical education.To overcome these challenges, educators have integrated various educational technologies, such as virtual reality, digital 3D anatomy apps, 3D printing, and AI chatbots, into preclinical education. These technologies have effectively improved students' learning experiences and knowledge retention. However, the integration of technologies into preclinical education requires appropriate pedagogical approaches and logistics to align with educational theories and achieve the intended learning outcomes.The chapter provides practical guidance and examples for integrating technologies into anatomy, histology, and biochemistry preclinical education. The author emphasizes that every technology has its own benefits and limitations and is best suited to specific learning scenarios. Therefore, it is recommended that educators and students should utilize multiple modalities for teaching and learning to achieve the best outcomes. The chapter also acknowledges that cadaver-based anatomy education is essential and proposes that educational technologies can serve as a crucial complement for promoting active learning, problem solving, knowledge application, and enhancing conventional cadaver-based education.
Collapse
Affiliation(s)
- Jian Yang
- The School of Biomedical Sciences, LKS Faculty of Medicine, The University of Hong Kong, Pok Fu Lam, Hong Kong, China.
| |
Collapse
|
10
|
Schoenherr DT, Dereski MO, Bernacki KD, Khayyata S, Attardi SM. Development and evaluation of an online integrative histology module: simple design, low-cost, and improves pathology self-efficacy. MEDICAL EDUCATION ONLINE 2022; 27:2011692. [PMID: 34905444 PMCID: PMC8676635 DOI: 10.1080/10872981.2021.2011692] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/21/2020] [Revised: 09/19/2021] [Accepted: 11/24/2021] [Indexed: 06/14/2023]
Abstract
Integration of core concepts is an important aspect of medical curriculum enhancement. Challenges to improving integration include the risk of curtailing the basic sciences in the process and the push to decrease contact hours in medical curricula. Self-paced learning tools can be developed that deliberately relate basic and clinical sciences to aid students in making interdisciplinary connections. The purpose of this project was to develop, implement, and evaluate a self-paced learning module that would be applicable to integration of different disciplines in medical education. The module was intended to improve integration between histology and anatomic pathology before a respiratory pathology laboratory session. Qualtrics XM, a survey software commonly available at educational institutions, was used in a novel manner to create the module. Module activities included pre- and post-module quizzes; four short videos emphasizing normal histological features and recalling associated pathologies; three categorization activities designed for students to recognize normal versus abnormal characteristics of lung specimens; and post-activity feedback. Preliminary data from first-year medical students showed that post-module quiz scores were significantly higher than pre-module quiz scores (p < 0.001) and that module users' pre-laboratory pathology self-efficacy was significantly higher than non-users (p < 0.05). These data suggest that module use facilitated short-term knowledge gain and improved pathology self-efficacy before the laboratory session. Online modules can be developed affordably using Qualtrics XM to integrate anatomical sciences with other disciplines, while providing students interactive learning resources without increasing contact hours. The module presented in this report focused on normal versus abnormal morphology, guiding students through recognizing the continuum from healthy to disease states before learning about the pathologies more in depth. A similar module design would likely be effective in integrating other disciplines in medicine, especially in disciplines that require recognition of changes in morphology.
Collapse
Affiliation(s)
- Daniel T. Schoenherr
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
- Family Medicine Residency, National Capital Consortium, Fort Belvoir, VA, USA
| | - Mary O. Dereski
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Kurt D. Bernacki
- Department of Anatomic Pathology, Beaumont Health, Royal Oak, MI, USA
- Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Said Khayyata
- Department of Anatomic Pathology, Beaumont Health, Royal Oak, MI, USA
- Department of Pathology, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| | - Stefanie M. Attardi
- Department of Foundational Medical Studies, Oakland University William Beaumont School of Medicine, Rochester, MI, USA
| |
Collapse
|
11
|
Khatskevich K, Oh YS, Ruiz D, McGlawn-McGrane B, Freire G, Liu L, Lewis N, Mhaskar R. Virtual Microscopy Tagging and Its Benefits for Students, Faculty, and Interprofessional Programs Alike. Cureus 2022; 14:e27860. [PMID: 36110439 PMCID: PMC9462525 DOI: 10.7759/cureus.27860] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2022] [Accepted: 08/10/2022] [Indexed: 11/05/2022] Open
Abstract
Background Over the years, due to technological innovations in medical education, virtual microscopy has become a popular tool used to teach histology. The Virtual Microscopy Project is a faculty and student collaborative project at the University of South Florida (USF) Health to transfer and update online histology slides from an outdated viewer to a completely new viewer. Methodology The project goal is to better facilitate the educational experience for students and faculty through the implementation of updated technology and features. Results At USF Health, multiple programs use the online histology slide viewer to teach normal histology. The previous website’s organization and lack of additional features severely hindered opportunities for personalized education; users could not write any notes, circle or point to important features, or easily search for specific organs or tissue. An updated website user interface and additional instructional features will improve the students’ accessibility and overall quality of their learning. The updated viewer will be more integrated into the USF Health Morsani College of Medicine (MCOM) curriculum, providing faculty with organized and readily available material. USF MCOM has faculty integration directors to create a balanced curriculum that can be reviewed by faculty for consistency and accuracy. Adding this same organizational structure to the online microscopy viewer will assist directors in forming and modifying the curriculum and may also provide them with additional resources for their education delivery. Conclusion The Virtual Microscopy Project hopes to produce an accessible, user-friendly online microscopy viewer that is beneficial to students for learning, to faculty for teaching/curriculum planning, and to medical education as a whole.
Collapse
|
12
|
Performance of Dental Students in Understanding and Retention of Oral Pathology Concepts: A Comparative Analysis of Traditional versus Live-Field Teaching Methods. ScientificWorldJournal 2022; 2022:3257377. [PMID: 35833055 PMCID: PMC9273418 DOI: 10.1155/2022/3257377] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/14/2022] [Accepted: 06/04/2022] [Indexed: 12/03/2022] Open
Abstract
Background Understanding oral aspects of pathology by traditional techniques has always been a paradigm in the field of dental education. Traditional methods of teaching include interaction using black board, projectors, and alternate methods of teaching such as a student-centered approach where live-field demonstrations, audio visual aids, and student interaction are also gaining importance, ultimately promoting active education. The aim of the study was to compare live-field and static-field teaching methods in understanding and retention of the histopathological features in dental students. Methods This was a cross-sectional analytical study, wherein a uniform cohort of III-year dental students was obtained by randomizing the study subjects. Practical classes were conducted using traditional black board/static pictures and dynamic live-field teaching comprising of microscope connected to an HD screen and projector demonstrating the preferred microscopic field. Alternately, the level of retention of knowledge was measured using customized topic-based tests. The comparison of average scores was done between live-field and static-field teaching groups using the paired t-test. Results The test scores using the paired t-test were marginally elevated in the conventional mode of teaching; however, it varied with respect to precise topics taken using both the genres of teaching. Conclusion A balance of both conventional and virtual teaching needs to be achieved to enhance the comprehension in student learning. Nevertheless, in the impending years, advanced research is entailed to see if the virtual mode of teaching could replace the conventional method for the advancement in the study prospects.
Collapse
|
13
|
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
|
14
|
Qing J, Cheng G, Ni XQ, Yang Y, Zhang W, Li Z. Implementation of an interactive virtual microscope laboratory system in teaching oral histopathology. Sci Rep 2022; 12:5492. [PMID: 35361839 PMCID: PMC8970071 DOI: 10.1038/s41598-022-09473-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/26/2021] [Accepted: 03/16/2022] [Indexed: 11/24/2022] Open
Abstract
Laboratory course acts as a key component of histopathology education. Recent trends of incorporating visual and interactive technology in active and inquiry-based learning pedagogical methods have led to significant improvement of histopathology laboratory courses. The present work aimed to describe interactive virtual microscope laboratory system (IVMLS) as a virtual platform for teaching histopathology in order to improve the quality and efficiency of teaching. The system is based on interactive technology and consists of interactive software, slide-reading software, teaching resources and integrated auxiliary equipment. It allows real-time interaction between teachers and students and provides students with a wealth of learning and review materials. In order to evaluate the effectiveness of the system, we conducted a comparative study with the use of light microscope (LM) as a method. Specifically, we compared the results of six assignments and one laboratory final exam between IVMLS group and LM group to analyse the impact of IVMLS on students' academic performance. A questionnaire survey was also conducted to obtain students' attitudes and views on this system. There was no overall difference in assignment performance between IVMLS group and LM group. But laboratory final test grades increased from a mean of 62% (43.8–80.0, 95% CI) before to 83% (71.0–94.2, 95% CI) after implement IVMLS, suggesting highly significant (p < 0.001) improvement on students' histopathology laboratory performance. Feedback of the questionnaire was positive, indicating that students were satisfied with the system, which they believed improved student communication and teacher-student interaction, increased learning resources, increased their focus on learning, and facilitated their independent thinking process. This study proves that IVMLS is an efficient and feasible teaching technology and improves students' academic performance.
