The standard medical microscopic anatomy course: histology circa 1998

Virtual microscopy as a teaching-learning tool for histology in a competency-based medical curriculum

Background

Histology forms an important component of first-year medical education. Unfortunately, it is limited to the practical laboratory due to the need for a microscope and good quality slides. Virtual microscopy is a recent advancement, which uses computers as an alternative to microscopes. The aim of the study was to compare virtual microscopy (VM)-based practical classes with traditional microscopy (TM)-based practical classes for two cohorts of first-year medical students, by comparing learning achieved using two different test scores as well as a qualitative assessment of student and faculty perspectives regarding the feasibility and usefulness of VM.

Methods

Each cohort of students was divided into two equal batches and each batch underwent eight histology modules of which, four utilised traditional microscopes and four utilised virtual microscopes. Quantitative analysis was performed using a theory test (which assessed preparation, theory knowledge and understanding) as well as a spotter test (which assessed identification skills, reasoning, and recall). Qualitative analysis was performed using a structured questionnaire and focus group discussions.

Results

Modules using VM were better when compared with those using TM, showing statistically significant and better grades. Qualitative analysis performed, yielded important information as to how this technology can serve as a good adjunct to traditional histology classes in the competency-based curriculum by increasing student interest, enabling self-study, and reducing students dependence on the tutor.

Conclusions

VM forms a good adjunct as well as a standalone modality of learning to TM, as it improves accessibility to slides and promotes self-learning.

Histology as a paradigm for a science-based learning experience: Visits by histology education spirits of past, present, and future

The term "histology" was coined a little over 200 years ago and the subject has always relied on microscopy as its defining technology. Microscopy was and still is an essential approach for the description of cellular components and their arrangements in living organisms. For more than a century and a half, histology or microanatomy has also been part of the basic science education for biomedical students. Traditionally, it has been taught in two major components, a didactic transfer of information, either in a lecture or self-learning format, and in active-learning laboratory sessions. These two modes of histology instruction conform with the dual-processing theory of learning, one being more automatic and depending mainly on rote memorization, whereas the other is analytical, requiring more advanced reasoning skills. However, these two components of histology education are not separate and independent, but rather complementary and part of a multi-step learning process that encourages a scientific analysis of visual information and involves higher-level learning skills. Conventional, as well as modern electronic instruction methods (e-learning) have been used in complementary ways to support the integrated succession of individual learning steps as outlined in this manuscript. However, as recent curricular reforms have curtailed instructional time, this traditional format of teaching histology is no longer sustainable and a reflective reassessment of the role of histology in modern biomedical education is a timely necessity.

Teaching Cellular Architecture: The Global Status of Histology Education

Histology or microanatomy is the science of the structure and function of tissues and organs in metazoic organisms at the cellular level. By definition, histology is dependent on a variety of microscope techniques, usually light or more recently virtual, as well as electron microscopy. Since its inception more than two centuries ago, histology has been an integral component of biomedical education, specifically for medical, dental, and veterinary students. Traditionally, histology has been taught in two sequential phases, first a didactic transfer of information to learners and secondly a laboratory segment in which students develop the skill of analyzing micrographic images. In this chapter, the authors provide an overview of how histology is currently taught in different global regions. This overview also outlines which educational strategies and technologies are used, and how the local and cultural environment influences the histology education of medical and other students in different countries and continents. Also discussed are current trends that change the teaching of this basic science subject.

Virtual Microscopy Goes Global: The Images Are Virtual and the Problems Are Real

For the last two centuries, the scholarly education of histology and pathology has been based on technology, initially on the availability of low-cost, high-quality light microscopes, and more recently on the introduction of computers and e-learning approaches to biomedical education. Consequently, virtual microscopy (VM) is replacing glass slides and the traditional light microscope as the main instruments of instruction in histology and pathology laboratories. However, as with most educational changes, there are advantages and disadvantages associated with a new technology. The use of VM for the teaching of histology and pathology requires an extensive infrastructure and the availability of computing devices to all learners, both posing a considerable financial strain on schools and students. Furthermore, there may be valid reasons for practicing healthcare professionals to maintain competency in using light microscopes. In addition, some educators may be reluctant to embrace new technologies. These are some of the reasons why the introduction of VM as an integral part of histology and pathology instruction has been globally uneven. This paper compares the teaching of histology and pathology using traditional or VM in five different countries and their adjacent regions, representing developed, as well as developing areas of the globe. We identify general and local roadblocks to the introduction of this still-emerging didactic technology and outline solutions for overcoming these barriers.

