Improvements in education in pathology: Virtual 3D specimens

Three-Dimensional Virtual Pathology Specimens: Decrease in Student Performance upon Switching to Digital Models

Several alternatives to formalin-stored physical specimens have been described in medical literature, but only a few studies have addressed the issue of learning outcomes when these materials were employed. The aim of this study was to conduct a prospective controlled study to assess student performance in learning anatomic pathology when adding three-dimensional (3D) virtual models as adjunct teaching materials in the study of macroscopic lesions. Third-year medical students (n = 501) enrolled at the Victor Babes University of Medicine and Pharmacy in Timisoara, Romania, were recruited to participate. Student performance was assessed through questionnaires. Students performed worse with new method, with poorer results in terms of overall (mean 77.6% ±SD 11.8% vs. 83.6% ±10.5) and individual question scores (percentage of questions with maximum score 34.6% ±25.6 vs. 47.7 ± 24.6). This decreased performance was generalizable, as it was observed across all language divisions and was independent of the teaching assistant involved in the process. In an open-ended feedback evaluation of the new 3D specimens, most students agreed that the new method was better, bringing arguments both for and against these models. Although subjectively the students found the novel teaching materials to be more helpful, their learning performance decreased. A wider implementation as well as exposure to the technique and use of virtual specimens in medical teaching could improve the students' performance outcome by accommodating the needs for novel teaching materials for digital natives.

Nephrology education for medical students: a narrative review

BACKGROUND

Strategies used to teach nephrology to medical students are not well studied. This study assesses the published literature on medical student education in nephrology.

METHODS

A review of the published literature on nephrology education for medical students was conducted on two major online search engines (PubMed and ERIC). In addition, references of the manuscripts discovered in these searches were reviewed. The empirical studies were categorized by subject within nephrology and research design.

RESULTS

We found 26 original studies in which a method of teaching nephrology to medical students was described. The studies dated from 1977 to 2015. The focus of these nephrology teaching experiences was as follows: anatomy (6.5%), physiology (22.6%), pathophysiology (29.0%), pathology (6.5%), treatment (25.8%), and general nephrology (9.7%). The studies were also categorized into various types of research design. 6.9% had either no assessment of the educational experience or had a description too vague to categorize it; 3.4% involved a survey about the existing educational approach before a curriculum change was implemented; 55.2% used surveys or tests after an educational course was carried out; 10.3% sought feedback from students before and after the educational experience; 13.8% were case studies; and 10.3% included a randomized controlled trial. The randomized controlled trials involved teaching techniques focused on the pathophysiology of renal disease.

CONCLUSIONS

Rigor was lacking in most empirical studies on medical student education in nephrology. Well-designed randomized controlled studies are needed to accurately assess the effectiveness of the educational techniques introduced into medical school curricula.

Using stereoscopy to teach complex biological concepts

Used effectively, stereoscopic three-dimensional (3D) technologies can engage students with complex disciplinary content as they are presented with informative representations of abstract concepts. In addition, preliminary evidence suggests that stereoscopy may enhance learning and retention in some educational settings. Biological concepts particularly benefit from this type of presentation since complex spatially oriented structures frequently define function within these systems. Viewing biological phenomena in 3D as they are in real life allows the user to relate these spatial relationships and easily grasp concepts making the key connection between structure and function. In addition, viewing these concepts interactively in 3D and in a manner that leads to increased engagement for young prospective scientists can further increase the impact. We conducted two studies evaluating the use of this technology as an instructional tool to teach high school students complex biological concepts. The first study tested the use of stereoscopic materials for teaching brain function and human anatomy to four classes. The second study evaluated stereoscopic images to support the learning of cell structure and DNA in four different high school classes. Most important, students who used stereoscopic 3D had significantly higher test scores than those who did not. In addition, students reported enjoying 3D presentations, and it was among their top choices for learning about these complex concepts. In summary, our evidence adds further support for the benefits of 3D images to students' learning of science concepts.

A survey study on student preferences regarding pathology teaching in Germany: a call for curricular modernization

BACKGROUND

Pathology is a discipline that provides the basis of the understanding of disease in medicine. The past decades have seen a decline in the emphasis laid on pathology teaching in medical schools and outdated pathology curricula have worsened the situation. Student opinions and thoughts are central to the questions of whether and how such curricula should be modernized.

METHODS

A survey was conducted among 1018 German medical students regarding their preferences in pathology teaching modalities and their satisfaction with lecture-based courses. A qualitative analysis was performed comparing a recently modernized pathology curriculum with a traditional lecture-based curriculum. The differences in modalities of teaching used were investigated.

