by Alan Rampy, DO, PhD, Dell Medical School at The University of Texas at Austin
Many years before there were conversations about approval of Whole Slide Imaging (WSI) for primary diagnosis or the availability of WSI data to train and validate convolutional neural network models, digital pathology was viewed as a possible new tool to be used in the advancement of pathology in education. And, yes, we have come a long way since the very early single-slide prototype scanners we worked with to get reliable, quality representations of glass slides to be shared with learners. It is that long and winding road that is captured, reflected upon, and shared in the realms of future possibilities in a recent DPA-derived publication by Lewis Hassel and colleagues, Pathology education powered by virtual and digital transformation: now and the future.
Whether you are new to the world of pathology education or have been intimately involved in the associated digital transformation that has transpired of the past couple of decades, this new paper will come as a very nice overview of all that is now possible (and some yet to come) as it relates to teaching pathology. Even though some traditionalists or “purists” were hesitant with regard to the transition of teaching histology and histopathology with WSIs instead of exploring slides with a microscope, most educators readily appreciated the many advantages of the digitized medium. Moreover, the tools associated with digital pathology align well with the current educational paradigms of “flipped classroom”, “adaptive learning”, and “retrieval practice”. And, as we have all experienced over the past couple of years, the online platforms of digital pathology, have afforded the means to keep pathology education moving forward during the marked challenges of the pandemic.
Virtual and digital pathology (DP) are now widely applied across the domains of undergraduate medical education, dental, veterinary, as well as the allied health domains. As shared by the authors, the various areas of concentration are exploring means to best leverage the benefits of online pathology training, using it in such presentations as small-group problem-based learning, virtual clerkships, and image-based gamification modules. Some robust platforms for virtual and digital pathology, now may be used to build entire courses. With regard to graduate medical education, it is noted, that DP and telepathology proficiency is not included in the ACGME Milestones or program requirements, yet such practice has taken on a prominent role in many residency and fellowship expectations. Presented are the many benefits, challenges and opportunities across the components of both Anatomic and Clinical Pathology training. Beyond these discussions of graduate and undergraduate education experiences, there are also thoughts on less commonly considered arenas of digital pathology as it may be integrated into Continuing Education, Peer-to-Peer and Patient Education as well Professional Competency Assessments and Licensing. Each of these areas are presented as they have developed and with thoughts about additional tools needed and recent advances.
This thorough discussion ends appropriately with the essential drivers of DP adoption from the standpoint of education. Most recently, a primary driver for such adoption has been the COVID-19 pandemic. This experience has catalyzed, not only the rapid advancement of educational tools for virtual and digital pathology, but has also made a clear argument for adoption for the sake of remote accessibility. And, with regard to accessibility, the wide reach of cloud learning has also made it possible to extend and greatly expand the audience of learners. The thoughtful presentation of adoption drivers is presented across several perspectives, and is then followed with by useful ideas for confronting barriers to adoption and implementation.
For any interested reader with effort in pathology education – this is a must. Thanks for the memories of historical reference and for the inspiration of possibilities ahead in pathology education with virtual and digital transformation.
Disclaimer: In seeking to foster discourse on a wide array of ideas, the Digital Pathology Association believes that it is important to share a range of prominent industry viewpoints. This article does not necessarily express the viewpoints of the DPA, however we view this as a valuable point with which to facilitate discussion.