Collapse
Affiliation(s)
- Jia Qing
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.,School of Stomatology, Peking University, Beijing, China
| | - Gu Cheng
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.,Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Xiao-Qi Ni
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China.,Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China
| | - Yi Yang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China
| | - Wei Zhang
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China. .,Department of Endodontic, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| | - Zhi Li
- The State Key Laboratory Breeding Base of Basic Science of Stomatology (Hubei-MOST) and the Key Laboratory of Oral Biomedicine Ministry of Education, School and Hospital of Stomatology, Wuhan University, 237 Luoyu Road, Wuhan, 430079, China. .,Department of Oral and Maxillofacial Surgery, School and Hospital of Stomatology, Wuhan University, Wuhan, China.
| |
Collapse
|
15
|
Microscopic Imaging Methods for Organ-on-a-Chip Platforms. MICROMACHINES 2022; 13:mi13020328. [PMID: 35208453 PMCID: PMC8879989 DOI: 10.3390/mi13020328] [Citation(s) in RCA: 9] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/13/2022] [Revised: 02/15/2022] [Accepted: 02/15/2022] [Indexed: 02/06/2023]
Abstract
Microscopic imaging is essential and the most popular method for in situ monitoring and evaluating the outcome of various organ-on-a-chip (OOC) platforms, including the number and morphology of mammalian cells, gene expression, protein secretions, etc. This review presents an overview of how various imaging methods can be used to image organ-on-a-chip platforms, including transillumination imaging (including brightfield, phase-contrast, and holographic optofluidic imaging), fluorescence imaging (including confocal fluorescence and light-sheet fluorescence imaging), and smartphone-based imaging (including microscope attachment-based, quantitative phase, and lens-free imaging). While various microscopic imaging methods have been demonstrated for conventional microfluidic devices, a relatively small number of microscopic imaging methods have been demonstrated for OOC platforms. Some methods have rarely been used to image OOCs. Specific requirements for imaging OOCs will be discussed in comparison to the conventional microfluidic devices and future directions will be introduced in this review.
Collapse
|
16
|
Waugh S, Devin J, Lam AKY, Gopalan V. FE-learning and the virtual transformation of histopathology teaching during COVID-19: its impact on student learning experience and outcome. BMC MEDICAL EDUCATION 2022; 22:22. [PMID: 34996435 PMCID: PMC8740866 DOI: 10.1186/s12909-021-03066-z] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 05/19/2021] [Accepted: 11/30/2021] [Indexed: 06/14/2023]
Abstract
BACKGROUND Medical and pathology education has gone through an immense transformation from traditional face-to-face teaching mode to virtual mode during the COVID-19 pandemic. This study evaluated the effectiveness of online histopathology teaching in medical education during the 2020 COVID-19 pandemic in Griffith University, Australia. METHODS Second-year medical students (n = 150) who had previously completed one year of face-to-face histopathology teaching, completed an online questionnaire rating their learning experiences before and during the COVID-19 pandemic after the completion of their histology and pathology practical sessions. The students' histopathology assessment results were then compared to the histopathology results of a prior second-year cohort to determine if the switch to online histopathology teaching had an impact on students' learning outcome. RESULTS A thematic analysis of the qualitative comments strongly indicated that online histopathology teaching was instrumental, more comfortable to engage in and better structured compared to face-to-face teaching. Compared to the previous year's practical assessment, individual performance was not significantly different (p = 0.30) and compared to the prior cohort completing the same curriculum the mean overall mark was significantly improved from 65.36% ± 13.12% to 75.83% ± 14.84% (p < 0.05) during the COVID-19 impacted online teaching period. CONCLUSIONS The transformation of teaching methods during the 2020 COVID-19 pandemic improved student engagement without any adverse effects on student learning outcomes in histology and pathology education.
Collapse
Affiliation(s)
- Samantha Waugh
- School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, 4222, Australia
| | - James Devin
- School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Alfred King-Yin Lam
- School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, 4222, Australia
| | - Vinod Gopalan
- School of Medicine & Dentistry, Griffith University, Gold Coast, QLD, 4222, Australia.
| |
Collapse
|
17
|
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.
Collapse
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
| | | | | | | |
Collapse
|
18
|
Birkness-Gartman JE, White MJ, Salimian KJ, Voltaggio L. Web-based pathology modules with virtual slides are effective for teaching introductory gastrointestinal pathology concepts. Acad Pathol 2022; 9:100059. [DOI: 10.1016/j.acpath.2022.100059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/05/2022] [Revised: 09/04/2022] [Accepted: 09/17/2022] [Indexed: 11/27/2022] Open
|
19
|
Lakhtakia R. Virtual Microscopy in Undergraduate Pathology Education: An early transformative experience in clinical reasoning. Sultan Qaboos Univ Med J 2021; 21:428-435. [PMID: 34522409 PMCID: PMC8407892 DOI: 10.18295/squmj.4.2021.009] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/22/2020] [Revised: 08/12/2020] [Accepted: 09/10/2020] [Indexed: 11/25/2022] Open
Abstract
Objectives Whole-slide imaging and virtual microscopy (VM) have revolutionised teaching, diagnosis and research in histopathology. This study aimed to establish the feasibility of achieving early integration of clinical reasoning with undergraduate pathology teaching on a VM platform and to determine its student-centricity through student feedback. Methods This study was conducted at the Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, United Arab Emirates, between August and December 2017. A total of 38 VM-centred clinical cases were introduced to 49 students in an integrated undergraduate medical curriculum. The cases were aligned to curricular objectives, reinforced the pathologic basis of disease with critical thinking and were delivered across 15 interactive small-group sessions. A simulated cross-disciplinary integration and judicious choice of pertinent diagnostic investigations were linked to principles of management. Feedback was obtained through a mixed-methods approach. Results User-friendliness, gradual learning curve of VM and annotation-capacity were scored as 4–5 (on a Likert scale of 1–5) by 91.84%, 87.76% and 83.67% of the participants, respectively. Most students agreed that the content matched the stage of learning (81.63%), theme of the week (91.84%) and development of a strong clinical foundation (77.55%). Integration (85.71%) and clinico-pathological correlation (83.67%) were the strengths of this educational effort. High student attendance (~100%) and improved assessment scores on critical thinking (80%) were observed. Software lacunae included frequent logouts and lack of note-taking tools. Easy access was a significant student-centric advantage. Conclusion A VM-centred approach with a clinico-pathological correlation has been successfully introduced to inculcate integrated learning. Using the pathologic basis of disease as a fulcrum and critical reasoning as an anchor, a digitally-enabled generation of medical students have embraced this educational tool for tutor-guided, student-centred learning.
Collapse
Affiliation(s)
- Ritu Lakhtakia
- Department of Pathology, Mohammed Bin Rashid University of Medicine and Health Sciences, College of Medicine, Dubai, United Arab Emirates
| |
Collapse
|
20
|
Uraiby H, Grafton-Clarke C, Gordon M, Sereno M, Powell B, McCarthy M. Fostering intrinsic motivation in remote undergraduate histopathology education. J Clin Pathol 2021; 75:837-843. [PMID: 34429354 DOI: 10.1136/jclinpath-2021-207640] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2021] [Accepted: 06/30/2021] [Indexed: 11/04/2022]
Abstract
AIMS The levels of abstraction, vast vocabulary and high cognitive load present significant challenges in undergraduate histopathology education. Self-determination theory describes three psychological needs which promote intrinsic motivation. This paper describes, evaluates and justifies a remotely conducted, post-COVID-19 histopathology placement designed to foster intrinsic motivation. METHODS 90 fourth-year medical students took part in combined synchronous and asynchronous remote placements integrating virtual microscopy into complete patient narratives through Google Classroom, culminating in remote, simulated multidisciplinary team meeting sessions allowing participants to vote on 'red flag' signs and symptoms, investigations, histological diagnoses, staging and management of simulated virtual patients. The placement was designed to foster autonomy, competence and relatedness, generating authenticity, transdisciplinary integration and clinical relevance. A postpositivistic evaluation was undertaken with a validated preplacement and postplacement questionnaire capturing quantitative and qualitative data. RESULTS There was a significant (p<0.001) improvement in interest, confidence and competence in histopathology. Clinical integration and relevance, access to interactive resources and collaborative learning promoted engagement and sustainability post-COVID-19. Barriers to online engagement included participant lack of confidence and self-awareness in front of peers. CONCLUSIONS Fostering autonomy, competence and relatedness in post-COVID-19, remote educational designs can promote intrinsic motivation and authentic educational experiences. Ensuring transdisciplinary clinical integration, the appropriate use of novel technology and a focus on patient narratives can underpin the relevance of undergraduate histopathology education. The presentation of normal and diseased tissue in this way can serve as an important mode for the acquisition and application of clinically relevant knowledge expected of graduates.