Histology education in an integrated, time-restricted medical curriculum: Academic outcomes and students' study adaptations

In an ever-changing medical curricular environment, time dedicated for anatomical education has been progressively reduced. This happened at the University of Michigan Medical School starting in 2016-2017 when preclinical medical education was condensed to one year. Histology instruction remained integrated in organ system courses but reduced to a lecture-only format without scheduling time for laboratory exercises, requiring students to study virtual histology slides on their own time. In accordance with the shortened instructional time, the number of histology examination questions was reduced more than twofold. This study analyzed students' histology examination results and assessed their motivation to learn histology and use of educational opportunities before and after these curricular changes were implemented. Students' motivation to learn histology and their evaluation of histology lectures increased in the new curriculum. However, students devoted less study time to studying histology. Students' cumulative histology examination scores were significantly lower in the new curriculum and the number of students with overall scores <75%, defined as a substandard performance, increased more than 15-fold. Academically weaker students' histology scores were disproportionately more affected. As medical educational strategies, priorities, and curricular frameworks continue to evolve, traditional didactic topics like histology will need to adapt to continue providing educational value to future health care providers.

Attitude and Perception of Medical Students Towards Histology Subject at Wollo University, Ethiopia

INTRODUCTION

Students' perceptions and feedback have a significant impact on academic progress.

OBJECTIVE

To assess the attitude and perception of medical students towards histology subject at Wollo University, Northern Ethiopia.

METHODS

An institution-based cross-sectional study design was carried out in Wollo University from January, 2021 to February, 2021. A pre-tested and structured self-administered questionnaire was used for data collection. All opinions were rated using a positive-point Likert scale, which ranges from "strongly disagree" to "strongly agree." The data were entered and analyzed using SPSS version 20.

RESULTS

A total of 184 students participated in this study, with a 100% response rate. Of the respondents, 84.24% of them were very much interested in histology subject. However, only 31 (16.85%) thought of histology as a career choice. The two major reason for not joining histology was less chance of promotion (65, 35.33%) and financial growth (41, 22.28%) followed by difficulty of the subject (23, 12.5%). Most of the respondents (155, 84.24%) agreed or strongly agreed that histology knowledge will help them a lot in their future clinical practice. Regarding different methods of teaching histology, our study reveals that there were 82.61% of participants who agreed with the proposed integration of histology and pathology. Moreover, system approach in teaching pathology with other disciplines was preferred by 70.1% and was comparable to several studies.

CONCLUSION

Overall, the study findings indicate that medical students have a favorable attitude toward histology courses. But, they are unable to join the field due to the lower chance of promotion and financial growth. The curricular integration of histology and pathology in the first year needs to be continued, and much effort is needed to increase students' affinity for microscopic anatomy. This evidence serves as an additional motive for the development of histology courses focusing on practical application of knowledge in a clinically oriented setting.

Anonymous Audience Response Technology in Image-Based Quiz (IBQ) Neuropathology Lecture for Undergraduate Pre-clinical Medical Students: a Comparison with Traditional Lectures

Pathology teaching, an intensively image loaded discipline, poses a significant challenge in its delivery. A lot of effort has been placed into sourcing teaching methods that could effectively enhance students' understanding and knowledge retention in this discipline. We describe for the first time in the literature the use of an image-based quiz (IBQ) to deliver a neuropathology lecture. The participating medical students were randomised into either the study group (IBQ) or the control group (traditional lecture, TL). The students were asked to complete the pre- and post-multiple choice question (MCQ) test before and after attending either of the allocated interventions. In the IBQ group, the students were presented with image-based quizzes, and answers to the quizzes were projected in real-time on screen. The students in the TL group were given the usual, traditional lecture. A total of 75 third-year medical students participated in this study. The participants were recruited from third-year medical students representing two different academic years. There was no significant difference in the pre- and post-MCQ scores between the IBQ and TL groups. However, a significant improvement in the mean scores for the pre- and post-MCQ results in both the study (p = 0.001; 95% CI 0.572-1.954) and control (p < 0.001; 95% CI 0.561-1.763) groups was observed. We found that the IBQ was a simple, personalised, and cost-effective digitalised tool which our study suggests it to be as effective as the traditional lecture in the delivery of pathology knowledge in undergraduate medical students.

The usefulness of histopathology examples in teaching practical histology for medical students: A CONSORT-compliant randomized crossover trial

BACKGROUND

Teaching histology as an image-intensive discipline is a major challenge to medical teachers. We compared knowledge retention and student preference after performing comparison-based and traditional methods of teaching practical histology.

