Journal Article
. 2017 Jul; 4:2374289517691061.
doi: 10.1177/2374289517691061.

NDER: A Novel Web Application for Teaching Histology to Medical Students

Elizabeth U Parker 1 Nicholas P Reder 1 Daniel Glasser 1 Jonathan Henriksen 1 Mark R Kilgore 1 Mara H Rendi 1 
  • PMID: 28725787
  •     15 References
  •     5 citations


Medical students require a strong foundation in normal histology. However, current trends in medical school curricula have diminished time devoted to histology. Thus, there is a need for more efficient methods of teaching histology. We have developed a novel software program (Novel Diagnostic Educational Resource; that uses annotated whole slide images to teach normal histology. Whole slide images of a wide variety of tissues were annotated by a trainee and validated by an experienced pathologist. Still images were extracted and transferred to the Novel Diagnostic Educational Resource web application. In Novel Diagnostic Educational Resource, an image was displayed briefly and the user was forced to identify the tissue type. The display time changed inversely based on cumulative accuracy to challenge the user and maintain engagement. A total of 129 second-year medical students completed the 30-minute Novel Diagnostic Educational Resource module. Surveys showed an increase in confidence from premodule (0% extremely confident, 4% very, 47% somewhat, and 49% not) to postmodule (9% extremely confident, 57% very, 32% somewhat, and 2% not), P < .0001. Accuracy increased from 72.6% pretest to 95.7% posttest, P < .002. The effect size (Cohen d = 2.30) was very large, where 0.2 is a small effect, 0.5 moderate, and 0.8 large. Ninety-six percent of students would recommend Novel Diagnostic Educational Resource to other medical students, and 98% would use Novel Diagnostic Educational Resource to further enhance their histology knowledge. Novel Diagnostic Educational Resource drastically improved medical student accuracy in classifying normal histology and improved confidence. Additional study is needed to determine knowledge retention, but Novel Diagnostic Educational Resource has great potential for efficient teaching of histology given the curriculum time constraints in medical education.

Keywords: digital pathology; e-learning; histology; informatics; medical education.

Traditional microscopy instruction versus process-oriented virtual microscopy instruction: a naturalistic experiment with control group.
Laura Helle, Markus Nivala, +3 authors, Roger Säljö.
Diagn Pathol, 2011 Apr 22; 6 Suppl 1. PMID: 21489203    Free PMC article.
Giving learners the best of both worlds: do clinical teachers need to guard against teaching pattern recognition to novices?
Tavinder K Ark, Lee R Brooks, Kevin W Eva.
Acad Med, 2006 Mar 28; 81(4). PMID: 16565197
Virtual microscopy in pathology education.
Fred R Dee.
Hum Pathol, 2009 Jun 23; 40(8). PMID: 19540551
Remote histology learning from static versus dynamic microscopic images.
Sylvia Mione, Martin Valcke, Maria Cornelissen.
Anat Sci Educ, 2015 Oct 07; 9(3). PMID: 26441000
Curricular trends in instruction of pathology: a nationwide longitudinal study from 1993 to present.
K Kumar, A Indurkhya, H Nguyen.
Hum Pathol, 2001 Dec 01; 32(11). PMID: 11727251
Integrating histology and histopathology teaching in practical classes using virtual slides.
Rakesh K Kumar, Brian Freeman, Gary M Velan, Patrick J De Permentier.
Anat Rec B New Anat, 2006 Jul 26; 289(4). PMID: 16865702
Medical education in the anatomical sciences: the winds of change continue to blow.
Richard L Drake, Jennifer M McBride, Nirusha Lachman, Wojciech Pawlina.
Anat Sci Educ, 2009 Nov 06; 2(6). PMID: 19890982
Self-instructional "virtual pathology" laboratories using web-based technology enhance medical school teaching of pathology.
Alberto M Marchevsky, Anju Relan, Susan Baillie.
Hum Pathol, 2003 Jun 07; 34(5). PMID: 12792914
A retrospective and prospective look at medical education in the United States: trends shaping anatomical sciences education.
Richard L Drake.
J Anat, 2013 Apr 23; 224(3). PMID: 23600681    Free PMC article.
Are we throwing histology out with the microscope? A look at histology from the physician's perspective.
Rebecca L Pratt.
Anat Sci Educ, 2009 Aug 19; 2(5). PMID: 19688840
Resident preparation for practice: a white paper from the College of American Pathologists and Association of Pathology Chairs.
Michael L Talbert, Edward R Ashwood, +9 authors, Association of Pathology Chairs.
Arch Pathol Lab Med, 2009 Aug 01; 133(7). PMID: 19642741
The Virtual Pathology Instructor: a medical student teaching tool developed using patient simulator software.
Fiona E Craig, James B McGee, John F Mahoney, Christine G Roth.
Hum Pathol, 2014 Aug 06; 45(10). PMID: 25090919
NDER: A novel web application using annotated whole slide images for rapid improvements in human pattern recognition.
Nicholas P Reder, Daniel Glasser, +4 authors, Mark R Kilgore.
J Pathol Inform, 2016 Aug 27; 7. PMID: 27563490    Free PMC article.
Virtual microscopy and digital pathology in training and education.
Peter W Hamilton, Yinhai Wang, Stephen J McCullough.
APMIS, 2012 Mar 21; 120(4). PMID: 22429213
From chalkboard, slides, and paper to e-learning: How computing technologies have transformed anatomical sciences education.
Robert B Trelease.
Anat Sci Educ, 2016 Nov 02; 9(6). PMID: 27163170
A Taxonomic Index for Retrieval of Digitized Whole Slide Images from an Electronic Database for Medical School and Pathology Residency Education.
Agnes G Loeffler, Mark Smith, +2 authors, Daniel F I Kurtycz.
J Pathol Inform, 2019 Dec 05; 10. PMID: 31799019    Free PMC article.
Development of an interactive e-learning software "Histologie für Mediziner" for medical histology courses and its overall impact on learning outcomes and motivation.
Christina Drees, Estifanos Ghebremedhin, Miriam Hansen.
GMS J Med Educ, 2020 Jun 23; 37(3). PMID: 32566737    Free PMC article.
e-Learning for Instruction and to Improve Reproducibility of Scoring Tumor-Stroma Ratio in Colon Carcinoma: Performance and Reproducibility Assessment in the UNITED Study.
Marloes A Smit, Gabi W van Pelt, +5 authors, UNITED Group.
JMIR Form Res, 2021 Mar 20; 5(3). PMID: 33739293    Free PMC article.
Practicing Histotechnologists Identify the Core Competencies Needed by Newly Graduated Biomedical Laboratory Scientists in Histotechnology and Histology.
Eeva Liikanen.
Med Sci Educ, 2019 Jul 16; 29(4). PMID: 34457567    Free PMC article.
The "Make Surgical Pathology Easy" project: learning Pathology through tailored digital infographics - the case for renovation of an old teaching method.
Luca Cima, Abhijit Das, +2 authors, Francesca Pagliuca.
Pathologica, 2021 May 28; 113(4). PMID: 34042911    Free PMC article.