Virtual Pathology Education in Medical Schools Worldwide during the COVID-19 Pandemic: Advantages, Challenges Faced, and Perspectives

Abstract

The COVID-19 pandemic shifted pathology education in medical schools worldwide towards online delivery. To achieve this goal, various innovative platforms were used by pathology educators and medical students, facilitating both synchronous and asynchronous learning. The aim of this study was to review the published evidence regarding remote pathology teaching at the medical school level during this period, present our own experience, and provide some perspectives regarding the best mode of pathology teaching post-pandemic. Among its advantages, virtual pathology education was considered among students and educators as convenient, flexible, and engaging, while learning outcomes were met and students’ academic performance was in general satisfactory. However, several challenges were faced. For instance, suboptimal internet connection compromised the flow of classes and was even associated with a lower academic performance. The lack of hands-on laboratory activities, such as operating the light microscope and tissue grossing, and the reduced student interactions among themselves and their instructors, were also pointed out as significant drawbacks of remote pathology education. Whereas online education has multiple advantages, experiencing the physical university environment, in-person interactions and teamwork, exposure to the “hidden curriculum”, and hands-on activities are vital for medical school education and future student development. In conclusion, the implementation of a blended approach in pathology education—where online and face-to-face sessions are jointly used to promote students’ engagement, interaction with their instructors and peers, and learning—could be the most optimal approach to pathology teaching in medical schools post-pandemic.

The Michigan Histology website as an example of a free anatomical resource serving learners and educators worldwide

“…Schools like the University of Michigan that had disbanded faculty‐guided histology laboratory sessions previously continued to rely on online resources like the Michigan Histology website and offered recorded lecture videos to learners. Other schools that prior to the Covid‐19 pandemic still offered in‐person histology laboratory instruction had to find alternatives and many supplemented their histology and pathology learning resources with online tools like the Michigan Histology website or other similar material as listed in Table 1 34,67–71 . While the pandemic restricted in‐person teaching, the Michigan Histology website saw a noticeable increase in the number of sessions and users (Figure 2) and it raises the possibility that the forced change of teaching modalities contributed to that increase use of the website.…”

“…In the absence of solid data, many schools will have to decide whether to return to pre‐pandemic type of histology laboratory instruction or continue with an exclusive online approach. Even though several studies show that virtual microscopy is an effective technology to teach histology and pathology online, 73,74 the argument has been made that the ability to use traditional light microscopes is still a valuable skill for today's medical professionals 70,75,76 . If students are left without any expert faculty support during their study of virtual slides, pre‐pandemic experiences from the author's institution predict a decrease in students' histology learning outcomes 35,38 .…”

“…Other schools that prior to the Covid-19 pandemic still offered in-person histology laboratory instruction had to find alternatives and many supplemented their histology and pathology learning resources with online tools like the Michigan Histology website or other similar material as listed in Table 1. 34,[67][68][69][70][71] While the pandemic restricted in-person teaching, the Michigan Histology website saw a noticeable increase in the number of sessions and users (Figure 2) and it raises the possibility that the forced change of teaching modalities contributed to that increase use of the website. It will be of interest whether the observed increase in Michigan Histology website users and visits will be maintained with the pandemic ending or whether schools will return to their pre-pandemic modes of teaching.…”

“…Even though several studies show that virtual microscopy is an effective technology to teach histology and pathology online, 73,74 the argument has been made that the ability to use traditional light microscopes is still a valuable skill for today's medical professionals. 70,75,76 If students are left without any expert faculty support during their study of virtual slides, pre-pandemic experiences from the author's institution predict a decrease in students' histology learning outcomes. 35,38 Regardless, it appears unlikely that all changes that were forced by the Covid-19 pandemic will be reversed and online resources like the Michigan Histology website will remain an important component for teaching histology in the future.…”

Adversity and Turnaround in Medical Education:Development and vision of a framework for a multimodal teaching and learning interaction model

“…(2). Neglect of teacher-student relationships and teaching evaluations [15]: This describes the adverse effects of isolation on the relationships between teachers and students and between the teaching subjects and the lack of feedback on teaching results. While the epidemic has resulted in a strong emphasis on e-learning and digital learning, the lack of maturity of these teaching modes, such as reduced immersion and direct participation between teachers and students, has necessitated higher levels of self-management and self-motivation by learners due to the lack of face-to-face communication and interaction in heterochronic teaching [16].…”