Collapse
Affiliation(s)
- Hussein Uraiby
- Department of Clinical Education, University Hospitals of Leicester NHS Trust, Leicester, UK .,Leicester Medical School, University of Leicester, Leicester, UK
| | - Ciaran Grafton-Clarke
- Department of Clinical Education, University Hospitals of Leicester NHS Trust, Leicester, UK.,Leicester Medical School, University of Leicester, Leicester, UK
| | - Morris Gordon
- School of Medicine, University of Central Lancashire, Preston, UK
| | - Marco Sereno
- Department of Respiratory Sciences, University of Leicester, Leicester, UK
| | - Barbara Powell
- Leicester Medical School, University of Leicester, Leicester, UK
| | - Mark McCarthy
- Department of Clinical Education, University Hospitals of Leicester NHS Trust, Leicester, UK.,Leicester Medical School, University of Leicester, Leicester, UK
| |
Collapse
|
21
|
Abstract
Whole slide imaging (WSI), ever since its first introduction about two decades ago, has been validated for a number of applications in the field of pathology. The recent approval of US FDA to a WSI system for use in primary surgical pathology diagnosis has opened avenues for wider acceptance and application of this technology in routine practice. The ongoing technological advances in digital scanners, image visualization methods, and the integration of artificial intelligence-derived algorithms with these systems provide opportunities of its newer applications. Its benefits are innumerable such as ease of access through internet, avoidance of physical storage space, and no risk of deterioration of staining quality or breakage of slides to name a few. Various barriers such as the high cost, technical glitches, and professional hesitation to adopt a new technology have hindered its use in pathology. This review article summarizes the technical aspects of WSI, its applications in diagnostic pathology, training, and research along with future perspectives. It highlights the benefits, limitations, and challenges delaying the use of this technology in routine practice. The review is targeted at students, residents, and budding pathologists to better acquaint them with the key aspects of state-of-the-art technology and enable them to implement WSI judiciously.
Collapse
|
22
|
CACTUS: A Digital Tool for Quality Assurance, Education and Evaluation in Surgical Pathology. J Med Biol Eng 2021. [DOI: 10.1007/s40846-021-00643-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
|
23
|
Hassell LA, Afzal A. Flattening the World of Pathology Education and Training and Shortening the Curve of Pathology Learning. Am J Clin Pathol 2021; 156:176-184. [PMID: 33978156 DOI: 10.1093/ajcp/aqab034] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022] Open
Abstract
OBJECTIVES We review how the pandemic-related education disruption may interplay with pathology manpower worldwide and shifts in disease burden to identify workable solutions. METHODS Literature related to pathology education, pathology services in low-resource settings, and application of digital tools to pathology education was reviewed for trends and training gaps. Publications covering pathology manpower and cancer incidence worldwide were also included to assess needs. RESULTS Pandemic-related virtual teaching has produced abundant online training materials. Pathology learning resources in low- to middle-income countries remain considerably constrained and dampen pathology manpower growth to meet current needs. Projected increases in disease burden toward the developing world thus pose a major challenge. Digital pathology resources have expanded and are beginning to appear beyond the developed countries. CONCLUSIONS This circumstance offers a unique opportunity to leverage digital teaching resources to enhance and equitize training internationally, potentially sufficient to meet the rising wave of noncommunicable diseases. We propose four next steps to take advantage of the current opportunity: curate and organize digital training materials, invest in the digital pathology infrastructure for education and clinical care, expand student exposure to pathology through virtual electives, and develop further competency-based certification pathways.
Collapse
Affiliation(s)
- Lewis A Hassell
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| | - Anoshia Afzal
- Department of Pathology, University of Oklahoma Health Sciences Center, Oklahoma City, OK, USA
| |
Collapse
|
24
|
White MJ, Birkness JE, Salimian KJ, Meiss AE, Butcher M, Davis K, Ware AD, Zarella MD, Lecksell K, Rooper LM, Cimino-Mathews A, VandenBussche CJ, Halushka MK, Thompson ED. Continuing Undergraduate Pathology Medical Education in the Coronavirus Disease 2019 (COVID-19) Global Pandemic: The Johns Hopkins Virtual Surgical Pathology Clinical Elective. Arch Pathol Lab Med 2021; 145:814-820. [PMID: 33740819 DOI: 10.5858/arpa.2020-0652-sa] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 03/09/2021] [Indexed: 11/06/2022]
Abstract
CONTEXT.— In the early months of the response to the coronavirus disease 2019 (COVID-19) pandemic, the Johns Hopkins University School of Medicine (JHUSOM) (Baltimore, Maryland) leadership reached out to faculty to develop and implement virtual clinical clerkships after all in-person medical student clinical experiences were suspended. OBJECTIVE.— To develop and implement a digital slide-based virtual surgical pathology (VSP) clinical elective to meet the demand for meaningful and robust virtual clinical electives in response to the temporary suspension of in-person clinical rotations at JHUSOM. DESIGN.— The VSP elective was modeled after the in-person surgical pathology elective to include virtual previewing and sign-out with standardized cases supplemented by synchronous and asynchronous pathology educational content. RESULTS.— Validation of existing Web communications technology and slide-scanning systems was performed by feasibility testing. Curriculum development included drafting of course objectives and syllabus, Blackboard course site design, electronic-lecture creation, communications with JHUSOM leadership, scheduling, and slide curation. Subjectively, the weekly schedule averaged 35 to 40 hours of asynchronous, synchronous, and independent content, approximately 10 to 11 hours of which were synchronous. As of February 2021, VSP has hosted 35 JHUSOM and 8 non-JHUSOM students, who have provided positive subjective and objective course feedback. CONCLUSIONS.— The Johns Hopkins VSP elective provided meaningful clinical experience to 43 students in a time of immense online education need. Added benefits of implementing VSP included increased medical student exposure to pathology as a medical specialty and demonstration of how digital slides have the potential to improve standardization of the pathology clerkship curriculum.
Collapse
Affiliation(s)
- Marissa J White
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Jacqueline E Birkness
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kevan J Salimian
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alice E Meiss
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Monica Butcher
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Katelynn Davis
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Alisha D Ware
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Mark D Zarella
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Kristen Lecksell
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Lisa M Rooper
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Ashley Cimino-Mathews
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | | | - Marc K Halushka
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| | - Elizabeth D Thompson
- From the Department of Pathology, Johns Hopkins University School of Medicine, Baltimore, Maryland
| |
Collapse
|
25
|
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.
Collapse
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
| |
Collapse
|
26
|
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.
Collapse
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
| |
Collapse
|
27
|
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.
Collapse
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.
| |
Collapse
|
28
|
Johnson CM, Prayson RA. Editorial: On continuing to educate during these times. Ann Diagn Pathol 2020; 47:151555. [PMID: 32623313 PMCID: PMC7320264 DOI: 10.1016/j.anndiagpath.2020.151555] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2020] [Accepted: 06/18/2020] [Indexed: 12/02/2022]
Affiliation(s)
- Carrie M Johnson
- Cleveland Clinic Lerner College of Medicine, Department of Anatomic Pathology, Cleveland Clinic, United States of America
| | - Richard A Prayson
- Cleveland Clinic Lerner College of Medicine, Department of Anatomic Pathology, Cleveland Clinic, United States of America.
| |
Collapse
|
29
|
From Scope to Screen: The Evolution of Histology Education. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2020; 1260:75-107. [PMID: 33211308 DOI: 10.1007/978-3-030-47483-6_5] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Abstract
Histology, the branch of anatomy also known as microscopic anatomy, is the study of the structure and function of the body's tissues. To gain an understanding of the tissues of the body is to learn the foundational underpinnings of anatomy and achieve a deeper, more intimate insight into how the body is constructed, functions, and undergoes pathological change. Histology, therefore, is an integral element of basic science education within today's medical curricula. Its development as a discipline is inextricably linked to the evolution of the technology that allows us to visualize it. This chapter takes us on the journey through the past, present, and future of histology and its education; from technologies grounded in ancient understanding and control of the properties of light, to the ingenuity of crafting glass lenses that led to the construction of the first microscopes; traversing the second revolution in histology through the development of modern histological techniques and methods of digital and virtual microscopy, which allows learners to visualize histology anywhere, at any time; to the future of histology that allows flexible self-directed learning through social media, live-streaming, and virtual reality as a result of the powerful smart technologies we all carry around in our pockets. But, is our continuous pursuit of technological advancement projecting us towards a dystopian world where machines with artificial intelligence learn how to read histological slides and diagnose the diseases in the very humans that built them?