METHODS

We performed a crossover randomized controlled trial. Eighty nine first-year and 37 second-year medical students were randomly assigned to comparison-based or traditional classes in which PowerPoint slides were used. Each teaching approach was then switched to another group for a second tissue set. Quantitative assessment was performed using multiple-choice questions and a questionnaire.

RESULTS

The first-year students' overall examination scores were significantly higher in the comparison-based approach compared to the traditional approach for both tissue sets, with a large effect size. Interestingly, even for the second-year students, a significantly higher overall score for one set of tissue samples was observed in the comparison-based approach compared to the traditional approach. The students' responses to all the elements in the questionnaire were significantly in favor of the comparison-based approach.

CONCLUSION

Our findings indicate that the simple implementation of a few histopathology examples can yield a tremendous improvement in first-year medical students' understanding, enjoyment, and engagement in practical histology classes.

From chalkboard, slides, and paper to e-learning: How computing technologies have transformed anatomical sciences education

Until the late-twentieth century, primary anatomical sciences education was relatively unenhanced by advanced technology and dependent on the mainstays of printed textbooks, chalkboard- and photographic projection-based classroom lectures, and cadaver dissection laboratories. But over the past three decades, diffusion of innovations in computer technology transformed the practices of anatomical education and research, along with other aspects of work and daily life. Increasing adoption of first-generation personal computers (PCs) in the 1980s paved the way for the first practical educational applications, and visionary anatomists foresaw the usefulness of computers for teaching. While early computers lacked high-resolution graphics capabilities and interactive user interfaces, applications with video discs demonstrated the practicality of programming digital multimedia linking descriptive text with anatomical imaging. Desktop publishing established that computers could be used for producing enhanced lecture notes, and commercial presentation software made it possible to give lectures using anatomical and medical imaging, as well as animations. Concurrently, computer processing supported the deployment of medical imaging modalities, including computed tomography, magnetic resonance imaging, and ultrasound, that were subsequently integrated into anatomy instruction. Following its public birth in the mid-1990s, the World Wide Web became the ubiquitous multimedia networking technology underlying the conduct of contemporary education and research. Digital video, structural simulations, and mobile devices have been more recently applied to education. Progressive implementation of computer-based learning methods interacted with waves of ongoing curricular change, and such technologies have been deemed crucial for continuing medical education reforms, providing new challenges and opportunities for anatomical sciences educators. Anat Sci Educ 9: 583-602. © 2016 American Association of Anatomists.

Measuring dental students' preference: A comparison of light microscopy and virtual microscopy as teaching tools in oral histology and pathology

Objectives

Light microscopy used to be the traditional modality of teaching histology and pathology disciplines. Recent advances and innovations in the information technology field have revolutionized the use of hard- and software in medical education. An example of such an innovation is the so-called virtual microscopy. Many schools have started to adopt virtual microscopy as a new method aimed at enhancing student learning. Nonetheless, few reports have described the experiences of introducing virtual microscopy in dental education. We conducted this study to evaluate student perceptions of virtual microscopy use.

Materials and methods

A survey of 9 items with a five-point Likert scale was designed to assess student perceptions of different aspects of virtual microscopy use compared with light microscopy. Eighty-seven 2nd year dental students answered the survey for a response rate of 80%.

Results

The majority of the students (85.1%) reported positive feedback for the use of virtual slides as a method of learning. Students reported significantly higher scores in virtual microscopy compared with light microscopy (t test: t₈₆ = 9.832, P < 0.0001); however, a few students reported some technical difficulties when using computers to view the virtual slides.

Conclusions

Although light microscopy is the classical tool of teaching histology and pathology, virtual microscopy is a highly preferred substitute. We believe that virtual microscopy is a valuable teaching tool that enhances student educational experiences.

A practical hybrid model of application, integration, and competencies at interactive table conferences in histology (ITCH)

