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Digital morphology network for effective teaching of cytology, histology and histopathology for medical and biology curriculum. VM3.0 Erasmus+ project

Cornelia Amalinei1, Andrei Daniel Timofte1, Irina Draga Caruntu1, Piotr M. Wierzbicki2, Michal A. Żmijewski2, Spiros Sirmakessis3, Jose L. Girela4, Noemí Martínez-Ruiz4, M. Flores Vizcaya-Moreno4, Rosa M. Pérez-Cañaveras4, Zdravka Harizanova5, Ferihan Popova5, Cintia Colibaba6, Zbigniew Kmieć2


Introduction. Digital microscopy transformation, the basis for the virtual microscopy applications, is a challenge but also a requirement in modern Medical Education. This paper presents the scope, background, methods, and results of the project ”Digital Transformation of Histology and Histopathology by Virtual Microscopy (VM) for an Innovative Medical School Curriculum”, VM3.0, funded by the European Union under the Erasmus+ framework ( The project was initiated at Grigore T. Popa University of Medicine and Pharmacy, Iași, Romania, with the support of Euroed Foundation, Iași, and cooperation of University partners from Gdansk (Poland), Plovdiv (Bulgaria), Alicante (Spain), and Patras (Greece) aimed to implement digital histology and histopathology teaching in a common network.

Materials and methods. The backbone of the project was the development of a Digital Slide Platform based on the scans of histological slides collected from all the partners of the participating universities and the creation of a simple and fast digital/internet communication tool that could be used to improve histology and histopathology teaching of medical and natural sciences students. The construction of a Virtual Microscopy Library (VML) has been based on the acquisition of whole scans of high-quality histological slides stained by hematoxylin and eosin (H&E) and other classical staining methods and description of the details in English as well as respective languages of the project’s partners. The VML can be used for different approches, both for students’ instruction in classes as well as for individual students’ work and self-testing. Universities from other countries could use the modal structure of the developed VML system on the condition that more slides are provided and the implementation of national language(s) is implemented.

Conclusions. The combined efforts of all university partners allowed to establish the dynamic low-cost virtual microscopy educational system. The VM system could help unify the standards of cytology, histology, and histopathology teaching in a quest for the digital transformation of the European educational system.

