ABSTRACT
Background: Digital pathology is emerging as a critical tool in daily practice as highlighted by the SARS-CoV-2 pandemic. Pathology residents must gain adequate exposure to this technology as they approach independent practice. In this feasibility study, Canadian residents worked remotely with a United States (US)-based laboratory to help them prepare for careers in the digital age. Design: As part of their Canadian-based genitourinary (GU) pathology rotation, three 3rd-year Anatomical Pathology residents engaged in longitudinal screening and drafting of reports for digitally scanned US-based prostate biopsy cases prepared by a US laboratory specializing in digital pathology technology. Each trainee screened routine US-based digital case work as part of their curriculum and had access to artificial intelligence (AI) diagnostic software (Figure 1) during their case analyses. Residents also completed a digital pre- and post-test to assess diagnostic accuracy and time spent per core. Neither AI nor immunostains were permitted during the pre- and post-test sessions. Diagnoses were considered correct when no major discrepancies existed between resident and approved report. Results: Residents each screened and reported 10 digital prostate biopsy cases in addition to routine GU workload (Table 1). The digital pathology software allowed trainees to annotate specific histologic features and leave notes as required which could be subsequently reviewed remotely by supervisors. Feedback was provided by three anatomical pathologists, one practicing at the residents' home institution and the other two practicing at the US-based laboratory. Sign out session format varied but included video meetings with screen sharing, text messaging, phone calls, and/or email messages. Residents scored 76.67% (SD 5.7%) on the pre-test and 96.67% (SD 5.7%) on the post-test with respect to diagnostic accuracy;the average time per core decreased over the course of the rotation (Table 1). Conclusions: In this feasibility study, Canadian residents used a US-based digital pathology platform to remotely preview routine prostate biopsy casework. The residents gained exposure to digital pathology technology, including AI. Over the course of their rotations, all residents improved. These findings provide a framework for future global pathology education outreach.