Significant changes have been implemented in the way undergraduate medical education is structured. One of the challenges for component courses such as histology in medical and dental curricula is to restructure and deliver training within new frameworks. This article describes the process of aligning the purpose and experience in histology laboratory to the goal of applying knowledge gained to team-based medical practice at Tulane University School of Medicine. Between 2011 and 2015, 711 medical students took either a traditional laboratory-based histology course (353 students) or a team-based hybrid histology course with active learning in laboratory (358 students). The key difference was in the laboratory component of the hybrid course - interactive table conferences in histology-during which students developed new competencies by working in teams, reviewing images, solving problems by applying histology concepts, and sharing learning. Content, faculty and online resources for microscopy were the same in both courses. More student-student and student-faculty interactions were evident during the hybrid course but student evaluation ratings and grades showed reductions following introduction of table conferences when compared to previous ratings. However, outcomes at National Board of Medical Examiners(®) (NBME(®) ) Subject Examination in Histology and Cell Biology showed significant improvement (72.4 ± 9.04 and 76.44 ± 9.36 for percent correct answers, traditional and hybrid courses, respectively, P < 0.0001). This model of table conferences to augment the traditional histology laboratory experience exemplifies the extent that restructuring enhancements can be used in currently taught courses in the undergraduate medical curriculum. Anat Sci Educ 9: 286-294. © 2016 American Association of Anatomists.

Motivational component profiles in university students learning histology: a comparative study between genders and different health science curricula

BACKGROUND

The students' motivation to learn basic sciences in health science curricula is poorly understood. The purpose of this study was to investigate the influence of different components of motivation (intrinsic motivation, self-determination, self-efficacy and extrinsic -career and grade- motivation) on learning human histology in health science curricula and their relationship with the final performance of the students in histology.

METHODS

Glynn Science Motivation Questionnaire II was used to compare students' motivation components to learn histology in 367 first-year male and female undergraduate students enrolled in medical, dentistry and pharmacy degree programs.

RESULTS

For intrinsic motivation, career motivation and self-efficacy, the highest values corresponded to medical students, whereas dentistry students showed the highest values for self-determination and grade motivation. Genders differences were found for career motivation in medicine, self-efficacy in dentistry, and intrinsic motivation, self-determination and grade motivation in pharmacy. Career motivation and self-efficacy components correlated with final performance in histology of the students corresponding to the three curricula.

CONCLUSIONS

Our results show that the overall motivational profile for learning histology differs among medical, dentistry and pharmacy students. This finding is potentially useful to foster their learning process, because if they are metacognitively aware of their motivation they will be better equipped to self-regulate their science-learning behavior in histology. This information could be useful for instructors and education policy makers to enhance curricula not only on the cognitive component of learning but also to integrate students' levels and types of motivation into the processes of planning, delivery and evaluation of medical education.

Reception learning and self-discovery learning in histology: students' perceptions and their implications for assessing the effectiveness of different learning modalities

Two questionnaires were used to investigate students' perceptions of their motivation to opt for reception learning (RL) or self-discovery learning (SDL) in histology and their choices of complementary learning strategies (CLS). The results demonstrated that the motivation to attend RL sessions was higher than the motivation to attend SDL to gain new knowledge (P < 0.01) and to apply this acquired knowledge to diagnosis (P < 0.01), therapy (P < 0.01), and research (P < 0.05). Students also showed a stronger preference for RL based on motivations related to leadership (P < 0.01) and competition (P < 0.01), although the rates were very low in both cases (≤ 1.9 ± 1.1). Statistically significant differences were found between male and female students for leadership (higher in males), responsibility (higher in females), and acquiring new knowledge (higher in females only in RL). This study's findings for students' preferred CLS strategies suggested a greater need for additional complementary resources after RL than after SDL (P < 0.01). In conclusion, RL was associated with a greater need for complementary training resources such as textbooks, atlases, the internet, audiovisual media, and tutorials, whereas SDL was associated with a greater need to orient teaching and training toward medical practice. These results suggest the need to reorient both types of learning processes to enhance their effectiveness in teaching histology, especially in the case of SDL, which should place more emphasis on clinically oriented knowledge.

Clinico-histologic conferences: histology and disease

Providing a context for learning information and requiring learners to teach specific content has been demonstrated to enhance knowledge retention. To enhance students' appreciation of the role of science and specifically histology in clinical reasoning, disease diagnosis, and treatment, a new teaching format was created to provide clinical context, promote integration and application of science knowledge, and to foster peer teaching and learning: the Clinico-Histologic Conference (CHC) for the Mount Sinai School of Medicine Histology course. Teams of six students were each assigned specific disease processes and were charged with creating oral presentations and handouts that taught their classmates about the clinical manifestations, etiopathogeneses, diagnoses, and treatments of the assigned processes, along with comparisons of normal histology to the pathology of the disease. Each team also created four questions, some of which were used on Histology written examinations. The physician facilitator evaluated the presentation and handouts. About two-thirds of students agreed the CHC enhanced appreciation of the importance of histology, provided a context for integration and application of basic science to patient care and enhanced their ability to teach their peers. Student feedback demonstrated that the CHCs were successful in promoting teamwork, peer teaching, and the application of histology to diagnose diseases. The authors believe that teaching basic science content in this new format enhanced student learning and application of medical knowledge, and that this new teaching format can be adopted by other medical school courses.