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  1. Blake CA, Lavoie HA, Millette CF. Teaching medical histology at the University of South Carolina School of Medicine: transition to virtual slides and virtual microscopes. Anat Rec B New Anat. 2003; 275(1): 196–206.
  2. Krippendorf BB, Lough J. Complete and rapid switch from light microscopy to virtual microscopy for teaching medical histology. Anat Rec B New Anat. 2005; 285(1): 19–25.
  3. Feit J, Matyska L, Ulman V, et al. Virtual microscope interface to high resolution histological images. Diagn Pathol. 2008; 3 Suppl 1(Suppl 1): S10.
  4. Coleman R. Can histology and pathology be taught without microscopes? The advantages and disadvantages of virtual histology. Acta Histochem. 2009; 111(1): 1–4.
  5. Dee FR. Virtual microscopy in pathology education. Hum Pathol. 2009; 40(8): 1112–1121.
  6. Merk M, Knuechel R, Perez-Bouza A. Web-based virtual microscopy at the RWTH Aachen University: didactic concept, methods and analysis of acceptance by the students. Ann Anat. 2010; 192(6): 383–387.
  7. Bondi A, Pierotti P, Crucitti P, et al. The virtual slide in the promotion of cytologic and hystologic quality in oncologic screenings. Ann Ist Super Sanita. 2010; 46(2): 144–150.
  8. Fónyad L, Gerely L, Cserneky M, et al. Shifting gears higher — digital slides in graduate education — 4 years experience at Semmelweis University. Diagn Pathol. 2010; 5: 73.
  9. Gabril MY, Yousef GM. Informatics for practicing anatomical pathologists: marking a new era in pathology practice. Mod Pathol. 2010; 23(3): 349–358.
  10. Giansanti D, Grigioni M, D'Avenio G, et al. Virtual microscopy and digital cytology: state of the art. Ann Ist Super Sanita. 2010; 46(2): 115–122.
  11. Szymas J, Lundin M. Five years of experience teaching pathology to dental students using the WebMicroscope. Diagn Pathol. 2011; 6 Suppl 1(Suppl 1): S13.
  12. Hitchcock CL. The future of telepathology for the developing world. Arch Pathol Lab Med. 2011; 135(2): 211–214.
  13. Triola MM, Holloway WJ. Enhanced virtual microscopy for collaborative education. BMC Med Educ. 2011; 11: 4.
  14. Collier L, Dunham S, Braun MW, et al. Optical versus virtual: teaching assistant perceptions of the use of virtual microscopy in an undergraduate human anatomy course. Anat Sci Educ. 2012; 5(1): 10–19.
  15. Filipiak K, Malińska A, Krupa D, et al. Innovative methods of archiving, presentation and providing access to histological sections. Med J Cell Biol. 2011; 3(3): 41–53.
  16. Hamilton PW, Wang Y, McCullough SJ. Virtual microscopy and digital pathology in training and education. APMIS. 2012; 120(4): 305–315.
  17. Mione S, Valcke M, Cornelissen M. Evaluation of virtual microscopy in medical histology teaching. Anat Sci Educ. 2013; 6(5): 307–315.
  18. Khalil MK, Kirkley DL, Kibble JD. Development and evaluation of an interactive electronic laboratory manual for cooperative learning of medical histology. Anat Sci Educ. 2013; 6(5): 342–350.
  19. Walkowski S, Lundin M, Szymas J, et al. Students' performance during practical examination on whole slide images using view path tracking. Diagn Pathol. 2014; 9: 208.
  20. Craig FE, McGee JB, Mahoney JF, et al. The Virtual Pathology Instructor: a medical student teaching tool developed using patient simulator software. Hum Pathol. 2014; 45(10): 1985–1994.
  21. de Juan Herrero J, Girela HL, Pérez-Cañaveras RM, de Juan A. XIII Jornadas de Redes de Investigación en Docencia Universitaria [Recurso electrónico]: Nuevas estrategias organizativas y metodológicas en la formación universitaria para responder a la necesidad de adaptación y cambio. Universidad de Alicante, Alicante 2015.
  22. Hande A, Lohe V, Chaudhary M, et al. Impact of virtual microscopy with conventional microscopy on student learning in dental histology. Dent Res J. 2017; 14(2): 111.
  23. Kuo KH, Leo JM. Optical versus virtual microscope for medical education: a systematic review. Anat Sci Educ. 2019; 12(6): 678–685.
  24. Lee LMJ, Goldman HM, Hortsch M. The virtual microscopy database — sharing digital microscope images for research and education. Anat Sci Educ. 2018; 11(5): 510–515.
  25. McDaniel MJ, Russell GB, Crandall SJ. Innovative strategies for clinical microscopy instruction: virtual versus light microscopy. J Physician Assist Educ. 2018; 29(2): 109–114.
  26. Fernandes CIR, Bonan RF, Bonan PRF, et al. Dental students' perceptions and performance in use of conventional and virtual microscopy in oral pathology. J Dent Educ. 2018; 82(8): 883–890.