Collapse
|
30
|
Innovative Strategies for Clinical Microscopy Instruction: Virtual Versus Light Microscopy. J Physician Assist Educ 2019; 29:109-114. [PMID: 29697587 DOI: 10.1097/jpa.0000000000000198] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
PURPOSE The purpose of the study was to compare virtual microscopy with light microscopy to determine differences in learning outcomes and learner attitudes in teaching clinical microscopy to physician assistant (PA) students. METHODS A prospective, randomized, crossover design study was conducted with a convenience sample of 67 first-year PA students randomized to 2 groups. One group used light microscopes to find microscopic structures, whereas the other group used instructor-directed video streaming of microscopic elements. At the midpoint of the study, the groups switched instructional strategies. Learning outcomes were assessed via posttest after each section of the study, with comparison of final practical examination results to previous cohorts. Attitudes about the 2 educational strategies were assessed through a postcourse questionnaire with a Likert scale. RESULTS Analysis of the first posttest demonstrated that students in the video-streamed group had significantly better learning outcomes than those in the light microscopy group (P = .004; Cohen's d = 0.74). Analysis of the posttest after crossover showed no differences between the 2 groups (P = .48). Between the 2 posttests, students first assigned to the light microscopy group scored a 6.6 mean point increase (±10.4 SD; p = .0011), whereas students first assigned to the virtual microscopy group scored a 1.3 mean point increase (±7.1 SD; p = .29). The light microscopy group improved more than the virtual microscopy group (P = .019). Analysis of practical examination data revealed higher scores for the study group compared with 5 previous cohorts of first-year students (P < .0001; Cohen's d = 0.66). Students preferred virtual microscopy to traditional light microscopy. CONCLUSION Virtual microscopy is an effective educational strategy, and students prefer this method when learning to interpret images of clinical specimens.
Collapse
|
31
|
Kuo KH, Leo JM. Optical Versus Virtual Microscope for Medical Education: A Systematic Review. ANATOMICAL SCIENCES EDUCATION 2019; 12:678-685. [PMID: 30414261 DOI: 10.1002/ase.1844] [Citation(s) in RCA: 27] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 08/19/2018] [Revised: 10/21/2018] [Accepted: 10/26/2018] [Indexed: 06/08/2023]
Abstract
Many technological innovations have changed the traditional practice of medical education and clinical practice. Whole slide imaging (WSI) technology provided an unique way of viewing conventional glass slides in histology and pathology laboratories. The WSI technology digitalized glass slide images and made them readily accessible via the Internet using tablets or computers. Users utilized the pan-and-zoom function to view digital images of slides, also referred to as the virtual microscope (VM), simulating use of an optical microscope (OM). Several articles have reported various outcomes on the utility of VM in teaching laboratories. Recently, the Royal College of Physicians and Surgeons of Canada certification examinations for anatomical pathologists ha completely adopted VM for the national licensing examination. To better inform medical educators, there is an urgent need for more structured reviews to draw evidence-based conclusions on the effectiveness of VM and learner's perceptions, in comparison to OM. The current study provides a descriptive summary of published outcomes using the systematic review approach. In conclusion, medical students' performance was improved with adoption of VM into the curriculum and recognized as a preferred learning modality, compared to OM. On the contrary, resident learners' performance was comparable between using OM and VM, with OM being the favored slide-viewing modality.
Collapse
Affiliation(s)
- Kuo-Hsing Kuo
- Northern Medial Program, University of Northern British Columbia, Prince George, Canada
| | - Joyce M Leo
- Department of Laboratory Medicine, Royal Jubilee Hospital, Victoria, Canada
| |
Collapse
|
32
|
Yohannan DG, Oommen AM, Umesan KG, Raveendran VL, Sreedhar LSL, Anish TSN, Hortsch M, Krishnapillai R. Overcoming Barriers in a Traditional Medical Education System by the Stepwise, Evidence-Based Introduction of a Modern Learning Technology. MEDICAL SCIENCE EDUCATOR 2019; 29:803-817. [PMID: 34457545 PMCID: PMC8368117 DOI: 10.1007/s40670-019-00759-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/30/2023]
Abstract
INTRODUCTION Histology teaching in India and in other developing countries has not changed much over the past decades and has not joined the global movement of using virtual microscopy (VM). Many factors may have contributed to this academic inertia-including curricular requirements for traditional microscopy (TM) skills, assessments that are heavily based on TM, and unfamiliarity with modern technology among faculty, as well as infrastructural shortcomings. This study is aimed at overcoming these roadblocks by using a blended approach combining VM with TM in a tradition-centered curricular setting. METHODS For validation of this approach, the authors conducted a non-randomized controlled trial with a crossover design on first year medical students at the Government Medical College, Thiruvananthapuram, India. Examination scores and responses of a student group taught with VM as an adjunct to TM were compared with a student group taught with TM only. RESULTS The test group had significantly better results when compared to the control group for knowledge-based tests (p = 0.012; analysis of co-variance) and for an unannounced visual-based test conducted 1 month later (p = 0.001; Mann-Whitney U test). Feedback collected from students showed highly favorable responses to the use of VM for teaching histology. CONCLUSION This study should encourage Indian medical colleges and schools in other developing countries to start using VM as a supplementary approach for their histology education programs. Furthermore, as the Medical Council of India recommends the introduction of new competency-based integrated curriculum in India starting in 2019, the use of VM may facilitate more effective learning in the new scenario. TRIAL REGISTRATION CTRI/2018/04/012928.
Collapse
Affiliation(s)
| | - Aswathy Maria Oommen
- Department of Anatomy, Government Medical College, Thiruvananthapuram, Kerala India
| | | | | | | | | | - Michael Hortsch
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, MI USA
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, MI USA
| | - Renuka Krishnapillai
- Department of Anatomy, Government Medical College, Thiruvananthapuram, Kerala India
| |
Collapse
|
33
|
Yeh LH, Chowdhury S, Repina NA, Waller L. Speckle-structured illumination for 3D phase and fluorescence computational microscopy. BIOMEDICAL OPTICS EXPRESS 2019; 10:3635-3653. [PMID: 31467796 PMCID: PMC6706021 DOI: 10.1364/boe.10.003635] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/28/2019] [Revised: 06/09/2019] [Accepted: 06/11/2019] [Indexed: 05/29/2023]
Abstract
High-content biological microscopy targets high-resolution imaging across large fields-of-view, often achieved by computational imaging approaches. Previously, we demonstrated 2D multimodal high-content microscopy via structured illumination microscopy (SIM) with resolution > 2 × the diffraction limit, using speckle illumination from Scotch tape. In this work, we extend the method to 3D by leveraging the fact that the speckle illumination is in fact a 3D structured pattern. We use both a coherent and an incoherent imaging model to develop algorithms for joint retrieval of the 3D super-resolved fluorescent and complex-field distributions of the sample. Our reconstructed images resolve features beyond the physical diffraction-limit set by the system's objective and demonstrate 3D multimodal imaging with ∼ 0.6 × 0.6 × 6 μ m3 resolution over a volume of ∼ 314 × 500 × 24 μ m3.