Medical education in the anatomical sciences: the winds of change continue to blow

At most institutions, education in the anatomical sciences has undergone several changes over the last decade. To identify the changes that have occurred in gross anatomy, microscopic anatomy, neuroscience/neuroanatomy, and embryology courses, directors of these courses were asked to respond to a survey with questions pertaining to total course hours, hours of lecture, and hours of laboratory, whether the course was part of an integrated program or existed as a stand-alone course, and what type of laboratory experience occurred in the course. These data were compared to data obtained from a similar survey in 2002. Comparison between the data sets suggests several key points some of which include: decreased total hours in gross anatomy and neuroscience/neuroanatomy courses, increased use of virtual microscopy in microscopic anatomy courses, and decreased laboratory hours in embryology courses.

Improved learning efficiency and increased student collaboration through use of virtual microscopy in the teaching of human pathology

The implementation of virtual microscopy in the teaching of pathology at the Bloomington, Indiana extension of the Indiana University School of Medicine permitted the assessment of student attitudes, use and academic performance with respect to this new technology. A gradual and integrated approach allowed the parallel assessment with respect to both the virtual and optical microscopes. Student survey data indicated that the virtual imaging technology was enthusiastically received, and aggregate grade comparisons with the previous classes showed no decrease in content mastery. Survey questions assessing a variety of parameters reveal improved time and resource utilization, as well as increased student collaboration. Even so, 50% of the respondents indicated having both optical and virtual microscopes available was preferable.

Trends in histology laboratory teaching in United States medical schools

Owing to competition for faculty time among the three major missions of today's academic medical centers, as well as the rapid development of computer-based instructional technologies, laboratory instruction in medical schools in the United States has been undergoing dramatic change. In order to determine recent trends in histology laboratory instruction at U.S. medical schools, a detailed Web survey was administered to histology course directors, with about two-thirds of schools responding. The survey was designed to identify trends in the number of hours of histology laboratory instruction that each medical student receives, the amount of faculty effort devoted to histology laboratory instruction, and the use of various computer-based technologies (including virtual microscopy and virtual slides) in histology laboratory instruction. Consistent with the long-term trend of declining total laboratory teaching hours in U.S. medical schools, there is an ongoing reduction in the number of hours of faculty-directed histology laboratory instruction that each medical student receives, with a concomitant reduction in hours of faculty time devoted to histology laboratory instruction. In terms of the tools used in the histology laboratory, there has been a dramatic increase in the use of various forms of computer-aided instruction (including virtual slides). The large increase in the number of schools using computer-aided instruction has not been accompanied by an equivalent decrease in the number of schools that utilize microscopes and glass slides. Rather, the clear trend has been toward a blending of the new computer-based instructional technologies with the long-standing use of microscopes and glass slides.

Complete and rapid switch from light microscopy to virtual microscopy for teaching medical histology

During the interim between the 2003 and 2004 academic years, the cell and tissue biology and integrated medical neuroscience courses at the Medical College of Wisconsin made a complete and rapid switch from light microscopy- to virtual microscopy-based histology laboratories. This switch was prompted by the difficulties in maintaining and the cost of replacing the college's microscopes and microscope slides, and primarily by the desire to promote and streamline learning for our large classes (n > 200) of first-year medical students. A group of students who used the virtual microscope, another group of students who used the light microscope, and faculty with experience using both tools rated the effectiveness of the virtual microscope for learning and teaching. Also, to determine whether virtual microscopy affected student learning, laboratory examination scores for the 2004 class (n = 209) were compared with those of four previous classes that used light microscopes exclusively (n = 811). The switch from light microscopy to virtual microscopy was very favorably received by both students and faculty. More importantly, data from examination scores and course evaluation surveys indicated that use of the virtual microscope may significantly improve student performance and learning efficiency. Procedures for successfully implementing this change are described.