  27. Tauber Z, Cizkova K, Lichnovska R, et al. Evaluation of the effectiveness of the presentation of virtual histology slides by students during classes. Are there any differences in approach between dentistry and general medicine students? Eur J Dent Educ. 2019; 23(2): 119–126.
  28. Simok A, Hadie@Haji S, Manan@Sulong HA, et al. The impact of virtual microscopy on medical students’ intrinsic motivation. Educ Med J. 2019; 14(4): 47–59.
  29. Lee BC, Hsieh ST, Chang YL, et al. A web-based virtual microscopy platform for improving academic performance in histology and pathology laboratory courses: a pilot study. Anat Sci Educ. 2020; 13(6): 743–758.
  30. Cosnita R, Cimpean AM, Raica M. Online versus on-site e-assessment in medical education: are we ready for the change? ISETC. 2020.
  31. Cimpean A, Cosnita RM, Raica M. To “paint“ with human tissues and modern technology: this is art in histology gamification. ISETC. 2020.
  32. Cosnita R, Cimpean A, Maerz R, et al. Opening the door through the e-learning and eassessment for preclinical medical education in romania: academic, social and psychological impact. 2020 International Conference on e-Health and Bioengineering (EHB). 2020.
  33. Cosnita R, Cimpean A, Raica M. E-Learning and e-assessement: two big challenges of medical education management in romania. J Innov Bus Manag. 2020; 12(1): 61–71.
  34. Amer MG, Nemenqani DM. Successful use of virtual microscopy in the assessment of practical histology during pandemic COVID-19: a descriptive study. J Microsc Ultrastruct. 2020; 8(4): 156–161.
  35. Chang JYF, Lin TC, Wang LH, et al. Comparison of virtual microscopy and real microscopy for learning oral pathology laboratory course among dental students. J Dent Sci. 2021; 16(3): 840–845.
  36. Kolinko Y, Malečková A, Kochová P, et al. Using virtual microscopy for the development of sampling strategies in quantitative histology and design-based stereology. Anat Histol Embryol. 2022; 51(1): 3–22.
  37. Somera Dos Santos F, Osako MK, Perdoná Gd, et al. Virtual microscopy as a learning tool in brazilian medical education. Anat Sci Educ. 2021; 14(4): 408–416.
  38. Caruso MC. Virtual microscopy and other technologies for teaching histology during COVID-19. Anat Sci Educ. 2021; 14(1): 19–21.
  39. Lakhtakia R. Virtual microscopy in undergraduate pathology education: an early transformative experience in clinical reasoning. Sultan Qaboos Univ Med J. 2021; 21(3): 428–435.
  40. Christian RJ, VanSandt M. Using dynamic virtual microscopy to train pathology residents during the pandemic: perspectives on pathology education in the age of COVID-19. Acad Pathol. 2021; 8: 23742895211006819.
  41. Simok AA, Kasim F, Hadie S, et al. Knowledge acquisition and satisfaction of virtual microscopy usage among medical students of universiti sains malaysia. Educ Med J. 2021; 13(4): 43–55.
  42. Skokowski J, Bolcewicz M, Jendernalik K. et al. The digital tissue and cell atlas and the virtual microscope. Politechnika Gdańska, Gdańsk 2022: 61–69.
  43. Hortsch M. The Michigan Histology website as an example of a free anatomical resource serving learners and educators worldwide. Anat Sci Educ. 2023; 16(3): 363–371.
  44. Birkness-Gartman JE, White MJ, Salimian KJ, et al. Web-based pathology modules with virtual slides are effective for teaching introductory gastrointestinal pathology concepts. Acad Pathol. 2022; 9(1): 100059.
  45. Wu YH, Chiang CP. Comparison of virtual microscopy and real microscopy for learning oral histology laboratory course among dental students. J Dent Sci. 2022; 17(3): 1201–1205.
  46. Francis DV, Charles AS, Jacob TM, et al. Virtual microscopy as a teaching-learning tool for histology in a competency-based medical curriculum. Med J Armed Forces India. 2023; 79(Suppl 1): S156–S164.
  47. Maity S, Nauhria S, Nayak N, et al. Virtual versus light microscopy usage among students: a systematic review and meta-analytic evidence in medical education. Diagnostics (Basel). 2023; 13(3).
  48. Sergi CM. Digital pathology: the time is now to bridge the gap between medicine and technological singularity. In: Cvetković D. ed. Interactive multimedia — multimedia production and digital storytelling. IntechOpen, [online] 2019.
  49. From Garage to State-of-the-Art Facility, Leica Biosystems Aperio Pioneers Digital Pathology. (1.10.2023).
  50. Aperio ImageScope — Pathology Slide Viewing Software. (1.10.2023).