title: Cytopathology whole slide images and virtual microscopy adaptive tutorials: A software pilot.
abstract: BACKGROUND
  The constant growth in the body of knowledge in medicine requires pathologists and pathology trainees to engage in continuing education. Providing them with equitable access to efficient and effective forms of education in pathology (especially in remote and rural settings) is important, but challenging.
  
  
  METHODS
  We developed three pilot cytopathology virtual microscopy adaptive tutorials (VMATs) to explore a novel adaptive E-learning platform (AeLP) which can incorporate whole slide images for pathology education. We collected user feedback to further develop this educational material and to subsequently deploy randomized trials in both pathology specialist trainee and also medical student cohorts. Cytopathology whole slide images were first acquired then novel VMATs teaching cytopathology were created using the AeLP, an intelligent tutoring system developed by Smart Sparrow. The pilot was run for Australian pathologists and trainees through the education section of Royal College of Pathologists of Australasia website over a period of 9 months. Feedback on the usability, impact on learning and any technical issues was obtained using 5-point Likert scale items and open-ended feedback in online questionnaires.
  
  
  RESULTS
  A total of 181 pathologists and pathology trainees anonymously attempted the three adaptive tutorials, a smaller proportion of whom went on to provide feedback at the end of each tutorial. VMATs were perceived as effective and efficient E-learning tools for pathology education. User feedback was positive. There were no significant technical issues.
  
  
  CONCLUSIONS
  During this pilot, the user feedback on the educational content and interface and the lack of technical issues were helpful. Large scale trials of similar online cytopathology adaptive tutorials were planned for the future.
authors.affiliation: Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney, NSW 2052, Australia.
authors.forename: Simone L
authors.initials: SL
authors.lastname: Van Es
authors.affiliation: Royal College of Pathologists of Australasia, Durham Hall, Albion St, Surry Hills, NSW 2010, Australia.
authors.forename: Wendy M
authors.initials: WM
authors.lastname: Pryor
authors.affiliation: Smart Sparrow, 116-122 Kippax St, Surry Hills, Sydney, NSW 2010, Australia.
authors.forename: Zack
authors.initials: Z
authors.lastname: Belinson
authors.affiliation: Department of Anatomical Pathology, Prince of Wales Hospital, Barker St, Randwick, NSW 2031, Australia.
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.
authors.forename: Gary M
authors.initials: GM
authors.lastname: Velan
keywords: Cytopathology; digital microscopy; pathology education; software; virtual microscopy; virtual microscopy adaptive tutorials; virtual slides; whole slide image; whole slide images