Collapse
Affiliation(s)
- Li-Hao Yeh
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA 94720,
USA
| | - Shwetadwip Chowdhury
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA 94720,
USA
| | - Nicole A. Repina
- Graduate Program in Bioengineering, University of California, Berkeley, CA 94720,
USA
| | - Laura Waller
- Department of Electrical Engineering and Computer Sciences, University of California, Berkeley, Berkeley, CA 94720,
USA
- Graduate Program in Bioengineering, University of California, Berkeley, CA 94720,
USA
| |
Collapse
|
34
|
Yeh LH, Chowdhury S, Waller L. Computational structured illumination for high-content fluorescence and phase microscopy. BIOMEDICAL OPTICS EXPRESS 2019; 10:1978-1998. [PMID: 31061769 PMCID: PMC6485002 DOI: 10.1364/boe.10.001978] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 12/21/2018] [Revised: 02/17/2019] [Accepted: 03/13/2019] [Indexed: 05/05/2023]
Abstract
High-content biological microscopy targets high-resolution imaging across large fields-of-view (FOVs). Recent works have demonstrated that computational imaging can provide efficient solutions for high-content microscopy. Here, we use speckle structured illumination microscopy (SIM) as a robust and cost-effective solution for high-content fluorescence microscopy with simultaneous high-content quantitative phase (QP). This multi-modal compatibility is essential for studies requiring cross-correlative biological analysis. Our method uses laterally-translated Scotch tape to generate high-resolution speckle illumination patterns across a large FOV. Custom optimization algorithms then jointly reconstruct the sample's super-resolution fluorescent (incoherent) and QP (coherent) distributions, while digitally correcting for system imperfections such as unknown speckle illumination patterns, system aberrations and pattern translations. Beyond previous linear SIM works, we achieve resolution gains of 4× the objective's diffraction-limited native resolution, resulting in 700 nm fluorescence and 1.2 μm QP resolution, across a FOV of 2 × 2.7 mm 2 , giving a space-bandwidth product (SBP) of 60 megapixels.
Collapse
Affiliation(s)
- Li-Hao Yeh
- Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720,
USA
| | - Shwetadwip Chowdhury
- Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720,
USA
| | - Laura Waller
- Electrical Engineering and Computer Sciences, University of California, Berkeley, CA 94720,
USA
| |
Collapse
|
35
|
King TS, Sharma R, Jackson J, Fiebelkorn KR. Clinical Case-Based Image Portfolios in Medical Histopathology. ANATOMICAL SCIENCES EDUCATION 2019; 12:200-209. [PMID: 30118571 DOI: 10.1002/ase.1794] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/07/2017] [Revised: 02/02/2018] [Accepted: 04/03/2018] [Indexed: 06/08/2023]
Abstract
This descriptive article describes the use of clinical case-based portfolios in histopathology teaching laboratories in conjunction with virtual microscopy not only to integrate histology and pathology disciplines for first and second year medical students but also to stimulate student engagement, promote self-directed and group-based learning and enhance student-to-student interaction in a structured manner. Portfolios consisted of PowerPoint files encompassing four to five clinical case studies relevant to the topics covered that week. Portfolios integrated study materials provided in the module-specific lectures, clinical skill lectures, and online interactive content. Two sets of portfolios, Individual and Group, were used. Individual Portfolios were completed by each student and uploaded prior to the laboratory session. Group Portfolios were completed by students working together in small groups during the laboratory session with minimal faculty assistance. The functional utility and acceptance of Individual and Group Portfolios among first- and second-year medical students was evaluated using electronic surveys and examination performances. Both first- and second-year students agreed that the use of portfolios in conjunction with virtual microscopy promoted understanding and encouraged discussion of the topics covered during the week and that group members worked well together and contributed to the completion of the portfolios. Performances on the Histology and Cell Biology and Pathology sections on the United States Medical Licensing Examination® (USMLE® ) remained consistent and in line with national averages. Overall, use of portfolios promoted peer teaching and contributed towards successful transition to the new system-based integrated curriculum with continued strong performance on the USMLE.
Collapse
Affiliation(s)
- Thomas S King
- Department of Cell Systems and Anatomy, Long School of Medicine, UT-Health, San Antonio, Texas
- Department of Obstetrics-Gynecology, Long School of Medicine, UT-Health, San Antonio, Texas
| | - Ramaswamy Sharma
- Department of Cell Systems and Anatomy, Long School of Medicine, UT-Health, San Antonio, Texas
| | - Jeff Jackson
- Office of Undergraduate Medical Education, Long School of Medicine, UT-Health, San Antonio, Texas
| | | |
Collapse
|
36
|
Liu Y, Pantanowitz L. Digital pathology: Review of current opportunities and challenges for oral pathologists. J Oral Pathol Med 2019; 48:263-269. [DOI: 10.1111/jop.12825] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/22/2018] [Revised: 12/20/2018] [Accepted: 01/03/2019] [Indexed: 12/20/2022]
Affiliation(s)
- Yingci Liu
- Department of Diagnostic SciencesUniversity of Pittsburgh School of Dental Medicine Pittsburgh Pennsylvania
| | - Liron Pantanowitz
- Department of PathologyUniversity of Pittsburgh Medical Center Pittsburgh Pennsylvania
| |
Collapse
|
37
|
Lee LMJ, Goldman HM, Hortsch M. The virtual microscopy database-sharing digital microscope images for research and education. ANATOMICAL SCIENCES EDUCATION 2018; 11:510-515. [PMID: 29444388 DOI: 10.1002/ase.1774] [Citation(s) in RCA: 20] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/30/2017] [Revised: 01/20/2018] [Accepted: 01/20/2018] [Indexed: 06/08/2023]
Abstract
Over the last 20 years, virtual microscopy has become the predominant modus of teaching the structural organization of cells, tissues, and organs, replacing the use of optical microscopes and glass slides in a traditional histology or pathology laboratory setting. Although virtual microscopy image files can easily be duplicated, creating them requires not only quality histological glass slides but also an expensive whole slide microscopic scanner and massive data storage devices. These resources are not available to all educators and researchers, especially at new institutions in developing countries. This leaves many schools without access to virtual microscopy resources. The Virtual Microscopy Database (VMD) is a new resource established to address this problem. It is a virtual image file-sharing website that allows researchers and educators easy access to a large repository of virtual histology and pathology image files. With the support from the American Association of Anatomists (Bethesda, MD) and MBF Bioscience Inc. (Williston, VT), registration and use of the VMD are currently free of charge. However, the VMD site is restricted to faculty and staff of research and educational institutions. Virtual Microscopy Database users can upload their own collection of virtual slide files, as well as view and download image files for their own non-profit educational and research purposes that have been deposited by other VMD clients. Anat Sci Educ 11: 510-515. © 2018 American Association of Anatomists.
Collapse
Affiliation(s)
- Lisa M J Lee
- Department of Cell and Developmental Biology, University of Colorado School of Medicine, Aurora, Colorado
| | - Haviva M Goldman
- Department of Neurobiology and Anatomy, Drexel University College of Medicine, Philadelphia, Pennsylvania
| | - Michael Hortsch
- Department of Cell and Developmental Biology, University of Michigan Medical School, Ann Arbor, Michigan
- Department of Learning Health Sciences, University of Michigan Medical School, Ann Arbor, Michigan
| |
Collapse
|
38
|
Fernandes CI, Bonan RF, Bonan PR, Leonel AC, Carvalho EJ, de Castro JF, Perez DE. Dental Students’ Perceptions and Performance in Use of Conventional and Virtual Microscopy in Oral Pathology. J Dent Educ 2018; 82:883-890. [DOI: 10.21815/jde.018.084] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/17/2017] [Accepted: 11/29/2017] [Indexed: 11/20/2022]
Affiliation(s)
- Carla I.R. Fernandes
- Piracicaba Dental School, Oral Pathology Section; State University of Campinas; Piracicaba São Paulo Brazil
| | - Roberta F. Bonan
- School of Dentistry, Universidade Federal de Pernambuco; Recife Pernambuco Brazil
| | - Paulo R.F. Bonan
- School of Dentistry, Stomatology Section, Universidade Federal da Paraíba; João Pessoa Paraíba Brazil
| | | | - Elaine J.A. Carvalho
- School of Dentistry, Oral Pathology Section, Universidade Federal de Pernambuco; Recife Pernambuco Brazil
| | - Jurema F.L. de Castro
- School of Dentistry, Oral Pathology Section, Universidade Federal de Pernambuco; Recife Pernambuco Brazil
| | - Danyel E.C. Perez
- School of Dentistry, Oral Pathology Section, Universidade Federal de Pernambuco; Recife Pernambuco Brazil
| |
Collapse
|
39
|
Gopalan V, Kasem K, Pillai S, Olveda D, Ariana A, Leung M, Lam AKY. Evaluation of multidisciplinary strategies and traditional approaches in teaching pathology in medical students. Pathol Int 2018; 68:459-466. [PMID: 30043440 DOI: 10.1111/pin.12706] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Accepted: 06/22/2018] [Indexed: 11/28/2022]
Abstract
This study aims to evaluate the impact on the implementation of multiple strategies to improve medical student's pathology learning experience. In two consecutive years, medical students after a whole year of enrolling in pathology teaching, were invited to complete questionnaires rating and commenting on the personal learning experience of multiple teaching resources delivered in pathology. In both years, the overall score was high (mean score = 4.57 ± 0.63 /5) for the newly introduced sessions, namely histology lectures, clinical integrations and virtual microscopy pre-practical sessions. However, this was only marginally different from that of traditional practical (mean = 4.37 ± 0.68/5) and pathology lecture sessions (mean = 4.42 ± 0.61 /5). In addition, 53% positive correlation was noted for the overall responses between virtual microscopy guided pathology modules and practical sessions indicating the benefit of virtual microscopy in better preparing students for these sessions (P < 0.001). Qualitative comments suggested that the virtual microscopy sessions along with clinical scenario based learning were extremely useful for students' learning in pathology. To conclude, a multidisciplinary approach by clinical integration and flexibility in the mode of delivery by the use of virtual microscopy has the potential to better engage students to the learning of pathology.
