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Cubillos P, Diaz E, Báez P, Gutiérrez L, Molina C, Härtel S. E-learning module for cyto pathology education based on virtual microscopy. J Am Soc Cytopathol 2024; 13:42-52. [PMID: 37993377 DOI: 10.1016/j.jasc.2023.10.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/21/2023] [Revised: 09/04/2023] [Accepted: 10/12/2023] [Indexed: 11/24/2023]
Abstract
INTRODUCTION In cytopathology education, Virtual Microscopy e-learning modules (VM-eLM) have achieved remarkable results in the improvement and personalization of learning. However, it remains to be determined whether these modules can significantly contribute to improving the accuracy of cytological diagnosis. The aim of this work was to create a VM-eLM for gynecologic cytopathology education designed to improve screening and interpretation skills in two groups of cytologists: experienced and nonexperienced. MATERIALS AND METHODS The module was designed in Moodle with both Whole Slide Images and Static Images taken from Papanicolaou smears that were diagnosed as: negative for intraepithelial lesion, low-grade squamous intraepithelial lesion, high-grade squamous intraepithelial lesion, squamous cell carcinoma, or adenocarcinoma. We assessed the effectiveness of the module using 1) clinical quality indicators to measure skill development and 2) a user survey. RESULTS After training, participants significantly improved their cytological screening skills, decreasing their false negative diagnosis by 78% in the non-experienced group and eliminating them entirely in the experienced group. Nonexperienced participants also significantly increased their recognition of low-grade squamous intraepithelial lesion and high-grade squamous intraepithelial lesion by 31% and 50%, respectively. Participants positively evaluated the module, highlighting its novelty, the possibility to train remotely, the immediate feedback and the quality of the Whole Slide Images. CONCLUSIONS We designed, implemented and tested a VM-eLM for Gynecologic Cytopathology Education that improved cytological screening skills for both non-experienced and experienced cytologists, also increasing the diagnostic accuracy of preinvasive lesions by less experienced cytologists. The module was positively evaluated by participants, who perceived an improvement in their interpretive skills.
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Affiliation(s)
- Paulina Cubillos
- Faculty of Medicine, Preventive Oncology Center, University of Chile, Quinta Normal, Chile.
| | - Eugenia Diaz
- Laboratory of Scientific Image Processing (SCIAN-Lab), Program for Integrative Biology (PIB), Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Independencia, Chile
| | - Pablo Báez
- Laboratory of Scientific Image Processing (SCIAN-Lab), Program for Integrative Biology (PIB), Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Independencia, Chile
| | - Lorena Gutiérrez
- Faculty of Medicine, Preventive Oncology Center, University of Chile, Quinta Normal, Chile
| | - Carla Molina
- Faculty of Medicine, Preventive Oncology Center, University of Chile, Quinta Normal, Chile
| | - Steffen Härtel
- Laboratory of Scientific Image Processing (SCIAN-Lab), Program for Integrative Biology (PIB), Faculty of Medicine, Institute of Biomedical Sciences (ICBM), University of Chile, Independencia, Chile
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Harris CK, Chen Y, Alston EL, Brown A, Chabot-Richards D, Dintzis SM, Graber ML, Jackups Jr. R, Lomo LC, Laudadio J, Markwood PS, Nielson KJ, Samedi V, Sampson B, Haspel RL, Zafar N, Montone KT, Childs J, White KL, Heher YK. The next phase in patient safety education: Towards a standardized, tools-based pathology patient safety curriculum: A call to action from the Association of Pathology Chairs' Residency Program Directors Section Training Residents in Patient Safety Workgroup. Acad Pathol 2023; 10:100081. [PMID: 37313035 PMCID: PMC10258240 DOI: 10.1016/j.acpath.2023.100081] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/14/2022] [Revised: 01/26/2023] [Accepted: 01/29/2023] [Indexed: 06/15/2023] Open
Abstract
Patient safety education is a mandated Common Program Requirement of the Accreditation Council for Graduate Medical Education and for the Royal College of Physicians and Surgeons of Canada in all medical residency and fellowship programs. Although many hospitals and healthcare environments have general patient safety education tools for trainees, few to none focus on the unique training milieu of pathologists, including a mix of highly automated and manual error-prone processes, frequent multiplicity of events, and lack of direct patient relationships for error disclosure. We established a national Association of Pathology Chairs-Program Directors Section Workgroup focused on patient safety education for pathology trainees entitled Training Residents in Patient Safety (TRIPS). TRIPS included diverse representatives from across the United States, as well as representatives from pathology organizations including the American Board of Pathology, the American Society for Clinical Pathology, the United States and Canadian Academy of Pathology, the College of American Pathologists, and the Society to Improve Diagnosis in Medicine. Objectives of the workgroup included developing a standardized patient safety curriculum, designing teaching and assessment tools, and refining them with pilot sites. Here we report the establishment of TRIPS as well as data from national needs assessment of Program Directors across the country, who confirmed the need for a standardized patient safety curriculum.
