Improving Medical Students’ Learning Experience of Pathology by Online Practical Sessions through Virtual Microscopy

  • Safina Ahmed Shifa College of Medicine
  • Maryam Habib SCM
  • Hania Naveed SCM
  • Ghazala Mudassir
  • Mahwish Majid Bhatti SCM
  • Rifat Nadeem Ahmad SCM
Keywords: Education, medical, pathology, undergraduate, virtual microscopy.



Objective: To assess the impact of interactive virtual pathology slides on students’ understanding of pathological disease processes.

Materials & Methods: The study was conducted at Shifa College of medicine, Islamabad. Class of 3rd year MBBS, comprising of 111 students, was divided into two groups during two teaching modules. All students received online lectures prior to practical sessions. In the first module, one group was taught virtual slides through online interactive sessions, whereas the second group was taught same set of slides, using light microscopy and glass slides. Both groups were assessed at the end of the module by online test and their scores were compared. Similar exercise was repeated in the second module in which the control group became the test group to remove the selection bias. Questionnaire feedback was taken from students to get their perceptions. The results were compared by applying t-test and p-value was calculated.

Results: The mean score of test group (group-1) in first module was 14.90 whereas mean score of control group (group-2) was 10.99. The t test was applied, and p-value calculated was significant (p=0.04). In the second module the groups were flipped. The mean score of test group (group-2) was 14.29 whereas control group (group-1) was 10.09. The p value was calculated which was again significant (p=0.04). The students gave their feedback through questionnaire.

Conclusion: Overall, we believe that the use of virtual microscopy significantly improves student’s understanding of pathological lesions.

Keywords: Education, medical, pathology, undergraduate, virtual microscopy.


1. Nauhria S, Hangfu L. Virtual microscopy enhances the reliability and validity in histopathology curriculum: Practical guidelines (Version 2). MedEdPublish. 2019. 8. 10.15694/mep.2019.000028.2.
2. Kumar RK, Velan GM, Korell SO, Kandara M, Dee FR, Wakefield D. Virtual microscopy for learning and assessment in pathology. J Pathol. 2004; 204(5): 613-8. doi: 10.1002/path.1658.
3. Becerra D, Grob M, Assadi JL, Astorga C, Tricio J, Melelli R, et al. Academic achievement and perception of two teaching methods in histology: light and digital microscopy: pilot study. Int J Morphol.2018; 36(3): 811-6.
4. Farahani N, Parwani A, Pantanowitz L. Whole slide imaging in pathology: advantages, limitations, and emerging perspectives.2015; Pathol Lab Med Int; 7(6):23-33.
5. Vyas NS, Markow M, Prieto-Granada C, Gaudi S, Turner L, Rodriguez-Waitkus P, et al. Comparing whole slide digital images versus traditional glass slides in the detection of common microscopic features seen in dermatitis. J Pathol Inform.2016; 7: 30-3.
6. Anyanwu GE, Agu AU, Anyaehie UB. Enhancing learning objectives by use of simple virtual microscopic slides in cellular physiology and histology: impact and attitudes. Adv Physiol Educ. 2012; 36: 158–163, doi:10.1152/advan.00008.2012
7. Chen CP & Clifford BM, O′Leary MJ, Hartman DJ, Picarsic J. Improving Medical Students' Understanding of Pediatric Diseases through an Innovative and Tailored Web-based Digital Pathology Program with Philips Pathology Tutor (Formerly PathXL). J Pathol Inform. 2019; 10:18.
8. Ordi O, Bombí J, & Martinez A, Ramírez J, & Alòs L, Saco A, et-al. Virtual microscopy in the undergraduate teaching of pathology. J Pathology Inform. 2015; 6: 1.
9. Brierley DJ, Speight PM, Hunter KD, Farthing P. Using virtual microscopy to deliver an integrated oral pathology course for undergraduate dental students. Br Dent J. 2017 Jul 21;223(2):115-120. doi: 10.1038/sj.bdj.2017.626. PMID: 28729584.
10. Krippendorf BB, Lough J. Complete and rapid switch from light microscopy to virtual microscopy for teaching medical histology. Anat Rec – Part B New Anat 2005; 285: 19–25.
11. Kumar R K, Freeman B, Velan G M, De Permentier PJ. Integrating histology and histopathology teaching in practical classes using virtual slides. Anat Rec B New Anat 2006; 289: 128–133.
12. Cimadamore A, Lopez-Beltran A, Scarpelli M, Cheng L, Montironi R. Digital pathology and COVID-19 and future crises: pathologists can safely diagnose cases from home using a consumer monitor and a mini PC. J Clin Pathol. 2020; 73:695-696.
13. Kim RH, Brinster NK, Meehan SA. Dermatopathology education during the COVID-19 pandemic: Virtual simulation of the multiheaded microscope. J Am Acad Dermatol. 2020;83(3): e243-e244. doi: 10.1016/j.jaad.2020.05.127
14. Dee FR, Lehman JM, Consoer D, Leaven T, Cohen MB. Implementation of virtual microscope slides in the annual pathobiology of cancer workshop laboratory. Hum Pathol. 2003; 34(5):430-6. doi: 10.1016/s0046-8177(03)00185-0. PMID: 12792915.
15. Szymas J, Lundin M. Five years of experience teaching pathology to dental students using the WebMicroscope. Diagn Pathol. 2011;6 (Suppl 1): S13. doi:10.1186/1746-1596-6-S1-S13
16. Farah, C. S. and Maybury, T. S. 'The e-evolution of microscopy in dental education', J Dent Educ. 2009; 73(8): 942-9.
17. Blake CA, Lavoie HA, Millette CF. Teaching medical histology at the University of South Carolina School of Medicine: Transition to virtual slides and virtual microscopes. Anat Rec B New Anat. 2003; 275(1): 196-206. doi: 10.1002/ar.b.10037. PMID: 14628320.
18. Fonseca FP, Santos-Silva AR, Lopes MA, Almeida OP, et al. 'Transition from glass to digital slide microscopy in the teaching of oral pathology in a Brazilian dental school'. Med Oral Patol Oral Cir Bucal. 2015; 20(1): e17-22.
19. Foster K. Medical education in the digital age: Digital whole slide imaging as an e-learning tool. J Pathol Inform. 2010; 1:14.
20. Gatumu MK, MacMillan FM, Langton PD, Headley PM, et al. Evaluation of usage of virtual microscopy for the study of histology in the medical, dental, and veterinary undergraduate programs of a UK University. Anat Sci Educ. 2014; 7(5): 389-98.
21. Goldberg HR, Dintzis R. The positive impact of team-based virtual microscopy on student learning in physiology and histology. Adv Physiol Educ. 2007; 31(3): 261-5.
22. Helle L, Nivala M, Kronqvist P. More technology, better learning resources, better learning? Lessons from adopting virtual microscopy in undergraduate medical education. Anat Sci Educ. 2013; 6(2):73-80.
How to Cite
Ahmed S, Habib M, Naveed H, Mudassir G, Bhatti M, Ahmad R. Improving Medical Students’ Learning Experience of Pathology by Online Practical Sessions through Virtual Microscopy. JRMC [Internet]. 31Mar.2022 [cited 27May2022];26(1):122-7. Available from: