Usage and Participation in a Resident-Built Virtual Slide-Based Atlas of Anatomic Pathology
R Ryan, V Brodsky, A Louissaint, J Gilbertson, Y Yagi. Massachusetts General Hospital, Boston, MA; Weill Cornell Medical College, New York, NY
Background: Over the past year, residents and fellows in our training program have built an intranet-based "Virtual Slidebox" (VSB), a collection of annotated whole-slide images representing specific diagnostic entities. The hardware and network design of this project have been previously reported.
Design: We designed a resident-run workflow system for scanning slides selected by residents from their service work and didactic conferences, and uploading them with related content to the website. We implemented and modified the open-source WordPress MU blog engine to create a site which supports multi-user viewing, feedback, and modification of content, subject to curation by project editors and supervising faculty. Each whole-slide image is categorized by diagnosis and subspecialty, and can be linked to text describing clinical information and diagnostic features, as well as static images of ancillary studies. On-image annotation of whole-slide images is enabled. Users can also view random 'unknown' cases from within a subspecialty. We conducted a survey of all AP and AP/CP residents, as well as clinical fellows in anatomic pathology, to evaluate usage and contribution to the VSB over a three-month period.
Results: Our site has grown by approximately 100 whole-slide images per month over the first eight months of operation, to a total of 800+ posts as of 10/09. Of the survey respondents (n=24), 71% had visited the site in the prior 3 months, and 42% had used it 3 or more times. Individuals reported using the site on at least three occasions for general study, self-assessment, preparation for board exams, assistance in diagnosis of service cases, preparation for educational conferences, and instruction of colleagues. 100% of site visitors expressed confidence in the accuracy of VSB content. Respondents cited the desire to build a resource for their own reference and study use, and the desire to help other residents, as the strongest incentives to contribute to the project (81-86%), while the desire to demonstrate sub-specialty interests to staff, or to increase proficiency in informatics, were less strong incentives.
Conclusions: Implementation of a virtual slide-based, user-generated pathology atlas is possible on the level of a large residency program. Trainees find such a resource useful for numerous purposes, and are most willing to contribute to such a project to the extent that it benefits their learning, or that of other residents.
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