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Affiliation(s)
- Cynthia K. Harris
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
- The New York City Office of Chief Medical Examiner, New York, NY, USA
| | - Yigu Chen
- Memorial Sloan Kettering Cancer Center, New York, NY, USA
| | - Erin L. Alston
- Department of Pathology, Brigham and Women's Hospital, Boston, MA, USA
| | - Ali Brown
- American Society for Clinical Pathology, Chicago, IL, USA
| | | | - Suzanne M. Dintzis
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Mark L. Graber
- Society to Improve Diagnosis in Medicine, Evanston, IL, USA
| | - Ronald Jackups Jr.
- Department of Pathology and Immunology, Washington University School of Medicine in St. Louis, St. Louis, MO
| | - Lesley C. Lomo
- Department of Pathology, University of Utah Health, Salt Lake City, UT, USA
| | - Jennifer Laudadio
- Department of Pathology, University of Arkansas for Medical Sciences, Little Rock, AR, USA
| | | | | | - Von Samedi
- Department of Pathology, University of Colorado Anschutz Medical Campus, Aurora, CO, USA
| | - Barbara Sampson
- Department of Pathology, Icahn School of Medicine at Mount Sinai, New York, NY, USA
| | - Richard L. Haspel
- Department of Pathology, Beth Israel Deaconess Medical Center, Boston, MA, USA
| | - Nadeem Zafar
- Department of Laboratory Medicine and Pathology, University of Washington, Seattle, WA, USA
| | - Kathleen T. Montone
- Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA
| | - John Childs
- Department of Pathology, Geisinger Medical Center, Danville, PA, USA
| | - Kristie L. White
- Departments of Pathology and Laboratory Medicine, University of California San Francisco, San Francisco, CA, USA
| | - Yael K. Heher
- Department of Pathology, Massachusetts General Hospital, Boston, MA, USA
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Hearle P, Wong WF, Chan J. Undergraduate medical student perspectives on the role of autopsy in medical education. Acad Pathol 2023; 10:100068. [PMID: 36798955 DOI: 10.1016/j.acpath.2022.100068] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/06/2022] [Revised: 10/19/2022] [Accepted: 12/03/2022] [Indexed: 02/04/2023] Open
Abstract
Medical autopsy has historically been considered a valued experience in undergraduate medical education; however, student participation has declined in recent years. Medical education literature from the educator point of view supports autopsy as an educational tool, but more data are needed on undergraduate medical students' (UMS) perspectives on autopsy. This study aims to assess UMS opinions on the role of autopsy in undergraduate medical education. A 5-point Likert scale survey concerning autopsy and medical education was offered to all UMS at Sidney Kimmel Medical College. In addition, 28 senior students were assigned a 500 word essay on hospital autopsy and its role in medical education. Senior students were given the opportunity to view an autopsy prior to completing their essays. UMS (n = 87) reported that witnessing an autopsy can improve anatomic knowledge (μ = 4.3), observational skills (μ = 4.1), and clinicopathologic correlation (μ = 4.3) but were neutral in their perceived importance of viewing an autopsy in their pathology education (μ = 3.7). Senior students (n = 27) responding to the essay prompt reported that autopsy is essential in medical education (85.2%) and increases clinical and anatomical understanding (63.0%). This study suggests that many UMS acknowledge the importance and applicability of autopsy in their education. This concurrence of UMS opinion with the medical education literature supports making autopsy participation a widely available component of undergraduate medical education.
