Knowledge Acquisition and Satisfaction of Virtual Microscopy Usage Among Medical Students of Universiti Sains Malaysia

The virtual microscope has been employed as an adjunct tool to teach optical microscopy for histology learning in medical schools. However, there is no reliable evidence in the literature that virtual and optical microscopy impacts students’ learning. This study focuses on comparing two different methods in learning histology in Universiti Sains Malaysia, namely virtual microscopy and optical microscopy, with regard to medical students’ knowledge acquisition and satisfaction levels. A total number of 120 medical students, consisting of 53 first-year and 67 second-year students, were recruited. The students were divided into virtual microscopy and optical microscopy groups. During the one-day intervention, all students attended a pre-requisite lecture on “Histology of the Eye”, a slide demonstration and a hands-on session using a designated microscope. Students’ knowledge acquisition was evaluated through a pre- and post-practical evaluation and their satisfaction level on learning histology using respective learning tools was measured. The study revealed that the optical and virtual microscopy groups showed significant improvement from the pre- to post-practical tests scores with p < 0.001, respectively. However, the mean increment was higher in virtual microscopy (38.51%) than in optical microscopy (35.08%). Furthermore, the virtual microscopy group had a significantly higher satisfaction score towards the learning tool than the optical microscopy group, p = 0.008. The knowledge acquisition of the virtual microscopy group was equal to the optical microscopy group as they were shown to have a similar improvement in the test scores, comprehension level and learning ability. However, students were nonetheless satisfied with the usage of virtual microscopy as a learning tool.

Anatomy Education Environment among Pre-Clinical Medical Students in Universiti Putra Malaysia Using Anatomy Education Environment Measurement Inventory

Anatomy is the foundation of medicine. Having adequate anatomy knowledge would improve medical students’ comprehension of pathology and patient management. The evolving scenario in anatomy education has created a changing educational environment in medical schools. Since educational environment influence the students’ motivation and ability to learn, it is pertinent to measure anatomy education environment as a feedback mechanism tool for further improvement in the curriculum. This study was performed to measure pre-clinical medical students’ perception of the anatomy education environment in Universiti Putra Malaysia (UPM) by using a validated 25-item inventory, known as the Anatomy Education Environment Measurement Inventory (AEEMI). The inventory was distributed online to 171 first- and second-year medical students to measure their perception of anatomy teachers and instructors, anatomy knowledge, their intrinsic interest and efforts in learning anatomy, anatomy learning resources and histology practical facilities. The analysis revealed that most of the items show “positive area” indicated by score of more than four. The first-year medical students showed a significantly higher perception of the anatomy education environment compared to the second-year medical students (p ≤ 0.05). However, both cohorts perceived an “area of improvement” for histology practical facilities (score of 3 to 3.99). In conclusion, the students were pleased with the anatomy education experience in UPM except for histology practical facilities that may require further improvement. The use of virtual microscopy in histology teaching would be a good alternative to overcome the problem in histology teaching in UPM, especially during the COVID-19 pandemic.

Fostering intrinsic motivation in remote undergraduate histopathology education

AimsThe 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.Methods90 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.ResultsThere 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.ConclusionsFostering 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.

Eye Tracking—An Innovative Tool in Medical Parasitology

The innovative Eye Movement Modelling Examples (EMMEs) method can be used in medicine as an educational training tool for the assessment and verification of students and professionals. Our work was intended to analyse the possibility of using eye tracking tools to verify the skills and training of people engaged in laboratory medicine on the example of parasitological diagnostics. Professionally active laboratory diagnosticians working in a multi-profile laboratory (non-parasitological) (n = 16), laboratory diagnosticians no longer working in this profession (n = 10), and medical analyst students (n = 56), participated in the study. The studied group analysed microscopic images of parasitological preparations made with the cellSens Dimension Software (Olympus) system. Eye activity parameters were obtained using a stationary, video-based eye tracker Tobii TX300 which has a 3-ms temporal resolution. Eye movement activity parameters were analysed along with time parameters. The results of our studies have shown that the eye tracking method is a valuable tool for the analysis of parasitological preparations. Detailed quantitative and qualitative analysis confirmed that the EMMEs method may facilitate learning of the correct microscopic image scanning path. The analysis of the results of our studies allows us to conclude that the EMMEs method may be a valuable tool in the preparation of teaching materials in virtual microscopy. These teaching materials generated with the use of eye tracking, prepared by experienced professionals in the field of laboratory medicine, can be used during various training, simulations and courses in medical parasitology and contribute to the verification of education results, professional skills, and elimination of errors in parasitological diagnostics.

Virtual Microscopy in Undergraduate Pathology Education

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

Interchangeability of light and virtual microscopy for histopathological evaluation of prostate cancer

Virtual microscopy (VM) holds promise to reduce subjectivity as well as intra- and inter-observer variability for the histopathological evaluation of prostate cancer. We evaluated (i) the repeatability (intra-observer agreement) and reproducibility (inter-observer agreement) of the 2014 Gleason grading system and other selected features using standard light microscopy (LM) and an internally developed VM system, and (ii) the interchangeability of LM and VM. Two uro-pathologists reviewed 413 cores from 60 Swedish men diagnosed with non-metastatic prostate cancer 1998–2014. Reviewer 1 performed two reviews using both LM and VM. Reviewer 2 performed one review using both methods. The intra- and inter-observer agreement within and between LM and VM were assessed using Cohen’s kappa and Bland and Altman’s limits of agreement. We found good repeatability and reproducibility for both LM and VM, as well as interchangeability between LM and VM, for primary and secondary Gleason pattern, Gleason Grade Groups, poorly formed glands, cribriform pattern and comedonecrosis but not for the percentage of Gleason pattern 4. Our findings confirm the non-inferiority of VM compared to LM. The repeatability and reproducibility of percentage of Gleason pattern 4 was poor regardless of method used warranting further investigation and improvement before it is used in clinical practice.