title: Cytopathology whole slide images and adaptive tutorials for postgraduate pathology trainees: a randomized crossover trial.
abstract: To determine whether cytopathology whole slide images and virtual microscopy adaptive tutorials aid learning by postgraduate trainees, we designed a randomized crossover trial to evaluate the quantitative and qualitative impact of whole slide images and virtual microscopy adaptive tutorials compared with traditional glass slide and textbook methods of learning cytopathology. Forty-three anatomical pathology registrars were recruited from Australia, New Zealand, and Malaysia. Online assessments were used to determine efficacy, whereas user experience and perceptions of efficiency were evaluated using online Likert scales and open-ended questions. Outcomes of online assessments indicated that, with respect to performance, learning with whole slide images and virtual microscopy adaptive tutorials was equivalent to using traditional methods. High-impact learning, efficiency, and equity of learning from virtual microscopy adaptive tutorials were strong themes identified in open-ended responses. Participants raised concern about the lack of z-axis capability in the cytopathology whole slide images, suggesting that delivery of z-stacked whole slide images online may be important for future educational development. In this trial, learning cytopathology with whole slide images and virtual microscopy adaptive tutorials was found to be as effective as and perceived as more efficient than learning from glass slides and textbooks. The use of whole slide images and virtual microscopy adaptive tutorials has the potential to provide equitable access to effective learning from teaching material of consistently high quality. It also has broader implications for continuing professional development and maintenance of competence and quality assurance in specialist practice.
authors.affiliation: Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia. Electronic address: s.vanes@unsw.edu.au.
authors.forename: Simone L
authors.initials: SL
authors.lastname: Van Es
authors.affiliation: Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia. Electronic address: r.kumar@unsw.edu.au.
authors.forename: Rakesh K
authors.initials: RK
authors.lastname: Kumar
authors.affiliation: Royal College of Pathologists of Australasia, Surry Hills 2010, Australia. Electronic address: wendyp@rcpa.edu.au.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Pryor
authors.affiliation: Department of Anatomical Pathology, Prince of Wales Hospital, Randwick 2031, Australia. Electronic address: elizabeth.salisbury@sesiahs.health.nsw.gov.au.
authors.forename: Elizabeth L
authors.initials: EL
authors.lastname: Salisbury
authors.affiliation: Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia. Electronic address: g.velan@unsw.edu.au.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Velan
mesh_terms: D001296:Audiovisual Aids; D001315:Australia; D003196:Computer Graphics; D003194:Computer-Assisted Instruction / Q000379:methods*; D018592:Cross-Over Studies; D003479:Curriculum; D003581:Cytodiagnosis; D020375:Education, Distance / Q000379:methods*; D004503:Education, Medical, Graduate / Q000379:methods*; D006801:Humans; D007858:Learning; D008296:Malaysia; D008853:Microscopy; D009520:New Zealand; D010336:Pathology / Q000193:education*; D011795:Surveys and Questionnaires; D013663:Teaching / Q000379:methods*; D013782:Textbooks as Topic; D014584:User-Computer Interface
keywords: Cytopathology; Digital microscopy; Pathology education; Virtual microscopy adaptive tutorials; Virtual slides; WSI; Whole slide imaging