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Tucker CM, Jaffe R, Goldberg A. Supporting a culture of patient safety: Resident-led patient safety event reviews in a pathology residency training program. Acad Pathol 2023; 10:100069. [PMID: 36873567 PMCID: PMC9982285 DOI: 10.1016/j.acpath.2023.100069] [Citation(s) in RCA: 2] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/09/2022] [Revised: 11/22/2022] [Accepted: 01/08/2023] [Indexed: 03/05/2023] Open
Abstract
Patient safety is a critical component of quality patient care at any healthcare institution. In order to support a culture of patient safety, and in the context of a hospital-wide patient safety initiative at our institution, we have created and implemented a new patient safety curriculum within our training program. The curriculum is embedded in an introductory course for first-year residents, in which residents gain an understanding of the multifaceted role of the pathologist in patient care. The patient safety curriculum is a resident-centered event review process and includes 1) identification and reporting of a patient safety event, 2) event investigation and review, and 3) presentation of findings to the residency program including core faculty and safety champions for the consideration of implementation of the identified systems solution. Here we discuss the development of our patient safety curriculum, which was trialed over a series of seven event reviews conducted between January 2021 and June 2022. Resident involvement in patient safety event reporting and patient safety event review outcomes were measured. All event reviews conducted thus far have resulted in the implementation of the solutions discussed during event review presentations based on cause analysis and identification of strong action items. Ultimately this pilot will serve as the basis by which we implement a sustainable curriculum in our pathology residency training program centered on supporting a culture of patient safety, and in line with ACGME requirements.
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Affiliation(s)
- Catherine M Tucker
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Rebecca Jaffe
- Department of Medicine, Thomas Jefferson University Hospital, Philadelphia, PA, USA
| | - Allison Goldberg
- Department of Pathology, Anatomy, and Cell Biology, Thomas Jefferson University Hospital, Philadelphia, PA, USA
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Zhao AH, Zhao EE, Hartman M, Hill JG, Giardino A. AMSER Rad Path Case of the Month: Effect of Case-based Integration of Radiology and Pathology on Medical Student Education and Interdisciplinary Collaboration. Acad Radiol 2022; 29:1757-1762. [PMID: 35379530 DOI: 10.1016/j.acra.2022.02.014] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/10/2021] [Revised: 02/05/2022] [Accepted: 02/14/2022] [Indexed: 11/25/2022]
Abstract
RATIONALE AND OBJECTIVES Radiology and pathology are often underrepresented in undergraduate medical education. The Alliance of Medical Student Educators in Radiology (AMSER) hosts the AMSER Rad Path Case of the Month, an online archive of radiological case reports with pathology correlations submitted by medical students. The purpose of this study is to assess the value of preparing and submitting a case on medical students' educational experience. MATERIALS AND METHODS Students who had cases accepted for publication in AMSER Rad Path Case of the Month from July 2018 to December 2019 were contacted by email to request their participation in a voluntary, anonymous 22-question survey. Surveys were sent to 35 students from seven institutions. RESULTS Twenty three of the 35 students (65.7%) responded. Only five (21.7%) of respondents reported having previously followed a patient case through radiology and pathology during medical school, defined as interaction with a clinician in each specialty to discuss the case. When asked about their experience with AMSER Rad Path Case of the Month, most agreed or strongly agreed it was a valuable case-based learning experience (100%). Respondents also reported high satisfaction with improved understanding of disease process, increased understanding and ability to collaborate, and increased likelihood of participating in future academic work. CONCLUSION AMSER Rad Path Case of the Month is a valuable case-based educational experience that deepens students' understanding of disease processes while affording them an opportunity for interdisciplinary and scholarly collaboration.