Collapse
Affiliation(s)
- Vinod Gopalan
- Pathology, School of Medicine, Griffith University, Gold Coast
| | - Kais Kasem
- Pathology, School of Medicine, Griffith University, Gold Coast
- Faculty of Medicine, School of Biomedical Science, University of Queensland, Queensland
| | - Suja Pillai
- Pathology, School of Medicine, Griffith University, Gold Coast
- Faculty of Medicine, School of Biomedical Science, University of Queensland, Queensland
| | - David Olveda
- Pathology, School of Medicine, Griffith University, Gold Coast
| | - Armin Ariana
- Pathology, School of Medicine, Griffith University, Gold Coast
| | - Melissa Leung
- Pathology, School of Medicine, Griffith University, Gold Coast
| | - Alfred K Y Lam
- Pathology, School of Medicine, Griffith University, Gold Coast
- Pathology Queensland, Gold Coast University Hospital, Gold Coast, Australia
| |
Collapse
|
40
|
Decker P, Christian A, Xylander WER. VIRMISCO - The Virtual Microscope Slide Collection. Zookeys 2018:271-282. [PMID: 29706780 PMCID: PMC5904399 DOI: 10.3897/zookeys.741.22284] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2017] [Accepted: 02/08/2018] [Indexed: 11/22/2022] Open
Abstract
Digitisation allows scientists rapid access to research objects. For transparent to semi-transparent three-dimensional microscopic objects, such as microinvertebrates or small body parts of organisms, available databases are scarce. Most mounting media used for permanent microscope slides deteriorate after some years or decades, eventually leading to total damage and loss of the object. However, restoration is labour-intensive, and often the composition of the mounting media is not known. A digital preservation of important material, especially types, is important and an urgent need. The Virtual Microscope Slide Collection – VIRMISCO project has developed recommendations for taking microscopic image stacks of three-dimensional objects, depositing and presenting such series of digital image files or z-stacks as an online platform. The core of VIRMISCO is an online viewer, which enables the user to virtually focus through an object online as if using a real microscope. Additionally, VIRMISCO offers features such as search, rotating, zooming, measuring, changing brightness or contrast, taking snapshots, leaving feedback as well as downloading complete z-stacks as jpeg files or video file. The open source system can be installed by any institution and can be linked to common database or images can be sent to the Senckenberg Museum of Natural History Görlitz. The benefits of VIRMISCO are the preservation of important or fragile material, to avoid loan, to act as a digital archive for image files and to allow determination by experts from the distance, as well as providing reference libraries for taxonomic research or education and providing image series as online supplementary material for publications or digital vouchers of specimens of molecular investigations are relevant applications for VIRMISCO.
Collapse
Affiliation(s)
- Peter Decker
- Senckenberg Museum of Natural History Görlitz, Görlitz, Germany
| | - Axel Christian
- Senckenberg Museum of Natural History Görlitz, Görlitz, Germany
| | | |
Collapse
|
41
|
Nwizu NN, Owosho A, Ogbureke KUE. Emerging paradigm of virtual-microscopy for histopathology diagnosis: survey of US and Canadian oral pathology trainees. BDJ Open 2018; 3:17013. [PMID: 29607083 PMCID: PMC5842823 DOI: 10.1038/bdjopen.2017.13] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/21/2016] [Revised: 05/15/2017] [Accepted: 05/19/2017] [Indexed: 11/11/2022] Open
Abstract
Objectives/Aims: The application of virtual microscopy (VM) to research, pre-doctoral medical and dental educational training, and diagnostic surgical and anatomic pathology is well-documented but its application to the field of oral and maxillofacial pathology has not been explored. This is the first study to evaluate the enthusiasm and readiness of US-/Canada-based oral and maxillofacial pathology (OMFP) residents toward employing VM use over conventional microscopy (CM) for diagnostic purposes. Materials and Methods: All 46 current US-/Canada-based OMFP residents were invited to participate in an anonymous electronic survey via ‘Survey Monkey’ in 2015. The survey comprised sixteen multiple choice questions and two ‘free text’ questions. Results: 14% of respondents of the 22 (48%) respondents who completed the survey indicated a willingness to substitute CM with VM in <5 years, and 33% within 10 years. 52% reported they would never substitute CM with VM. Approximately 10 and 57% of respondents thought VM will become an acceptable sole diagnostic tool in most centers within 5 and 10 years, respectively. These findings are irrespective of the fact that overall, 90% of respondents reported being familiar with VM use. Discussion: VM technology is unlikely to substitute CM in diagnostic oral and maxillofacial histopathology practice among future OMFP practitioners in the foreseeable future.
Collapse
Affiliation(s)
- Ngozi N Nwizu
- Department of Diagnostic and Biomedical Sciences, The University of Texas School of Dentistry at Houston, Houston, TX, USA
| | - Adepitan Owosho
- Department of Surgery, Dental Services, Memorial Sloan-Kettering Cancer Center, New York, USA
| | - Kalu U E Ogbureke
- Department of Diagnostic and Biomedical Sciences, The University of Texas School of Dentistry at Houston, Houston, TX, USA
| |
Collapse
|
42
|
Abstract
Virtual microscopy is a method by which real-time microscopic illustrations get transmitted digitally via computer networks. There is increasing evidence to suggest that virtual microscopy combined with other didactic methods in teaching make significant improvements in student interaction and curiosity in histopathology and haematology teaching. The introduction of virtual microscopy has opened up a big arena in the field of e-learning in histopathology and haematology curriculum. Case studies prove the technological benefits of virtual microscopy in interacting off-campus students and educators. Recent technological advances have improved the use of virtual microscopy and enabled them to complement students learning in class room as well as for routine diagnostics. In this chapter, the authors discuss the significance, usefulness, and limitations of virtual microscopy in education. In addition, the chapter has provided several technical considerations to develop a friendly web-based virtual microscopy tool in teaching.
Collapse
|
43
|
Bertram CA, Firsching T, Klopfleisch R. Virtual Microscopy in Histopathology Training: Changing Student Attitudes in 3 Successive Academic Years. JOURNAL OF VETERINARY MEDICAL EDUCATION 2017; 45:241-249. [PMID: 29099317 DOI: 10.3138/jvme.1216-194r1] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 06/07/2023]
Abstract
Several veterinary faculties have integrated virtual microscopy into their curricula in recent years to improve and refine their teaching techniques. The many advantages of this recent technology are described in the literature, including remote access and an equal and constant slide quality for all students. However, no study has analyzed the change of perception toward virtual microscopy at different time points of students' academic educations. In the present study, veterinary students in 3 academic years were asked for their perspectives and attitudes toward virtual microscopy and conventional light microscopy. Third-, fourth-, and fifth-year veterinary students filled out a questionnaire with 12 questions. The answers revealed that virtual microscopy was overall well accepted by students of all academic years. Most students even suggested that virtual microscopy be implemented more extensively as the modality for final histopathology examinations. Nevertheless, training in the use of light microscopy and associated skills was surprisingly well appreciated. Regardless of their academic year, most students considered these skills important and necessary, and they felt that light microscopy should not be completely replaced. The reasons for this view differed depending on academic year, as the perceived main disadvantage of virtual microscopy varied. Third-year students feared that they would not acquire sufficient light microscopy skills. Fifth-year students considered technical difficulties (i.e., insufficient transmission speed) to be the main disadvantage of this newer teaching modality.
