Journal of the American Society of Cytopathology.

Cubillos, P., Diaz, E., Báez, P., Gutiérrez, L., Molina, C., & Härtel, S.

Abstract

Introduction

In cytopathology education, Virtual Microscopy e-learning modules (VM-eLM) have achieved remarkable results in the improvement and personalization of learning. However, it remains to be determined whether these modules can significantly contribute to improving the accuracy of cytological diagnosis. The aim of this work was to create a VM-eLM for Gynecologic Cytopathology Education designed to improve screening and interpretation skills in two groups of cytologists: experienced and non-experienced.

Method

The module was designed in Moodle with both Whole Slide Images (WSI) and Static Images (SI) taken from PAP smears that were diagnosed as: Negative for Intraepithelial Lesion (NIL), Low-grade Squamous Intraepithelial Lesion (LSIL), High-grade Squamous Intraepithelial Lesion (HSIL), Squamous Cell Carcinoma (SCC) or Adenocarcinoma (AC). We assessed the effectiveness of the module using 1) clinical quality indicators to measure skill development, and 2) a user survey.

Results

After training, participants significantly improved their cytological screening skills, decreasing their false negative diagnosis by 78% in the non-experienced group and eliminating them entirely in the experienced group. Non-experienced participants also significantly increased their recognition of LSIL and HSIL by 31% and 50%, respectively. Participants positively evaluated the module, highlighting its novelty, the possibility to train remotely, the immediate feedback and the quality of the WSI.

Conclusion

We designed, implemented and tested a VM-eLM for Gynecologic Cytopathology Education that improved cytological screening skills for both non-experienced and experienced cytologists, also increasing the diagnostic accuracy of preinvasive lesions by less experienced cytologists. The module was positively evaluated by participants, who perceived an improvement in their interpretive skills.

https://doi.org/10.1016/j.jasc.2023.10.002