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Affiliation(s)
- Anna H Zhao
- Department of Radiology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard Medical School, 75 Francis Street, Boston, MA 02115.
| | - Elise E Zhao
- Department of Radiology, Medical University of South Carolina, Charleston, SC
| | | | - Jeanne G Hill
- Department of Radiology, Medical University of South Carolina, Charleston, SC
| | - Angela Giardino
- Department of Radiology, Brigham and Women's Hospital/Dana Farber Cancer Institute, Harvard Medical School, 75 Francis Street, Boston, MA 02115
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Wan KL, Sen A, Selvaratnam L, Naing MIM, Khoo JJ, Rajadurai P. Visual-spatial dimension integration in digital pathology education enhances anatomical pathology learning. BMC Med Educ 2022; 22:587. [PMID: 35907832 PMCID: PMC9339176 DOI: 10.1186/s12909-022-03545-x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 01/02/2022] [Accepted: 06/10/2022] [Indexed: 06/15/2023]
Abstract
Literature review demonstrated a surprising lack of publications on digital e-learning pathology resources for senior medical undergraduates and interns. An interactive Digital Pathology Repository (iDPR) integrating two- and three-dimensional (2D, 3D) high-resolution anatomical pathology images with correlated digital histopathology was developed. The novel iDPR was rigorously evaluated using mixed methods to assess pathology knowledge gains (pre- and post-tests), quality impact analysis (questionnaire), user feedback (focus group discussions) and user visual behaviour (eye gaze tracking analysis of 2D/ 3D images).Exposure to iDPR appeared to improve user pathology knowledge, as observed by significantly increased test scores on topic-related quizzes (n = 69, p < 0.001). In addition, most users were highly satisfied with the key design elements of the iDPR tool. Focus group discussion revealed the iDPR was regarded as a relevant online learning resource, although some minor technical issues were also noted. Interestingly, visual behaviour trends indicated that specific diagnostic pathological lesions could be correctly identified faster in 3D images, when compared to 2D images.The iDPR offers promise and potential in pathology education for senior clinical students and interns, gauging from both qualitative and quantitative positive user feedback. With incorporation of image annotations and interactive functionality, and with further technology development, this would prove a useful tool for diagnostic pathology and telepathology. As images with added visual-spatial dimension can provide enhanced detail and aid more rapid diagnosis, future applications of the iDPR could include virtual reality or holographic images of anatomical pathology specimens.
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Affiliation(s)
- Ken Lee Wan
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia.
| | - Arkendu Sen
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Lakshmi Selvaratnam
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Mohd Imran Mohd Naing
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Joon Joon Khoo
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
| | - Pathmanathan Rajadurai
- Jeffrey Cheah School of Medicine and Health Sciences, Monash University Malaysia, Jalan Lagoon Selatan, 47500, Bandar Sunway, Selangor, Malaysia
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Smith CD, Kenwright D, Gladman T. Using the MUSIC Inventory to Evaluate Pathology Courses: an Exploratory Study. Med Sci Educ 2022; 32:299-303. [PMID: 35528293 PMCID: PMC9054953 DOI: 10.1007/s40670-022-01539-4] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 03/23/2022] [Indexed: 06/14/2023]
Abstract
BACKGROUND The MUSIC Inventory evaluates student's academic motivation across five constructs. We aimed to examine its use in undergraduate medical pathology courses. ACTIVITY Students from three pathology courses completed questions for three factors of the MUSIC Inventory plus one open-ended question. We conducted an exploratory analysis of the survey data. RESULTS Results showed that the open-ended responses corresponded to differences in ratings on the MUSIC Inventory. DISCUSSION Combining an open-ended question with the MUSIC Inventory identified differences in student motivation plus aspects of each course that could be improved. The MUSIC Inventory is an appropriate evaluation method for pathology teaching.
