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 Table of Contents  
ORIGINAL ARTICLE
Year : 2019  |  Volume : 5  |  Issue : 1  |  Page : 51-54

Teaching morphologic features of biopsy slides using projection microscope versus the conventional method of teaching: A comparative study


1 Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India
2 Department of Gynecological Oncology, Indira Gandhi Institute of Medical Sciences, Patna, Bihar, India

Date of Submission18-Dec-2018
Date of Acceptance21-Jan-2019
Date of Web Publication19-Jun-2019

Correspondence Address:
Vijayanand Choudhary
Department of Pathology, Indira Gandhi Institute of Medical Sciences, Patna - 800 014, Bihar
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/jcrsm.jcrsm_46_18

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  Abstract 


Introduction: Since time immemorial man has tried to improve upon teaching methods so that students can become more proficient. Biopsy slides of pathology have been difficult for medical students to understand and comprehend since a long time. The introduction of projection microscope for teaching biopsy slides would go a long way in simplifying the whole process.
Methodology: The authors compared the two teaching methods for identifying pathologic lesion in biopsy slides. Ninety nine fourth semester undergraduate students were divided into two groups with group A having fifty students and group B having forty nine students. The period of our study of four months was divided into two, two month period. In the first two months group B was made the test group and taught biopsy slides using projection microscope and group A was made control group and was taught by conventional method (atlas, chalk and board). To avoid any form of bias, in the second two months their roles were reversed so that group A was made the test group and group B was made the control group.
Result: After each two month OSPE was held and marks recorded. At the end of four month period a survey was taken from students and faculty in a feedback form based on Likert scale. In this survey it was found that ninety percent (90%) of the students and faculty were of the view that visual aided method of teaching was superior to conventional method of teaching biopsy slides. In the OSPE the group which underwent visual method of teaching scored higher than the group which underwent conventional method of teaching even after swapping of their roles after two months.
Discussion: Teaching tools using two or more senses is superior to teaching with one sense only. This is specially true while using visual and auditory method of teaching which accounts for 88% of our learning. Here we have made good use of visual aid in form of projection microscope to teach and explain the morphologic features of pathologic lesion in a biopsy slide.

Keywords: Biopsy slide, conventional method, Histopathology, Likert scale, morphologic feature, OSPE, projection microscope, teaching method, visual aid


How to cite this article:
Choudhary V, Pankaj S. Teaching morphologic features of biopsy slides using projection microscope versus the conventional method of teaching: A comparative study. J Curr Res Sci Med 2019;5:51-4

How to cite this URL:
Choudhary V, Pankaj S. Teaching morphologic features of biopsy slides using projection microscope versus the conventional method of teaching: A comparative study. J Curr Res Sci Med [serial online] 2019 [cited 2023 May 30];5:51-4. Available from: https://www.jcrsmed.org/text.asp?2019/5/1/51/260642




  Introduction Top


Biopsy slides of pathology have been difficult for medical students to understand since a long time. When I was an undergraduate student 25 years ago, we used to study from the  Atlas More Details of Histopathology, and the teacher explained the morphologic features of the samples studied using the biopsy slides. After this, we were given the biopsy slides to be observed under a microscope. We had a lot of difficulty in correlating between the Atlas' image and the one seen under the microscope. Even though technology has taken a giant leap over the years, the method of teaching biopsy slides has not changed much. With the introduction of new technologies students should be exposed to a realistic platform whenever possible. The introduction of projection microscope for teaching biopsy slides would go a long way in doing so. In the vision 2015 guidelines by MCI they have proposed promoting dialectic over didactic lectures.[1],[2] Introducing new technology would make teaching students centered, stimulate multiple senses, help students progress along multiple pathways and would also stimulate collaborative work. It is a two-way communication which activates inquiry-based learning, helps elicit better responses, is authentic and helps students learn in a real-world context. However, one must keep in mind that teaching aids are a supplement to teaching and should not be used to replace the teachers themselves as it is detrimental to the development of the student as a custodian of health.

Aims and objectives

  1. To find out if teaching with a projection microscope is better than the conventional method of teaching the identification of pathologic lesions shown on the biopsy slides
  2. To find out if teaching with a projection microscope is better than the conventional method in making the students draw labeled diagrams of the pathologic lesions shown on the biopsy slides.