Collapse
Affiliation(s)
- Christof A Bertram
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, 14163 Berlin, Germany
| | - Theresa Firsching
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, 14163 Berlin, Germany
| | - Robert Klopfleisch
- Institute of Veterinary Pathology, Freie Universität Berlin, Robert-von-Ostertag-Str. 15, 14163 Berlin, Germany.
| |
Collapse
|
44
|
Egevad L, Cheville J, Evans AJ, Hörnblad J, Kench JG, Kristiansen G, Leite KRM, Magi-Galluzzi C, Pan CC, Samaratunga H, Srigley JR, True L, Zhou M, Clements M, Delahunt B. Pathology Imagebase-a reference image database for standardization of pathology. Histopathology 2017; 71:677-685. [DOI: 10.1111/his.13313] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/11/2017] [Accepted: 07/15/2017] [Indexed: 11/28/2022]
Affiliation(s)
- Lars Egevad
- Department of Oncology and Pathology; Karolinska Institutet; Stockholm Sweden
| | - John Cheville
- Department of Laboratory Medicine and Pathology; Mayo Clinic; Rochester MN USA
| | - Andrew J Evans
- Laboratory Medicine Program; Toronto General Hospital; University Health Network; Toronto ON Canada
| | - Jonas Hörnblad
- Department of Oncology and Pathology; Karolinska Institutet; Stockholm Sweden
| | - James G Kench
- Department of Tissue Pathology and Diagnostic Oncology; Royal Prince Alfred Hospital and Central Clinical School; University of Sydney; Sydney NSW Australia
| | | | - Katia R M Leite
- Department of Urology; Laboratory of Medical Research; University of Sao Paulo Medical School; Sao Paulo Brazil
| | - Cristina Magi-Galluzzi
- Department of Anatomic Pathology; Cleveland Clinic Lerner College of Medicine; Cleveland Clinic; Cleveland OH USA
| | - Chin-Chen Pan
- Department of Pathology; Taipei Veterans General Hospital; Taipei Taiwan
| | | | - John R Srigley
- Department of Laboratory Medicine and Pathobiology; University of Toronto; Toronto ON Canada
| | - Lawrence True
- Department of Pathology; University of Washington Medical Center; Seattle WA USA
| | - Ming Zhou
- Department of Pathology; UT Southwestern Medical Center; Dallas TX USA
| | - Mark Clements
- Department of Medical Epidemiology and Biostatistics; Karolinska Institutet; Stockholm Sweden
| | - Brett Delahunt
- Department of Pathology and Molecular Medicine; Wellington School of Medicine and Health sciences; University of Otago; Wellington New Zealand
| | | |
Collapse
|
45
|
Amaral KB, Silva TP, Dias FF, Malta KK, Rosa FM, Costa-Neto SF, Gentile R, Melo RCN. Histological assessment of granulomas in natural and experimental Schistosoma mansoni infections using whole slide imaging. PLoS One 2017; 12:e0184696. [PMID: 28902908 PMCID: PMC5597217 DOI: 10.1371/journal.pone.0184696] [Citation(s) in RCA: 40] [Impact Index Per Article: 5.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/16/2017] [Accepted: 08/29/2017] [Indexed: 01/21/2023] Open
Abstract
The pathology of schistosomiasis mansoni, a neglected tropical disease of great clinical and socioeconomic importance, results from the parasite eggs that become trapped in host tissues, particularly in the liver and intestines. Continuous antigenic stimulation from these eggs leads to recruitment of inflammatory cells to the sites of infection with formation of periovular granulomas. These complex structures have variable size and composition and are the most striking histopathological feature of schistosomiasis mansoni. However, evaluation of granulomas by conventional microscopy methods is time-consuming and limited, especially in large-scale studies. Here, we used high resolution Whole Slide Imaging (WSI), which allows fast scanning of entire histological slides, and multiple morphometric evaluations, to assess the granulomatous response elicited in target organs (liver, small and large intestines) of two models of schistosomiasis mansoni. One of the advantages of WSI, also termed virtual microscopy, is that it generates images that simultaneously offer high resolution and a wide field of observation. By using a model of natural (Nectomys squamipes, a wild reservoir captured from endemic areas in Brazil) and experimental (Swiss mouse) infection with Schistosoma mansoni, we provided the first detailed WSI characterization of granulomas and other pathological aspects. WSI and quantitative analyses enabled a fast and reliable assessment of the number, evolutional types, frequency and areas of granulomas and inflammatory infiltrates and revealed that target organs are differentially impacted by inflammatory responses in the natural and experimental infections. Remarkably, high-resolution analysis of individual eosinophils, key cells elicited by this helminthic infection, showed a great difference in eosinophil numbers between the two infections. Moreover, features such as the intestinal egg path and confluent granulomas were uncovered. Thus, WSI may be a suitable tool for detailed and precise histological analysis of granulomas and other pathological aspects for clinical and research studies of schistosomiasis.
Collapse
Affiliation(s)
- Kátia B. Amaral
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Thiago P. Silva
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Felipe F. Dias
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Kássia K. Malta
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Florence M. Rosa
- Laboratory of Parasitology, Department of Parasitology, Microbiology and Immunology, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
| | - Sócrates F. Costa-Neto
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Rosana Gentile
- Laboratory of Biology and Parasitology of Wild Reservoir Mammals, Oswaldo Cruz Foundation, Rio de Janeiro, RJ, Brazil
| | - Rossana C. N. Melo
- Laboratory of Cellular Biology, Department of Biology, Federal University of Juiz de Fora (UFJF), Juiz de Fora, MG, Brazil
- * E-mail:
| |
Collapse
|
46
|
Pereira E Silva A, Nicolau Campos SM, Guimarães IM, Agate Platais Brasil Teixeira G. Comparison between digital and optical microscopy: Analysis in a mouse gut inflammation model. Biomed Rep 2017; 7:247-250. [PMID: 28894572 DOI: 10.3892/br.2017.950] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/05/2017] [Accepted: 06/28/2017] [Indexed: 12/20/2022] Open
Abstract
Virtual microscopy is currently widely used for various purposes, such as teaching, archiving, collaborations and research. Although the cost of this technique has reduced, it continues to be expensive for the majority of laboratories in developing countries. The Graduate Program in Pathology at the Federal Fluminense University (Niterói, Brazil) has acquired equipment for virtual microscopy. However, this novel method faced prejudice, as students and technicians were skeptical about its reliability. Thus, the aim of the current study was to evaluate whether virtual microscopy is a reliable method of analysis for our research. Thus, a mouse gut inflammation model developed by our research group was used in the present study. Analysis was performed using optical microscopy and digital imaging using the APERIO scanning system and the ImageScope® software. Intestinal epithelial cells (IECs), intra epithelial leucocytes (IEL), and villi number and area were evaluated. No significant differences were observed in villi number, IEC and IEL; however, the villi area was significantly smaller when measured using the computer. Thus, the present study indicates that virtual microscopy is a trustworthy method for research purposes.
Collapse
Affiliation(s)
- Airton Pereira E Silva
- Gastrointestinal Immunology Group, Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Rio de Janeiro 24020-150, Brazil.,Graduation Program in Pathology, Medicine School, Antônio Pedro Hospital, Federal Fluminense University, Niterói, Rio de Janeiro 24033-900, Brazil
| | - Sylvia Maria Nicolau Campos
- Gastrointestinal Immunology Group, Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Rio de Janeiro 24020-150, Brazil
| | - Isabelle Mazza Guimarães
- Gastrointestinal Immunology Group, Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Rio de Janeiro 24020-150, Brazil.,Graduation Program in Science and Biotechnology, Federal Fluminense University, Niterói, Rio de Janeiro 24020-141, Brazil
| | - Gerlinde Agate Platais Brasil Teixeira
- Gastrointestinal Immunology Group, Department of Immunobiology, Institute of Biology, Federal Fluminense University, Niterói, Rio de Janeiro 24020-150, Brazil.,Graduation Program in Pathology, Medicine School, Antônio Pedro Hospital, Federal Fluminense University, Niterói, Rio de Janeiro 24033-900, Brazil.,Graduation Program in Science and Biotechnology, Federal Fluminense University, Niterói, Rio de Janeiro 24020-141, Brazil
| |
Collapse
|
47
|
Bertram CA, Klopfleisch R. The Pathologist 2.0: An Update on Digital Pathology in Veterinary Medicine. Vet Pathol 2017; 54:756-766. [DOI: 10.1177/0300985817709888] [Citation(s) in RCA: 45] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/19/2022]
Affiliation(s)
- Christof A. Bertram
- Institute of Veterinary Pathology, Freie Universitaet Berlin, Berlin, Germany
| | - Robert Klopfleisch
- Institute of Veterinary Pathology, Freie Universitaet Berlin, Berlin, Germany
| |
Collapse
|
48
|
Vainer B, Mortensen NW, Poulsen SS, Sørensen AH, Olsen J, Saxild HH, Johansen FF. Turning Microscopy in the Medical Curriculum Digital: Experiences from The Faculty of Health and Medical Sciences at University of Copenhagen. J Pathol Inform 2017; 8:11. [PMID: 28382225 PMCID: PMC5364742 DOI: 10.4103/2153-3539.201919] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2016] [Accepted: 12/13/2016] [Indexed: 11/15/2022] Open
Abstract
Familiarity with the structure and composition of normal tissue and an understanding of the changes that occur during disease is pivotal to the study of the human body. For decades, microscope slides have been central to teaching pathology in medical courses and related subjects at the University of Copenhagen. Students had to learn how to use a microscope and envisage three-dimensional processes that occur in the body from two-dimensional glass slides. Here, we describe how a PathXL virtual microscopy system for teaching pathology and histology at the Faculty has recently been implemented, from an administrative, an economic, and a teaching perspective. This fully automatic digital microscopy system has been received positively by both teachers and students, and a decision was made to convert all courses involving microscopy to the virtual microscopy format. As a result, conventional analog microscopy will be phased out from the fall of 2016.
