Learning Digitally in a Pandemic

The COVID-19 pandemic has thrown the medical education landscape into disarray – and its impact has triggered urgent concerns for medical students. Formal classes have been officially canceled in most schools, forcing scores of students into “homeschooling.” But balancing online hours with student motivation is difficult at the best of times – and even more so in a time of global crisis.

To kick off pathology education without pause, we designed an improved institutional strategy to deliver online content enriched with digital pathological and radiological data and clinical case scenarios. Our goal? To address students’ learning needs in a way that is not only feasible during the pandemic, but also dynamic and challenging.

Converting undergraduate pathology education to an online format involves transforming almost every element of teaching and learning. The most common concerns expressed by students and teachers alike include technology issues, revamping content to suit the needs of online learners, and educator and learner acclimatization. Instructors, in particular, face several challenges: switching from in-person to distance teaching, developing novel instructional methods, managing time, and gauging feedback from the students without face-to-face contact. Students face similar predicaments, including a lack of motivation and inclination, technical troubles, and limited opportunities for enrichment. Course development is affected, too, with online learning considerations now a vital aspect of course updates.

As lockdown protocols were initiated and traditional classes suspended, the Systems & Diseases IV course switched to online sessions, using Panopto to record and Zoom to deliver live lectures. Online resources – particularly Osmosis videos, digital pathology, and digital radiology, woven into clinical cases – enhanced the online pathology learning experience. Students received readings and annotated digital slides before each class. During the class, clinical case scenarios were presented along with all relevant pathology, laboratory, and radiology data. Students worked in groups using Zoom’s “breakout room” feature to answer questions and solve cases; faculty encouraged and monitored discussions by going from “room” to “room.” Finally, we evaluated students’ understanding of concepts and clinical correlation and analyzed their feedback on the learning process.

In a generation of millennials who have “grown up digital,” and with the ever-increasing connectedness of people and institutions, the latest developments in information technology have considerably advanced the delivery of online pathology instruction. Millennials are now schooled amid a sea of instant information and consultative engagement, both real and virtual.

A fundamental awareness of the organization and structure of tissues in the body, both normal and pathological, is the cornerstone of the study of medicine. Learning the particulars of gross and microscopic pathology is pivotal to appreciating the disease process in basic sciences. With the abundance of digital pathology atlases available online today, students can access more information than ever. Add to this the benefit of synchronous online communication – using smartphones, tablets, and social media – and it’s easier than ever to learn pathology digitally.

However, information means little without appropriate context. The use of digital pathology slides in combination with the framework of clinical cases, followed by a question-and-answer session, creates a semi-interactive learning experience to make up for the absence of classroom teaching. These tools allow us to strengthen the pathology content in students’ online curriculum – selecting robust content, augmenting it with virtual pathology, and further fortifying it with active learning approaches that promote comprehension and application.

Digital pathology education is not without obstacles: erratic student participation, issues with technical and infrastructural support, and some perceive online classes as less gratifying because of the lack of face-to-face interaction and feedback. Nonetheless, most students felt that annotated digital images presented in an entertaining, easy-to-understand clinical setting made up for the limitations and significantly improved comprehension, critical thinking, and clinical reasoning. Importantly, the platform ensured that teaching, curriculum, and examination objectives were all aligned, while still permitting individualized education.

In the era of COVID-19 – and in an increasingly digital world – online pathology classes are crucial for the development of future pathologists. In my opinion, our approach not only enhanced students’ learning potential, but also inspired them to consider pathology as a lifelong career.