ArticleCMAJ open
Performance of residents using digital images versus glass slides on certification examination in anatomical pathology: a mixed methods pilot study.
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1 citing paper in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.
- The use of digital microscopy as a teaching method for human pathology: a systematic review.Virchows Archiv : an international journal of pathology · 2020Pooled it
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Authors and funding
16 authors at 3 institutions in 1 country.
Lorna MirhamDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Christopher NauglerDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Malcolm HayesDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Nadia IsmiilDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Annie BelisleDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Shachar SadeDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Catherine StreutkerDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Christina MacMillanDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Golnar RastyDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Snezana PopovicDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Mariamma JosephDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Manal GabrilDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Penny BarnesDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Richard G HegeleDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
Beverley CarterDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
George M YousefDepartment of Laboratory Medicine and Pathobiology (Mirham, Ismiil, Sade, Streutker, MacMillan, Rasty, Hegele, Yousef), University of Toronto, Toronto, Ont.; Department of Pathology and Laboratory Medicine (Naugler), University of Calgary, Calgary, Alta.; Department of Pathology and Laboratory Medicine (Hayes), University of British Columbia, Vancouver, BC; Department of Pathology and Cellular Biology (Belisle), Université de Montréal, Montréal, Que.; Department of Pathology and Molecular Medicine (Popovic), McMaster University, Hamilton, Ont.; Department of Pathology (Joseph, Gabril), Western University, London, Ont.; Department of Pathology and Laboratory Medicine (Barnes), Dalhousie University, Halifax, NS; Department of Pathology (Carter), Memorial University of Newfoundland, St. John's, NL; Department of Laboratory Medicine (Yousef), St. Michael's Hospital, Toronto, Ont.
University of British Columbia · CADalhousie University · CAMemorial University of Newfoundland · CA
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundIt is anticipated that many licensing examination centres for pathology will begin fully digitizing the certification examinations. The objective of our study was to test the feasibility of a fully digital examination and to assess the needs, concerns and expectations of pathology residents in moving from a glass slide-based examination to a fully digital examination.
methodsWe conducted a mixed methods study that compared, after randomization, the performance of senior residents (postgraduate years 4 and 5) in 7 accredited anatomical pathology training programs across Canada on a pathology examination using either glass slides or digital whole-slide scanned images of the slides. The pilot examination was followed by a post-test survey. In addition, pathology residents from all levels of training were invited to participate in an online survey.
resultsA total of 100 residents participated in the pilot examination; 49 were given glass slides instead of digital images. We found no significant difference in examination results between the 2 groups of residents (estimated marginal mean 8.23/12, 95% confidence interval [CI] 7.72-8.87, for glass slides; 7.84/12, 95% CI 7.28-8.41, for digital slides). In the post-test survey, most of the respondents expressed concerns with the digital examination, including slowly functioning software, blurring and poor detail of images, particularly nuclear features. All of the respondents of the general survey (n = 179) agreed that additional training was required if the examination were to become fully digital.
interpretationAlthough the performance of residents completing pathology examinations with glass slides was comparable to that of residents using digital images, our study showed that residents were not comfortable with the digital technology, especially given their current level of exposure to it. Additional training may be needed before implementing a fully digital examination, with consideration for a gradual transition.
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