RESULTS

Student satisfaction with the lecture-based curriculum positively correlated with student grades (spearman's correlation coefficient 0.24). Additionally, students with lower grades supported changing the curriculum (spearman's correlation coefficient 0.47). The majority supported virtual microscopy, autopsies, seminars and podcasts as preferred didactic methods.

CONCLUSIONS

The data supports the implementation of a pathology curriculum where tutorials, autopsies and supplementary computer-based learning tools play important roles.

Lossless compression of JPEG2000 whole slide images is not required for diagnostic virtual microscopy

The use of lossy compression in medical imaging is controversial, although it is inevitable to reduce large data amounts. In contrast with lossy compression, lossless compression does not impair image quality. In addition to our previous studies, we evaluated virtual 3-dimensional microscopy using JPEG2000 whole slide images of gastric biopsy specimens with or without Helicobacter pylori gastritis using lossless compression (1:1) or lossy compression with different compression levels: 5:1, 10:1, and 20:1. The virtual slides were diagnosed in a blinded manner by 3 pathologists using the updated Sydney classification. The results showed no significant differences in the diagnosis of H pylori between the different levels of compression in virtual microscopy. We assume that lossless compression is not required for diagnostic virtual microscopy. The limits of lossy compression in virtual microscopy without a loss of diagnostic quality still need to be determined. Analogous to the processes in radiology, recommendations for the use of lossy compression in diagnostic virtual microscopy have to be worked out by pathology societies.

Digital imaging in cytopathology

Rapid advances are occurring in the field of cytopathology, particularly in the field of digital imaging. Today, digital images are used in a variety of settings including education (E-education), as a substitute to multiheaded sessions, multisite conferences, publications, cytopathology web pages, cytology proficiency testing, telecytology, consultation through telecytology, and automated screening of Pap test slides. The accessibility provided by digital imaging in cytopathology can improve the quality and efficiency of cytopathology services, primarily by getting the expert cytopathologist to remotely look at the slide. This improved accessibility saves time and alleviates the need to ship slides, wait for glass slides, or transport pathologists. Whole slide imaging (WSI) is a digital imaging modality that uses computerized technology to scan and convert pathology and cytology glass slides into digital images (digital slides) that can be viewed remotely on a workstation using viewing software. In spite of the many advances, challenges remain such as the expensive initial set-up costs, workflow interruption, length of time to scan whole slides, large storage size for WSI, bandwidth restrictions, undefined legal implications, professional reluctance, and lack of standardization in the imaging process.

Automated generation of massive image knowledge collections using Microsoft Live Labs Pivot to promote neuroimaging and translational research

BACKGROUND

Massive datasets comprising high-resolution images, generated in neuro-imaging studies and in clinical imaging research, are increasingly challenging our ability to analyze, share, and filter such images in clinical and basic translational research. Pivot collection exploratory analysis provides each user the ability to fully interact with the massive amounts of visual data to fully facilitate sufficient sorting, flexibility and speed to fluidly access, explore or analyze the massive image data sets of high-resolution images and their associated meta information, such as neuro-imaging databases from the Allen Brain Atlas. It is used in clustering, filtering, data sharing and classifying of the visual data into various deep zoom levels and meta information categories to detect the underlying hidden pattern within the data set that has been used.

METHOD

We deployed prototype Pivot collections using the Linux CentOS running on the Apache web server. We also tested the prototype Pivot collections on other operating systems like Windows (the most common variants) and UNIX, etc. It is demonstrated that the approach yields very good results when compared with other approaches used by some researchers for generation, creation, and clustering of massive image collections such as the coronal and horizontal sections of the mouse brain from the Allen Brain Atlas.

RESULTS

Pivot visual analytics was used to analyze a prototype of dataset Dab2 co-expressed genes from the Allen Brain Atlas. The metadata along with high-resolution images were automatically extracted using the Allen Brain Atlas API. It is then used to identify the hidden information based on the various categories and conditions applied by using options generated from automated collection. A metadata category like chromosome, as well as data for individual cases like sex, age, and plan attributes of a particular gene, is used to filter, sort and to determine if there exist other genes with a similar characteristics to Dab2. And online access to the mouse brain pivot collection can be viewed using the link http://edtech-dev.uthsc.edu/CTSI/teeDev1/unittest/PaPa/collection.html (user name: tviangte and password: demome)

CONCLUSIONS

Our proposed algorithm has automated the creation of large image Pivot collections; this will enable investigators of clinical research projects to easily and quickly analyse the image collections through a perspective that is useful for making critical decisions about the image patterns discovered.