Continuing Undergraduate Pathology Medical Education in the Coronavirus Disease 2019 (COVID-19) Global Pandemic: The Johns Hopkins Virtual Surgical Pathology Clinical Elective

Abstract

Context: In the early months of the response to the coronavirus disease 2019 (COVID-19) pandemic, the Johns Hopkins University School of Medicine (JHUSOM) (Baltimore, Maryland) leadership reached out to faculty to develop and implement virtual clinical clerkships after all in-person medical student clinical experiences were suspended. Objective: To develop and implement a digital slide-based virtual surgical pathology clinical elective to meet the demand for meaningful and robust virtual clinical electives in response to the temporary suspension of in-person clinical rotations at JHUSOM. Design: The Virtual Surgical Pathology (VSP) elective was modeled after the in-person surgical pathology elective, to include virtual previewing and sign-out with standardized cases supplemented by synchronous and asynchronous pathology educational content. Results: Validation of existing web communications technology and slide scanning systems was performed by feasibility testing. Curriculum development included drafting of course objectives and syllabus, Blackboard course site design, electronic-lecture creation, communications with JHUSOM leadership, scheduling, and slide curation. Subjectively, the weekly schedule averaged 35–40 hours to asynchronous, synchronous, and independent content, approximately 10–11 hours of which were synchronous. As of February 2021, VSP has hosted 35 JHUSOM and eight non-JHUSOM students, who have provided positive subjective and objective course feedback. Conclusions: The Johns Hopkins VSP elective provided meaningful clinical experience to 43 students in a time of immense online education need. Added benefits of implementing VSP included increased medical student exposure to pathology as a medical specialty and demonstration of how digital slides have the potential to improve standardization of the pathology clerkship curriculum.

Implementation and Effectiveness of a Completely Virtual Pathology Rotation for Visiting Medical Students

“…The major drawback of the virtual visiting rotation is the amount of time required of the participating faculty, which was also noted in a similar virtual elective implemented at Johns Hopkins. 12 Daily signout required the use of microscope cameras and Zoom as well as time spent communicating and scheduling with the students. Because of the pandemic, many services were conducting signout virtually already, making these changes less noticeable.…”

Outcomes of Remote Pathology Instruction in Student Performance and Course Evaluation

“…[20][21][22] These changes reflected similar adjustments imposed on pathology resident training and upper-class student electives and mostly concerned the replacement of instruction centered on a physical microscope with the use of virtually accessed digitized slides. [23][24][25][26][27] Among individual medical schools, the decision of how to modify instruction depended on factors such as content complexity, technical feasibility, time limitations, and infrastructure capacity. 28 In our institution, the decision involved an immediate transition to completely remote instruction for all preclinical courses and was partly influenced by the fact that our school's location was at the time an epicenter of the pandemic.…”

Experiência no ensino de patologia em tempos de pandemia

“…O "Projeto Atlas" que desenvolvemos se baseou na análise dos achados microscópicos de casos anatomopatológicos corriqueiros, com o estudo de doenças que fazem parte da rotina do médico generalista. A Faculdade de Medicina da Universidade Johns Hopkins reportou sessões síncronas e assíncronas semelhantes com estudantes da graduação, nas quais eram discutidos casos da rotina do laboratório de patologia, inclusive em tempo real para liberação dos laudos 14 .…”

“…Essa universidade norte-americana utilizou lâminas escaneadas e transmissão ao vivo de lâminas de vidro, com o auxílio de câmeras acopladas a microscópios de múltiplas cabeças 14 . Nosso projeto foi bem dinâmico com grande aceitação por parte dos alunos que tiveram atitudes mais proativas, principalmente em relação ao estudo dos casos de microscopia.…”