Collapse
Affiliation(s)
- Ben Vainer
- Department of Biomedical Sciences, Molecular Pathology Section, University of Copenhagen, Copenhagen, Denmark; Department of Pathology, Copenhagen University Hospital, Rigshospitalet, Denmark
| | | | - Steen Seier Poulsen
- Department of Biomedical Sciences, Endocrinology Research Section, University of Copenhagen, Copenhagen, Denmark
| | | | - Jørgen Olsen
- Department of Cellular and Molecular Medicine, Section VIII, University of Copenhagen, Copenhagen, Denmark
| | - Hans Henrik Saxild
- The Dean's Office, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Flemming Fryd Johansen
- Department of Biomedical Sciences, Molecular Pathology Section, University of Copenhagen, Copenhagen, Denmark
| |
Collapse
|
49
|
Elmore JG, Longton GM, Pepe MS, Carney PA, Nelson HD, Allison KH, Geller BM, Onega T, Tosteson ANA, Mercan E, Shapiro LG, Brunyé TT, Morgan TR, Weaver DL. A Randomized Study Comparing Digital Imaging to Traditional Glass Slide Microscopy for Breast Biopsy and Cancer Diagnosis. J Pathol Inform 2017; 8:12. [PMID: 28382226 PMCID: PMC5364740 DOI: 10.4103/2153-3539.201920] [Citation(s) in RCA: 24] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/27/2016] [Accepted: 01/18/2017] [Indexed: 01/19/2023] Open
Abstract
Background: Digital whole slide imaging may be useful for obtaining second opinions and is used in many countries. However, the U.S. Food and Drug Administration requires verification studies. Methods: Pathologists were randomized to interpret one of four sets of breast biopsy cases during two phases, separated by ≥9 months, using glass slides or digital format (sixty cases per set, one slide per case, n = 240 cases). Accuracy was assessed by comparing interpretations to a consensus reference standard. Intraobserver reproducibility was assessed by comparing the agreement of interpretations on the same cases between two phases. Estimated probabilities of confirmation by a reference panel (i.e., predictive values) were obtained by incorporating data on the population prevalence of diagnoses. Results: Sixty-five percent of responding pathologists were eligible, and 252 consented to randomization; 208 completed Phase I (115 glass, 93 digital); and 172 completed Phase II (86 glass, 86 digital). Accuracy was slightly higher using glass compared to digital format and varied by category: invasive carcinoma, 96% versus 93% (P = 0.04); ductal carcinoma in situ (DCIS), 84% versus 79% (P < 0.01); atypia, 48% versus 43% (P = 0.08); and benign without atypia, 87% versus 82% (P < 0.01). There was a small decrease in intraobserver agreement when the format changed compared to when glass slides were used in both phases (P = 0.08). Predictive values for confirmation by a reference panel using glass versus digital were: invasive carcinoma, 98% and 97% (not significant [NS]); DCIS, 70% and 57% (P = 0.007); atypia, 38% and 28% (P = 0.002); and benign without atypia, 97% and 96% (NS). Conclusions: In this large randomized study, digital format interpretations were similar to glass slide interpretations of benign and invasive cancer cases. However, cases in the middle of the spectrum, where more inherent variability exists, may be more problematic in digital format. Future studies evaluating the effect these findings exert on clinical practice and patient outcomes are required.
Collapse
Affiliation(s)
- Joann G Elmore
- Department of Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA
| | - Gary M Longton
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA
| | - Margaret S Pepe
- Fred Hutchinson Cancer Research Center, Seattle, WA 98109, USA; Department of Biostatistics, University of Washington School of Public Health, Seattle, WA 98104, USA
| | - Patricia A Carney
- Department of Family Medicine, Oregon Health and Science University, Portland, OR 97239, USA
| | - Heidi D Nelson
- Department of Medical Informatics and Clinical Epidemiology, Oregon Health and Science University, Portland, OR 97239, USA; Providence Cancer Center, Providence Health and Services Oregon, Portland, OR 97213, USA
| | - Kimberly H Allison
- Department of Pathology, Stanford University School of Medicine, Stanford, CA 94305, USA
| | - Berta M Geller
- Department of Family Medicine, University of Vermont, Burlington, VT 05405, USA
| | - Tracy Onega
- Department of Biomedical Data Science, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Anna N A Tosteson
- The Dartmouth Institute for Health Policy and Clinical Practice, Norris Cotton Cancer Center, Geisel School of Medicine at Dartmouth, Lebanon, NH 03756, USA
| | - Ezgi Mercan
- Department of Computer Science and Engineering, University of Washington, Seattle, WA 98195, USA
| | - Linda G Shapiro
- Department of Computer Science and Engineering, University of Washington, Seattle, WA 98195, USA
| | - Tad T Brunyé
- Department of Psychology, Tufts University, Medford, MA 02155, USA
| | - Thomas R Morgan
- Department of Medicine, University of Washington School of Medicine, Seattle, WA 98104, USA
| | - Donald L Weaver
- Department of Pathology, UVM Cancer Center, University of Vermont, Burlington, VT 05405, USA
| |
Collapse
|
50
|
Telang A, Jong ND, Dalen JV. Media Matter: The Effect of Medium of Presentation on Student's Recognition of Histopathology. J Clin Diagn Res 2017; 10:JC01-JC05. [PMID: 28208881 DOI: 10.7860/jcdr/2016/22208.8969] [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: 06/23/2016] [Accepted: 09/12/2016] [Indexed: 11/24/2022]
Abstract
INTRODUCTION Pathology teaching has undergone transformation with the introduction of virtual microscopy as a teaching and learning tool. AIM To assess if dental students can identify histopathology irrespective of the media of presentation and if the media affect student's oral pathology case based learning scores. The perception of students towards "hybrid" approach in teaching and learning histopathology in oral pathology was also assessed. MATERIALS AND METHODS A controlled experiment was conduc-ted on year 4 and year 5 dental student groups using a perfor-mance test and a questionnaire survey. RESULTS A response rate of 81% was noted for the performance test as well as the questionnaire survey. Results show a significant effect of media on performance of students with virtual microscopy bringing out the best performance across all student groups in case based learning scenarios. The order of preference for media was found to be virtual microscopy followed by photomicrographs and light microscopy. However, 94% of students still prefer the present hybrid system for teaching and learning of oral pathology. CONCLUSION The study shows that identification of histo-pathology by students is dependent on media and the type of media has a significant effect on the performance. Virtual microscopy is strongly perceived as a useful tool for learning which thus brings out the best performance, however; the hybrid approach still remains the most preferred approach for histopathology learning.
Collapse
Affiliation(s)
- Ajay Telang
- Associate Professor, Department of Oral Pathology, Penang International Dental College , Butterworth, Penang, Malaysia
| | - Nynke De Jong
- Assistant Professor, Department of Educational Development and Research, School of Health Professions Education, Maastricht University , Maastricht, Netherlands
| | - Jan Van Dalen
- Director of Training and Assessment of Communication Skills, Department of Skills Lab, School of Health Professions Education, Maastricht University , Maastricht, Netherlands
| |
Collapse
|