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Affiliation(s)
- Christopher Dimick Smith
- Department of Pathology and Molecular Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Diane Kenwright
- Department of Pathology and Molecular Medicine, University of Otago Wellington, Wellington, New Zealand
| | - Tehmina Gladman
- Education Unit, University of Otago Wellington, PO Box 7343, Newtown, Wellington 6242 New Zealand
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Seto C, Zayat V. A Spoonful of Eponyms Helps the Pathology Go Down: Using Food Eponyms and Visual Mnemonics in Preclinical Pathology Education. Med Sci Educ 2022; 32:131-140. [PMID: 35154897 PMCID: PMC8814165 DOI: 10.1007/s40670-021-01474-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Accepted: 11/17/2021] [Indexed: 06/14/2023]
Abstract
UNLABELLED Food eponymophilia in medicine describes a phenomenon by which diseases or pathologies are named for food items, such as "oat cell carcinoma" or "coffee bean nucleus." Some argue that these metaphors enrich medical education by providing familiar analogies to communicate pathology that is otherwise difficult to describe. Others argue that these metaphors are esoteric, burdensome, culturally irrelevant, and outdated. Few studies have ever focused on the use of metaphors in medical education, and even fewer have focused particularly on pathology or food eponyms. We aim to investigate the use of food eponyms in undergraduate medical education, particularly in pathology education, at the University of Central Florida College of Medicine. We used an interactive learning module to objectively assess whether or not students learn and retain pathology knowledge better using food eponyms, and a post-module survey to assess student perception of the use of these visual mnemonics within pathology educational activities. Results suggest that students not only learn and retain pathology knowledge through this type of activity, but that they also find these eponyms and mnemonics useful as they prepare for their USMLE step 1 exam, clinical clerkship, and future practice. This study is the first of its kind to investigate the usefulness of food eponymophilia in medical education and suggests that students empirically benefit from the use of these memory aids and find this form of learning enjoyable. Preclinical pathology education should make use of these tools in an effort to make pathology as palatable as possible. SUPPLEMENTARY INFORMATION The online version contains supplementary material available at 10.1007/s40670-021-01474-w.
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Affiliation(s)
- Christina Seto
- Kaweah Health, 400 W. Mineral King Ave, Visalia, CA 93292 USA
| | - Vania Zayat
- University of Central Florida College of Medicine, 6850 Lake Nona Blvd, Orlando, FL 32827 USA
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Abstract
OBJECTIVES Resident assessment tends to consist of multiple-choice examinations, even in nuanced areas, such as quality assurance. Internal medicine and many other specialties use objective structured clinical examinations, or OSCEs, to evaluate residents. We adapted the OSCE for pathology, termed the Objective Structured Pathology Examination (OSPE). METHODS The OSPE was used to evaluate first- and second-year residents over 2 years. The simulation included an anatomic pathology sign-out session, where the resident could be evaluated on diagnostic skills and knowledge of key information for cancer staging reports, as well as simulated frozen-section analysis, where the resident could be evaluated on communication skills with a "surgeon." The OSPE also included smaller cases with challenging quality issues, such as mismatched slides or gross description irregularities. All cases were scored based on the Pathology Milestones created by the Accreditation Council for Graduate Medical Education. RESULTS Using this OSPE, we were able to demonstrate that simulated experiences can be an appropriate tool for standardized evaluation of pathology residents. CONCLUSIONS Yearly evaluation using the OSPE could be used to track the progress of both individual residents and the residency program as a whole, identifying problem areas for which further educational content can be developed.
