Digital educational resources as support tools for teaching general pathology in undergraduate health courses / Recursos educativos digitales como herramientas de apoyo para la enseñanza de patología general en cursos de pregrado del área de la salud

Los recursos educativos digitales se han transformado en un importante material de apoyo al proceso de enseñanza- aprendizaje, especialmente durante la pandemia por COVID-19. Estos corresponden a recursos de autoaprendizaje, generalmente en línea y de dominio público cuya disponibilidad inmediata a todo tipo de dispositivos electrónicos permite una rápida interacción del estudiante con materiales didácticos programados. El objetivo de este estudio fue evaluar el grado de satisfacción de cinco recursos educativos digitales, desarrollados como herramientas de apoyo para la enseñanza de la patología general, en estudiantes de carreras de pregrado del área de la salud de la Universidad Austral de Chile. Estudio descriptivo y exploratorio. Se desarrollaron cinco recursos educativos digitales donde se visualizan imágenes microscópicas correspondientes a procesos patológicos ocurridos en diferentes tejidos. Estos recursos fueron alojados en repositorios de la universidad y se encuentran actualmente disponibles en el canal de YouTube. Para conocer el grado de satisfacción, en sus aspectos pedagógicos y técnicos, se realizó una encuesta digital, anónima y voluntaria a estudiantes que cursaron asignaturas de patología, la que contempló cuatro dominios con sus respectivas preguntas: forma; control de usuario; contenido educativo y valoración global. El 94 % de los estudiantes calificaron el recurso de excelente o muy bueno y todos los dominios obtuvieron sobre el 80 % de satisfacción. Los contenidos representan lo que el recurso dice ofrecer, ayuda a resolver dudas y facilita la comprensión de la materia. El tamaño y color del texto es el adecuado y las imágenes presentan una excelente calidad y resolución. Los recursos cumplen con una alta calidad técnica y pedagógica, que asegura un gran potencial de uso para la enseñanza de la patología general, guiar el trabajo autónomo del estudiante y las actividades prácticas con el microscopio.

SUMMARY: Digital educational resources have become an important material to support the teaching-learning process, especially during the COVID-19 pandemic. These correspond to self-learning resources, generally online and the public domain, whose immediate availability to all types of electronic devices allows for rapid learner interaction with programmed didactic materials. The public domain and its immediate availability to all types of electronic devices allows a quick interaction of the student with self-explanatory didactic materials. The objective of this study was to evaluate the degree of satisfaction of five digital educational resources, developed as support tools for the teaching of general pathology, in undergraduate students of the health area of the Universidad Austral de Chile. Descriptive and exploratory study. Five digital educational resources have been developed where microscopic images corresponding to pathological processes occurring in different tissues are visualized these resources were hosted in university repositories and uploaded to the YouTube channel. To determine the degree of satisfaction, in their pedagogical and technical aspects, an anonymous and voluntary digital survey was carried out among students taking pathology courses, which included four domains with their respective questions: form; user control; educational content and overall assessment. The 94 % of the students evaluated the resource as excellent or very good and all domains obtained over 80 % satisfaction. The contents represent what the resource says it offers, helps to resolve doubts and facilitates the understanding of the subject. The size and color of the text is adequate, and the images present excellent quality and resolution. The resources developed offer a high technical and pedagogical quality, which guarantees a great potential for use in the teaching of general pathology, guiding the student's autonomous work and practical activities with the microscope.

Impact of the COVID-19 pandemic on a healthy and physically active person. Case report and update of the main findings / Impacto de la pandemia por COVID-19 en persona sana y físicamente activa. Reporte de un caso y actualización de los principales hallazgos