Teaching medical histology at the University of South Carolina School of Medicine: Transition to virtual slides and virtual microscopes

We describe how the histology course we teach to first-year medical students changed successfully from using glass slides and microscopes to using virtual slides and virtual microscopes. In 1988, we taught a classic medical histology course. Subsequently, students were loaned static labeled images on projection slides to introduce them to their microscope glass slides, and we made laser disks of histological images available in the teaching lab. In 2000, we placed the static labeled images and laboratory manual on the Web. We abandoned the Web-based approach in 2001. Faculty selected specific areas on microscope glass slides in student collections for scanning at a total magnification of 40, 100, 200, or 400. Christopher M. Prince of Petro Image, LLC, scanned the glass slides; digitized, encoded, and compressed (95%) the images; and placed them on CD-ROMs. The scanned images were viewed up to a magnification of 400 using the MrSID viewer (LizardTech software) and the computer as a virtual microscope. This viewer has many useful features, including effective microscope and telescope functions that provide greater versatility for sample study and speed in localizing structures than was possible with the actual microscope. Image detail is indistinguishable from that viewed under the light microscope at equivalent magnifications. Static labeled images were also placed on CD-ROMs to introduce students to the virtual slides. Students could view all the images on their CD-ROMs at any time and in any place with their laptop computers without going online. Students no longer rented light microscopes in 2002. Both students and faculty have shown strong support for using this approach to teaching histology during the past 2 years.

Anatomical sciences in the allopathic medical school curriculum in the United States between 1967-2001

The present article surveys the changes in the time allocated for the four disciplines in the anatomical sciences in the medical curricula of allopathic medical schools in the United States from 1967-2001. The results indicate that there was a great reduction in the laboratory portions, but not in the lecture portions of Gross Anatomy, Histology, Neuroanatomy, and Embryology. The greatest time reduction overall for the disciplines occurred between 1967-1973 (502 to 387 hr), followed by the time reduction between 1982-1995 (380 to 329 hr).

Integrated approach to teaching and testing in histology with real and virtual imaging

The University of Iowa College of Medicine histology teaching laboratory incorporates extensive Web- and computer-based teaching modalities, including the Virtual Microscope (VM), as emerging learning aids in histology and pathology laboratory instruction. We report here our experience in offering a multiple resource-based approach to laboratory instruction while retaining the opportunity and requirement of examining actual microscopic slide preparations with the microscope. Acceptance of this approach has been high among our students and faculty, and performance levels established over years of teaching histology by traditional means have been maintained.

Laboratory instruction in histology at the University at Buffalo: recent replacement of microscope exercises with computer applications

Histology is a morphologic science in which the structure of the cells, tissues, and organs of the body are examined with a microscope. In the laboratory courses in histology at the School of Medicine of the University at Buffalo, histologic specimens had been used since the late 19th century to teach the principles of cell, tissue, and organ structure. Students also had to learn how to analyze or "read" slides with a microscope. Learning histology in this way, i.e., by direct examination of actual specimens, is time consuming and viewed by some as unnecessary. As a result of recent curricular reform at the School of Medicine that reduced contact time in histology, half of all laboratory exercises that would have been performed with a microscope were performed instead with interactive computer applications. By replacing some microscope exercises with more efficient computer applications, the histology course accommodated curricular change by both reducing contact time and continuing to offer valuable microscope laboratories for most of the organ systems of the body. To provide a basis for comparing traditional microscope exercises with computer-assisted instruction in histology, the nature of the laboratory experience between 1846 and 1998 is briefly reviewed. The instructional strategy behind the use of computers is presented, along with the nature of the computer applications and the means by which the computer applications were incorporated into the school's laboratory course in histology.

Exhibits facilitate histology laboratory instruction: student evaluation of learning resources

Some professional schools have replaced microscopes for histology laboratory instruction with printed and electronic media. It is recognized that these media cannot replace experience with the microscope and that there is a cognitive dissonance of completely replacing microscope study. In addition, students believe that their time is not optimally used in the traditional histology laboratory. Therefore, at Loma Linda University, nine weekly microscope exhibits consisting of 10-15 slides each were prepared. For each exhibited slide, a one page "atlas" is provided, consisting of labeled low- and high-power color micrographs taken from that slide and an informative legend. By referring to the atlas, the student can easily identify the exact field and the labeled features with little help from an instructor. A live or taped video demonstration of the microscope exhibit is available on the first day of the exhibit. During the eighth week of the quarter, students were asked to evaluate the various learning resources available to them. No resource was valued significantly more than the microscope exhibits, but the video demonstrations were valued significantly more than the printed black and white atlas or the color atlas on CD. These exhibits have been used for 2 years to instruct a class of 90 dental students. Advantages are (1) students' time is used efficiently, (2) only one slide set and a fourth as many microscopes need be maintained compared with a traditional laboratory, and (3) one-of-a-kind slides derived from research activities provide for high impact learning.