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Affiliation(s)
| | - Sondra R Zabar
- Department of Medicine, NYU Langone Health, New York, NY
| | - Dana Warfield
- Department of Pathology, NYU Langone Health, New York, NY
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Xu C, Li Y, Chen P, Pan M, Bu X. A survey on the attitudes of Chinese medical students towards current pathology education. BMC Med Educ 2020; 20:259. [PMID: 32771019 PMCID: PMC7414265 DOI: 10.1186/s12909-020-02167-5] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 03/04/2020] [Accepted: 07/22/2020] [Indexed: 06/11/2023]
Abstract
BACKGROUND Pathology education provides information on pathology and guides students to become pathologists. Recently, the Ministry of Education of the People's Republic of China required the establishment of the system of 'High-quality Online and Offline Courses', which indicates that online courses will play an important role in higher education. Furthermore, the number of pathologists currently cannot satisfy clinical needs. To solve this health issue and implement the policy from the Ministry of Education, it is necessary to improve the current state of pathology education. First, we need to know students' opinions of the current courses and their professional choices. METHODS Online questionnaires covering the quality of traditional courses, attitudes towards online courses, and suggestions for optimizing courses were designed and applied. Whether students want to become pathologists and the underlying reasons for this interest are also included in this survey. Participants are medical students from certain colleges in Nanjing. The collected data were assessed by statistical analyses, and p-values less than 0.05 were considered significant. RESULTS Of the 342 valid responses, 60.94% of undergraduate students showed their interest in pathology courses, and among them, 48.72% expressed that they may become pathologists. However, the corresponding percentage is only 29.59% in the group without interest. To optimize curricula, the top two suggestions are introducing more clinical cases (undergraduate students, 64.45%; graduate students, 79.09%) and making the classes lively and interesting (undergraduate students, 59.77%; graduate students, 62.79%). Approximately 80.00% of students consider online courses to be good supplementary materials to traditional courses, and approximately half prefer an online-offline mixed learning model. Salary, interest, and employment status are the main factors influencing students' professional choices. CONCLUSIONS Students are generally satisfied with traditional pathology courses, and online courses are good supplementary materials in their opinions. It has been suggested that clinical cases be introduced in classes. It is more likely that students who have an interest in pathology will become pathologists. The data from this survey also show that the main causes of the shortage of pathologists are a lack of engaging work and an unsatisfactory salary.
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Affiliation(s)
- Chun Xu
- Department of Pathology and Pathophysiology, School of Medicine, Southeast University, Nanjing, 210009 China
| | - Yiping Li
- Department of Pathology and Pathophysiology, School of Medicine, Southeast University, Nanjing, 210009 China
| | - Pingsheng Chen
- Department of Pathology and Pathophysiology, School of Medicine, Southeast University, Nanjing, 210009 China
| | - Min Pan
- Department of Pathology and Pathophysiology, School of Medicine, Southeast University, Nanjing, 210009 China
| | - Xiaodong Bu
- Department of Pathology and Pathophysiology, School of Medicine, Southeast University, Nanjing, 210009 China
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Abstract
The coronavirus disease 2019 (COVID-19) is a pandemic caused by the SARS-CoV-2 virus. The infection has predominantly respiratory transmission and is transmitted through large droplets or aerosols, and less commonly by contact with infected surfaces or fomites. The alarming spread of the infection and the severe clinical disease that it may cause have led to the widespread institution of social distancing measures. Because of repeated exposure to potentially infectious patients and specimens, health care and laboratory personnel are particularly susceptible to contract COVID-19. This review paper provides an assessment of the current state of knowledge about the disease and its pathology, and the potential presence of the virus in cytology specimens. It also discusses the measures that cytology laboratories can take to function during the pandemic, and minimize the risk to their personnel, trainees, and pathologists. In addition, it explores potential means to continue to educate trainees during the COVID-19 pandemic.
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Affiliation(s)
- Stefan E Pambuccian
- Department of Pathology and Laboratory Medicine, Loyola University Medical Center, Maywood, Illinois.
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Abstract
OBJECTIVES Receiving and reflecting on feedback is a critical skill in medicine. Learning how to provide effective feedback is important in assessment and engendering performance improvement. METHODS We outline a curriculum for laboratory medicine trainees on providing effective feedback. A group of trainees (26/30 attendees) was surveyed regarding their perspectives on effective feedback and impressions of an educational session focused on how to give effective feedback. RESULTS The curriculum involved a 1-hour session focused on how to provide useful feedback. The two presenters used role-plays, group discussion, and didactic talk to present the material. Most attendees (n = 22/26) indicated that regular or frequent effective feedback was important to their learning. When asked, "What makes feedback effective for you?" the most frequent responses were being specific (n = 11) and being balanced (ie, presenting both positives and negative) (n = 10). On a Likert scale (1 = poor; 7 = excellent), attendees rated their ability to give feedback higher after the session (mean, 5.2) vs before the session (mean, 3.8). CONCLUSIONS Feedback is an important component of assessment and reflective practice. Pathology trainees believe that being specific and balanced were characteristics of effective feedback. It is important to provide training on giving effective feedback to pathology trainees.