Introducción. No todas las personas expuestas al COVID-19 desarrollan una en-fermedad respiratoria grave y el número de personas adultas jóvenes sin patologías previas, afectadas gravemente por el virus, viene en aumento. Se ha evidenciado un gran número de síntomas inespecíficos y complicaciones, posterior a la recuperación. Objetivo. Evaluar las repercusiones en un sujeto sano y físicamente activo que pre-sentó complicaciones médicas graves y complicaciones posteriores al COVID-19. Reporte de caso. Hombre de 41 años de edad, físicamente activo y sin enfermeda-des conocidas, en quien se documenta infección por SARS-CoV2 con prueba PCR positiva. Requirió 22 días en UCI, 17 días en hospitalización general, 57 días de incapacidad y posterior a doce meses presenta pérdida evidente de peso y de memo-ria, dificultad para pensar y concentrarse, pérdida de masa muscular, compromiso de la función hepática, cansancio y fatiga, dolor muscular, problemas para dormir, cambios en el estado de ánimo y alteraciones del gusto. De acuerdo con los actuales hallazgos, la producción de un tipo de anticuerpo impide que el sistema inmune ten-ga una respuesta adecuada contra la enfermedad. Sumado a esto, se ha descrito una nueva puerta de entrada del virus en el organismo: la proteína neuropilina-1 (NRP1), además de la posible disminución del surfactante que permite la flexibilidad de los pulmones. Lo anterior podría dar respuestas a las complicaciones en personas sanas y físicamente activas posterior a la infección por COVID-19. Conclusiones. Entendiendo que el COVID-19 es una enfermedad reciente, aún hay mucha información por recolectar para así entender su comportamiento en el cuerpo humano. Sin embargo, las investigaciones van dando evidencia del porqué el COVID-19 puede generar graves complicaciones médicas en personas sanas y físicamente activas. Son necesarias más investigaciones con esta población, para así realizar planteamientos de manejo clínico acordes a la enfermedad y evitar desenlaces fatales.

Introduction. Not all people exposed to COVID-19 develop a severe respiratory disease and the number of young adults without previous pathologies, seriously af-fected by the virus, is increasing. Many of non-specific symptoms and complications have been evidenced after the recovery. Objective. To evaluate the repercussions in a healthy and physically active subject who presented serious medical complications and post-COVID-19 complications.Case report. A 41-year-old man, physically active and without known diseases, in whom SARS-CoV2 infection with a positive PCR test is documented. He required 22 days in the ICU, 17 days in general hospitalization, 57 days of disability and after twelve months there is evident weight and memory loss, difficulty thinking and con-centrating, loss of muscle mass, compromised liver function, tiredness and fatigue, muscle pain, sleep problems, changes in mood, and alterations in the taste. According to the current findings, the production of a type of antibody prevents the immune system from having an adequate response against the disease. In addition to this, a new gateway for the virus into the body has been described: the protein neuropilin- 1 (NRP1), as well as the possible decrease in surfactant that allows the flexibility of the lungs. This could provide answers to complications in healthy and physically active people after COVID-19 infection. Conclusions. Understanding that COVID-19 is a recent disease, there is still a lot of information to collect to understand its behavior in the human body. However, research is providing evidence on why COVID-19 can cause serious medical compli-cations in healthy and physically active people. Understanding that it is a multifac-torial situation, more research is necessary with this population in order to carry out clinical management approaches according to the disease and avoid fatal outcomes.

Remote Pathology teaching under the COVID-19 pandemic: Medical students' perceptions.

CONTEXT: The COVID-19 pandemic has forced traditional teaching to be re-structured and delivered online. OBJECTIVE: To analyse medical students' perceptions about the benefits and difficulties of the remote teaching of Pathology during the COVID-19 pandemic. DESIGN: A cross-sectional study was performed with an online survey applied to students from the third and fourth year of medical graduation, who attended the remote teaching of Pathology during the COVID-19 pandemic. Online teaching methods consisted of synchronous activities with live interactive lectures, case-based discussions and asynchronous activities with recorded lectures, tutorials and texts available on the online teaching platform. Students' perceptions about the remote teaching of Pathology were assessed through online survey. RESULTS: Ninety students (47.4%) of 190 participants completed the questionnaire, 45 were male and 52 in the third year of medical graduation. Perceived conditions that facilitated Pathology learning included the use of the online teaching platform and time flexibility for study. Students regarded live interactive lectures as superior to traditional face-to-face lectures. Perceived conditions that hindered the implementation of the online teaching included difficulty separating study from home activities, lack of motivation and worsening of quality of life due to physical distancing from colleagues and the faculty. Overall, the remote teaching of Pathology was positively valued by 80% of the students. CONCLUSION: Online tools allowed the content of Pathology to be successfully delivered to the students during the COVID-19 pandemic. This experience may be a model for future teaching activities of Pathology in health science education.

