E-education for medical Students using WSI in Egypt

Introduction Classic practical Teaching of pathology for both under & post graduates requires microscopes and glass slides. Medical schools in developing countries are confronted with many challenges, among them, the large number of the students especially if this is compared with the limited resources of the medical schools. Furthermore, the high cost of acquisition and maintenance of microscopes. As a consequence, more than one student may have to share a microscope in the teaching laboratory (Figure 1). Furthermore, glass slide specimens may also be shared among students since preparation of new specimens and replacement of broken slides are often expensive as well. Moreover, the time for laboratory hours is limited, and micro-scopes are often locked up and unavailable for use after class hours. Although the medical schools in developed countries do not suffer a lot from the same problems but the reported trial for applying digital pathology techniques has shown to provide advantages of this digital technique over the usual method of teaching histology and pathology [1,2]. Few developing countries applied the digital pathology in the form of telepathology in clinical practice [3,4]. The use of digital pathology telepathology in education [5], second-opinion consultations [6] and primary diagnosis [7] has been reported in several journals. The early trials for applying digital pathology in medical education using the older techniques like the static & dynamic forms were not greatly satisfactory for the teachers or the students. Using the WSI technology changed the teaching circumstances completely. The entire microscopic glass slides were scanned and changed to digital files available on the Web server that can be viewed on a computer monitor with a Web browser. The dynamic and interactive mode of viewing images (horizontal and vertical movement of images, and zooming in and out) simulates viewing a glass slide under the microscope (virtual microscope). Its interactive features and facility to view the image on a large monitor promotes group interaction and discussion. Images can be viewed anytime with an Internet or Intranet connected desktop computer, portable or tablet computer, or even through smartphones anywhere. Its main challenge may be the requirement for high bandwidth. Implementing digital pathology in low-resource areas remains a challenge even today. Access to the Internet on academic networks is often slow and expensive. Other barriers include: the high cost of equipment for digitizing glass slides and limited student access to computer workstations especially after class hours. Very few trials tried to explore the student perspective of digital pathology especially in developing countries [8]. In this paper, we attempt to determine the student’s attitudes in one medical school towards digital pathology.