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Brooks EG, Paus AM, Corliss RF, Ranheim EA. Enhancing preclinical year pathology exposure: the Angevine approach. Hum Pathol 2016; 53:58-62. [PMID: 27016489 DOI: 10.1016/j.humpath.2016.02.006] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/14/2015] [Revised: 01/22/2016] [Accepted: 02/04/2016] [Indexed: 10/22/2022]
Abstract
Less than 2% of graduating US medical seniors select pathology residencies. One major obstacle to attracting prospective residents is the relative "invisibility" of pathology; medical students lacking positive preclinical exposure to pathology are unlikely to later select pathology clerkships or residencies. The Angevine Fellowship is a 10-week competitive pathology internship medical students may apply for the summer following their first year of preclinical training at our institution. We sought to determine whether it was an effective pathology recruitment tool and how it compared with the postsophomore pathology fellowship (PSF). Angevine fellow and PSF data from 2000 to 2014 were retrospectively analyzed. Specialty choices of former fellows already matched into residency programs were tabulated. Data regarding annual percentage of graduating seniors at our institution who matched into pathology during the years former fellow cohorts matched were also examined. Our results showed that of the former Angevine fellow cohorts already matched into residency programs, 40% (8/20) matched in pathology and 20% (4/20) at our own institution. Angevine fellows comprised a disproportionately high number of the graduating seniors matching in pathology at our medical school (26.7%). PSFs comprised 6.67%. Although we have endowment funding for 2 Angevine fellows annually, the level of interest among applicants has increased to the point that our department has consistently contributed funding for 1-2 additional fellowship spots since 2011. We conclude that the Angevine Fellowship offers an effective alternative to the postsophomore fellowship. It has proven successful at our institution and could be implemented at others to potentially improve pathology recruitment trends nationwide.
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Affiliation(s)
- Erin G Brooks
- University of Wisconsin Hospital and Clinics, Department of Pathology and Laboratory Medicine, Madison, WI 53705.
| | - Amanda M Paus
- University of Wisconsin Hospital and Clinics, Graduate Medical Education Office, Madison, WI 53705
| | - Robert F Corliss
- University of Wisconsin Hospital and Clinics, Department of Pathology and Laboratory Medicine, Madison, WI 53705
| | - Erik A Ranheim
- University of Wisconsin Hospital and Clinics, Department of Pathology and Laboratory Medicine, Madison, WI 53705
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Engelberg JA, Retallack H, Balassanian R, Dowsett M, Zabaglo L, Ram AA, Apple SK, Bishop JW, Borowsky AD, Carpenter PM, Chen YY, Datnow B, Elson S, Hasteh F, Lin F, Moatamed NA, Zhang Y, Cardiff RD. "Score the Core" Web-based pathologist training tool improves the accuracy of breast cancer IHC4 scoring. Hum Pathol 2015; 46:1694-704. [PMID: 26410019 DOI: 10.1016/j.humpath.2015.07.008] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/03/2015] [Revised: 07/07/2015] [Accepted: 07/15/2015] [Indexed: 01/27/2023]
Abstract
Hormone receptor status is an integral component of decision-making in breast cancer management. IHC4 score is an algorithm that combines hormone receptor, HER2, and Ki-67 status to provide a semiquantitative prognostic score for breast cancer. High accuracy and low interobserver variance are important to ensure the score is accurately calculated; however, few previous efforts have been made to measure or decrease interobserver variance. We developed a Web-based training tool, called "Score the Core" (STC) using tissue microarrays to train pathologists to visually score estrogen receptor (using the 300-point H score), progesterone receptor (percent positive), and Ki-67 (percent positive). STC used a reference score calculated from a reproducible manual counting method. Pathologists in the Athena Breast Health Network and pathology residents at associated institutions completed the exercise. By using STC, pathologists improved their estrogen receptor H score and progesterone receptor and Ki-67 proportion assessment and demonstrated a good correlation between pathologist and reference scores. In addition, we collected information about pathologist performance that allowed us to compare individual pathologists and measures of agreement. Pathologists' assessment of the proportion of positive cells was closer to the reference than their assessment of the relative intensity of positive cells. Careful training and assessment should be used to ensure the accuracy of breast biomarkers. This is particularly important as breast cancer diagnostics become increasingly quantitative and reproducible. Our training tool is a novel approach for pathologist training that can serve as an important component of ongoing quality assessment and can improve the accuracy of breast cancer prognostic biomarkers.