  Methodology Top


After obtaining permission from the Institute's Ethics Committee, we divided 99 undergraduate medical students in the fourth semester of their study into two groups. Group A consisted of 50 students and group B consisted of 49 students. The period of the study was of 4 months and was further divided into two, 2-month periods. During thefirst 2 months, Group B was made the test group and was taught pathologic lesion on biopsy slides using a projection microscope and Group A was made the control group and was taught by the conventional method using the Atlas and a chalk-board. We have practical classes once a week on Wednesdays for an hour. Hence, Group B being thefirst test group was shown four biopsy slides with the help of a projection microscope for 20 min. They were simultaneously explained all the morphological features and asked questions accordingly. In the next 40 min, each of these 49 students was given the same biopsy slides to be observed under the microscope. During the same period, Group A students took tutorial classes as usual. The following Wednesday, Group A being the control group, was taught the same four biopsy slides using a chalk-board with reference to the Atlas of Histopathology. After 20 min, Group A was also given the same four slides to be observed under the microscope. On that day, Group B students took tutorial classes as usual. Therefore, by the end of thefirst 2 months, Group A and Group B both had taken four practical classes held every alternate week. At the end of thefirst 2 months, an objective structured practical examination (OSPE) was held on two successive days with Group-A students appearing on Day-1 and Group-B students appearing on Day-2. The same protocol was followed for the next 2 months with Group-A becoming the test group and Group-B becoming the control group and an OSPE being held at the end of 2 months on two successive days. The marks secured by the students in these two OSPEs were recorded.

Type of study – This was comparative study.

Study setting – Lecture theater and practical hall of IGIMS Medical College, Patna.

Study population – All undergraduate medical students in the fourth semester of their study and the faculty of Pathology Department.

Period of study – 4 months.

Inclusion criteria – All undergraduate medical students of fourth semester willing to participate in the study.

Exclusion criteria – Any undergraduate medical student of the fourth semester not willing to participate in the study. At the end of 4 months period, feedback was taken from the students and faculty regarding the new method of teaching (based on Likert scale).


  Result Top


In this study we compared the result of the two teaching methods.

We found that the group which underwent visual method of teaching scored sixteen percent higher marks than the group that underwent conventional method of teaching even when the groups swapped their roles after two months.

We found that 90% of students are of the view that teaching with visual aid enhances understanding, enhances memory, simplifies information, saves time, is more informative, simulates real world experience, leads to a balanced development of mental faculties, makes the topic interesting, keeps the mind focused and is comparatively more expensive than conventional method of teaching.

We found that 90% of faculty is of the view that visual teaching aid is better than conventional method of teaching in all the above aspects.

As shown in [Table 1], we find that around 90% of students felt that teaching with visual aid enhances understanding, enhances memory, simplifies information, saves time, is more informative, simulates real-world experience, leads to a balanced development of mental faculties, makes the topic interesting, keeps the mind focused and is comparatively more expensive than the conventional method of teaching.
Table 1: Marks obtained by all the medical students in OSPE (n=99)

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In [Table 2], we find that around 90% of the faculty felt that visual teaching aid is better than the conventional method of teaching in all the above aspects.
Table 2: Feedback from the students (n=99)

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In [Table 3], we find that the group which was taught using the visual method of teaching scored 16%–20% higher marks than the group which was taught using the conventional method of teaching even when the groups swapped the roles after 2 months.
Table 3: Feedback from Faculty n=5)

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  Discussion Top


In normal day-to-day life, we learn 3% by taste, 3% by smell, 6% by touch, 13% by hearing, and 75% by seeing.[3] Thus, we find that the visual and auditory methods combined are responsible for 88% of our learning. It is true that a didactic lecture in comparison with dialectic lecture is monotonous and becomes uninteresting after around 15 min of the start of the lecture.[4] To keep the students motivated and attentive in class, we must combine visual aid with auditory aid and take the help of a chalk-board wherever needed. This is especially necessary while teaching the subject of pathology where it is important to understand the morphology of a lesion at the microscopic level and for which the help of visual aid is necessary. With the help of a projection microscope, we were able to show the biopsy slides on a bigger screen and simultaneously explain its salient features. This was followed by the distribution of the same biopsy slides to all the students for viewing under the microscope. This enabled the students to form an association between what was taught and the given biopsy slides as it is a replica of the projected biopsy slides. Research has shown that every student is unique and has a unique learning style.[5] About 30% of the students learn by auditory means, 40% of students learn by visual means and the rest learn by the kinesthetic method, i.e., by doing the things themselves. Therefore, it is necessary to use a combination of different teaching methods so that the needs of different students are met. As visual learners comprise about 40% of the students, special arrangements should be made to combine visual learning with auditory learning.[6] It is generally accepted that the best learning takes place when the greatest number of senses are stimulated.[7] The use of audio-visual aid together will stimulate a greater number of senses. For this reason, good teachers have always used audio-visual materials.[7]