Excellence Available Everywhere: The Virtual Pathology Grand Rounds Experience.

OBJECTIVES: The goal is to describe the use of a virtual platform in the delivery of Virtual Pathology Grand Rounds (VPGR) and discuss the overall experience from the perspective of hosts, speakers, and participants. METHODS: Zoom was a natural choice for an online format because virtual platforms had been increasingly used to conduct meetings and medical education. VPGR hosted 14 speakers on a variety of topics, including subspecialty anatomic pathology material, digital pathology, molecular pathology, and medical education. RESULTS: There were 221 registrants and 114 participants for the first lecture, reaching a maximum of 1,268 registrants for the 12th lecture and the maximum limit of 300 participants during 3 lectures. Speakers stated that VPGR conveniently provided career-building opportunities through partnerships with host universities and remote attendance. Participants identified a lack of interpersonal communication and technical challenges as downsides. CONCLUSIONS: VPGR serves as strong proof of concept for the feasibility and demand for high-quality, remote academic pathology talks.

Future of Education or Present Reality?

CONTEXT.­: The main focus of education in most pathology residency and subspecialty pathology fellowships is the light microscopic examination of pathology specimens. Classes with multiheaded scopes are the most popular among pathology trainees. Until recently, it was difficult to imagine that this educational approach could change. In the beginning of March 2020, our country faced a serious challenge, which all of us now know as the coronavirus disease 2019 (COVID-19) pandemic. The rules of social distancing and work from home were applied. These types of restrictions were implemented in almost all parts of our life, including work and pathology education. OBJECTIVE.­: To share our experience in the Department of Hematopathology at the University of Texas MD Anderson Cancer Center during the COVID-19 pandemic. We describe our experience in modifying our approaches to education. We show how we overcame many obstacles to learning by building one of the largest virtual hematopathology educational platforms via Cisco WebEx and using social media, in particular Twitter. These tools facilitated the learning of hematopathology by medical students, pathology trainees, and practicing pathologists from all over the world. DATA SOURCES.­: During the first 3 months of the pandemic (April, May, and June, 2020), we evaluated the visitor attendance to the MD Anderson Cancer Center Hematopathology Virtual Educational Platform using data collected by the Cisco WebEx Web site. To determine the impact that the platform had on medical education for the hematopathology community on Twitter, the analytic metrics obtained from Symplur LLC (www.symplur.com, April 27, 2020) were used via its Symplur Signals program. CONCLUSIONS.­: Our experience using the MD Anderson Hematopathology Virtual Platform showed that there is substantial global interest and desire for virtual hematopathology education, especially during the COVID-19 pandemic.

Financial and educational impact of the COVID-19 pandemic in an academic hospital-based tertiary cytopathology practice.

BACKGROUND: The ongoing COVID-19 pandemic has led to a dramatic shift in volumes and practice patterns for hospitals around the globe. We analyzed its effect on the cytopathology subspecialty practice and resident education at our institution. DESIGN: Specimen volumes were analyzed for the cytology practice for 2019 and 2020. Patient registration and elective and scheduled surgery volumes were also included in the analysis for 2020. The impact of innovative concepts, such as virtual teaching, on resident teaching was evaluated using a survey consisting of 5 multiple choice questions with 4 possible responses each. RESULTS: The total number of specimens decreased by 28% in March 2020 (P < 0.00001), with a continuing decline in April (66% decrease year-over-year, P < 0.00001), followed by recovery in May and return to baseline within June 2020. Specimen volumes continued to show an upward trend thereafter. Improved specimen volumes correlated with patient registration and surgical volumes. The majority of residents considered virtual teaching conferences (75%) and self-study sets (58%) as beneficial and did not view absence of one-on-one microscope learning (58%) as significantly affecting their education. CONCLUSION: The recovery curve for our cytopathology service was V-shaped, essentially the most ideal response to an economic downturn. The majority of residents viewed virtual teaching conferences and self-study sets favorably and did not regard absence of one-on-one microscope learning as adversely affecting their education.