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Affiliation(s)
- Jesse A Engelberg
- Center for Comparative Medicine, University of California Davis, Davis, CA 95616.
| | - Hanna Retallack
- School of Medicine, University of California San Francisco, San Francisco, CA 94143
| | - Ronald Balassanian
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Mitchell Dowsett
- Centre for Molecular Pathology, Royal Marsden Hospital, London, SW3 6JJ United Kingdom
| | - Lila Zabaglo
- Institute of Cancer Research, London, SM2 5NG United Kingdom
| | - Arishneel A Ram
- Center for Comparative Medicine, University of California Davis, Davis, CA 95616
| | - Sophia K Apple
- Department of Pathology, University of California Los Angeles, Los Angeles, CA 90404
| | - John W Bishop
- Department of Pathology, University of California Davis, Davis, CA 95616
| | | | - Philip M Carpenter
- Department of Pathology, University of California Irvine, Orange, CA 92697
| | - Yunn-Yi Chen
- Department of Pathology, University of California San Francisco, San Francisco, CA 94143
| | - Brian Datnow
- Department of Pathology, University of California San Diego, San Diego, CA 92093
| | - Sarah Elson
- Center for Comparative Medicine, University of California Davis, Davis, CA 95616
| | - Farnaz Hasteh
- Department of Pathology, University of California San Diego, San Diego, CA 92093
| | - Fritz Lin
- Department of Pathology, University of California Irvine, Orange, CA 92697
| | - Neda A Moatamed
- Department of Pathology, University of California Los Angeles, Los Angeles, CA 90404
| | - Yanhong Zhang
- Department of Pathology, University of California Davis, Davis, CA 95616
| | - Robert D Cardiff
- Department of Pathology, University of California Davis, Davis, CA 95616
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15
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Van Es SL, Kumar RK, Pryor WM, Salisbury EL, Velan GM. Cytopathology whole slide images and adaptive tutorials for postgraduate pathology trainees: a randomized crossover trial. Hum Pathol 2015; 46:1297-305. [PMID: 26093936 DOI: 10.1016/j.humpath.2015.05.009] [Citation(s) in RCA: 28] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/02/2015] [Revised: 04/29/2015] [Accepted: 05/07/2015] [Indexed: 11/28/2022]
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.
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Affiliation(s)
- Simone L Van Es
- Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia.
| | - Rakesh K Kumar
- Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia.
| | - Wendy M Pryor
- Royal College of Pathologists of Australasia, Surry Hills 2010, Australia.
| | - Elizabeth L Salisbury
- Department of Anatomical Pathology, Prince of Wales Hospital, Randwick 2031, Australia.
| | - Gary M Velan
- Department of Pathology, School of Medical Sciences, The University of New South Wales, Sydney NSW 2052, Australia.
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16
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Abstract
OBJECTIVES To suggest a basic new approach for pathology training programs to consider when a resident requires remediation, probation, or dismissal. METHODS Remediation, probation, or dismissal of the poorly performing pathology resident is one of the most difficult and challenging aspects of any pathology training program. The poorly performing resident requires extra time and resources from the faculty and the program and can be disruptive for the entire program. Effective remediation requires faculty development, a well-constructed remediation or probation plan, and documentation. RESULTS Despite best efforts, not all remediation plans are successful and dismissal of the resident will need to be seriously considered. CONCLUSIONS Approaches to dealing with resident performance issues can be variable and need to be tailored to the issue being addressed.
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Affiliation(s)
- Ronald E. Domen
- Department of Pathology and Laboratory Medicine, Penn State Hershey Medical Center and College of Medicine, Hershey, PA
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