In a similar study, the meta-analysis detected a small yet significant positive effect on learner performance (standardized mean difference 0.28, 95% confidence interval 0.09–0.47; P = 0.003), indicating that learners experience marked knowledge gains when exposed to virtual microscopy over optical microscopy.[8]

In another study conducted at a Chinese Medical University, it was seen that test scores in the Virtual Microscope group showed a significant improvement compared with those in the Light Microscope group (P < 0.05). There were no substantial differences between the two groups in the mean score rate of multiple-choice questions and the short essay category (P > 0.05); however, there were notable differences in the mean score rate of case analysis questions and identification of the structure of tissue (P < 0.05).[9]

The introduction of a restructured curriculum and training program with an emphasis on early clinical exposure, integration of basic and clinical sciences, clinical competence and skills and new teaching-learning methodologies will lead to a new generation of medical graduates of global standards.[10]

An experienced teacher realizes that the use of words alone cannot provide a vivid learning experience. They are constantly alert for methods and devices that will make learning more meaningful. With the wise selection of a variety of instructional devices or audio-visual materials, experiences can be provided that will develop into understanding.

Limitations

This was a short-term study of 4 months. Longer term study spanning over 2 years would be desirable for confirming the inferences.


  Conclussion Top


Ninety percent of the students and faculty felt that the visual aided method of teaching is superior to the conventional method of teaching. This is especially true while teaching biopsy slides which is difficult for undergraduate medical students to understand and comprehend. The group that underwent special teaching sessions (visual aided) got 16%–20% higher marks than the group which was taught by the conventional method of teaching as assessed by the OSPEs even after the swapping of roles. A combination of auditory and visual method of teaching should be inducted into different departments of medical sciences with good results.

Financial support and sponsorship

Nil.

Conflicts of interest

There are no conflicts of interest.



 
  References Top

1.
Berlin B. Graduate medical education: Where do we go from here? N J Med 1996;93:23-5.  Back to cited text no. 1
    
2.
Steinert Y, Mann K, Centeno A, Dolmans D, Spencer J, Gelula M, et al. Asystematic review of faculty development initiatives designed to improve teaching effectiveness in medical education: BEME guide no 8. Med Teach 2006;28:497-526.  Back to cited text no. 2
    
3.
Duffield KE, Spencer JA. A survey of medical students' views about the purposes and fairness of assessment. Med Educ 2002;36:879-86.  Back to cited text no. 3
    
4.
Lowry S. Assessment of students. BMJ 1993;306:51-4.  Back to cited text no. 4
    
5.
Smee S. Skill based assessment. BMJ 2003;326:703-6.  Back to cited text no. 5
    
6.
Rushforth HE. Objective structured clinical examination: Review of literature and implications for nursing education. Nurse Educ Today 2007;27:481-90.  Back to cited text no. 6
    
7.
Puja M. The Use of Audio-Visual Aids in Teaching. Available from: http://globlinktech.blogspot.com. [Last accessed on 2018 Oct 10].  Back to cited text no. 7
    
8.
Wilson AB, Taylor MA, Klein BA, Sugrue MK, Whipple EC, Brokaw JJ, et al. Meta-analysis and review of learner performance and preference: Virtual versus optical microscopy. Med Educ 2016;50:428-40.  Back to cited text no. 8
    
9.
Tian Y, Xiao W, Li C, Liu Y, Qin M, Wu Y, et al. Virtual microscopy system at Chinese Medical University: An assisted teaching platform for promoting active learning and problem-solving skills. BMC Med Educ 2014;14:74.  Back to cited text no. 9
    
10.
Duffield KE, Spencer JA. A survey of medical students' views about the purposes and fairness of assessment. Med Educ. 2002;36:879-86.  Back to cited text no. 10
    



 
 
    Tables

  [Table 1], [Table 2], [Table 3]



 

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