Flattening the World of Pathology Education and Training and Shortening the Curve of Pathology Learning.

OBJECTIVES: We review how the pandemic-related education disruption may interplay with pathology manpower worldwide and shifts in disease burden to identify workable solutions. METHODS: Literature related to pathology education, pathology services in low-resource settings, and application of digital tools to pathology education was reviewed for trends and training gaps. Publications covering pathology manpower and cancer incidence worldwide were also included to assess needs. RESULTS: Pandemic-related virtual teaching has produced abundant online training materials. Pathology learning resources in low- to middle-income countries remain considerably constrained and dampen pathology manpower growth to meet current needs. Projected increases in disease burden toward the developing world thus pose a major challenge. Digital pathology resources have expanded and are beginning to appear beyond the developed countries. CONCLUSIONS: This circumstance offers a unique opportunity to leverage digital teaching resources to enhance and equitize training internationally, potentially sufficient to meet the rising wave of noncommunicable diseases. We propose four next steps to take advantage of the current opportunity: curate and organize digital training materials, invest in the digital pathology infrastructure for education and clinical care, expand student exposure to pathology through virtual electives, and develop further competency-based certification pathways.

The medical student's guide to pathology residency, fellowships, and careers.

Recent studies have shown that relatively few MD, DO, and underrepresented in medicine (URM) students and physicians are matching into pathology residency in the United States (US). In the 2021 Main Residency Match, just 33.6% of filled pathology residency positions were taken by senior year students at US allopathic medical schools. This has been attributed to the fact that pathology is not a required rotation in most US medical schools, pathology is often taught in an integrated curriculum in the US where is does not stand out as a distinct field, and because the COVID-19 pandemic led to a suspension of in-person pathology rotations and electives. Ultimately, many US medical students fail to consider pathology as a career pathway. The objective of this article is to provide medical students with basic information, in the form of frequently asked questions (FAQs), about pathology training and career opportunities. This was accomplished by forming a team of MD and DO pathology attendings, pathology trainees, and a medical student from multiple institutions to create a pathology guide for medical students. This guide includes information about post-sophomore fellowships, 5 major pathology residency tracks, more than 20 fellowship pathways, and allopathic and osteopathic board examinations. This guide also contains photographs and descriptions of major pathology sub-specialties, including the daily and on-call duties and responsibilities of pathology residents. The exciting future of pathology is also discussed. This guide supports the agenda of the College of American Pathologists' (CAP) Pathologist Pipeline Initiative to improve student recruitment into pathology.

Protection measures against SARS-CoV-2 infection for cytopathology and histopathology laboratories personnel: practical recommendations.

In the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic, healthcare workers are at high risk to be infected with this new coronavirus, particularly when they handle not only patients, but also their body fluids. In Romania, even though the protective measures to be used by medical staff in emergency departments, clinical departments, radiology departments, clinical laboratories and morgues services are well known, there is little information about the protection of medical staff in the laboratories of cytopathology and histopathology. In this article, we will discuss the transmission routes of the new coronavirus, the surfaces it could contaminate in a hospital, as well as the modalities of its inactivation. We will present some guidelines for preparing the pathology departments to face the pandemic situation like the present one. Also, we will point out some possible recommendations/suggestions for protective measures to be taken by laboratory staff during the cytological and histopathological procedures when they manipulate body fluids or surgical samples of patients with suspected or confirmed coronavirus disease 2019 (COVID-19). Laboratory personnel should be aware that any body fluid or surgical specimen that arrives in the laboratory may contain SARS-CoV-2 and, as such, they should act after new working procedures. We recommend restraint from performing extemporaneous examination (smear and frozen section) and cytopathological examination in laboratories that do not have adequate condition for handling and processing Hazard Group 3 (HG3) pathogens, as SARS-CoV-2. Also, laboratory personnel should pay attention to instruments, technical equipment, or environmental surfaces as these also can be contaminated with the new coronavirus.