Virtual Microscopy in Undergraduate Pathology Education: An early transformative experience in clinical reasoning

Abstract

Objectives: Whole-slide imaging (WSI) and virtual microscopy (VM) have revolutionized teaching, diagnosis and research in histopathology. The aims of this study were to establish the feasibility of achieving early integration of clinical reasoning with undergraduate pathology teaching on a virtual microscopy platform and, to determine its student-centricity through student feedback. Methods: Thirty-eight VM-centered clinical cases were introduced to forty-nine 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 fifteen interactive small-group sessions. A simulated cross-disciplinary integration and judicious choice of pertinent diagnostic investigations was 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 4-5 on a Likert scale of 1-5 by 91.84%, 87.75% and 83.67% students respectively. Students agreed on content-match to the stage of learning (81.63%), theme of the week (91.84%) and development of a strong clinical foundation (77.5%). Integration (85.71%) and clinico-pathological correlation (83.67%) were 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-centered approach with clinico-pathological correlation has been successfully introduced to inculcate integrated learning. Using the pathologic basis of disease as fulcrum and critical reasoning as anchor, a digitally-enabled generation of medical students have embraced this educational tool for tutor-guided, student-centered learning.

Keywords: virtual, digital, pathology, microscopy, medical education