The Frozen Section: Practicum Using Video Tutorial and Mock Specimens
Nathan Aardsma, Rajyasree Emmadi, Elizabeth Wiley. University of Illinois at Chicago, Chicago, IL
Background: Frozen section diagnosis for first year pathology Residents can be a daunting task because there is unfamiliarity with the equipment and procedure as well as the need to provide rapid, accurate diagnoses for the operating surgeons. As part of a new curriculum for incoming Residents, we introduced a new learning initiative for the frozen section process involving practice with fresh mammalian organs. This alleviated some of the trepidation involved before commencement of actual service work.
Design: The first step involved viewing of an instructional video detailing the entire process from specimen receipt to result reporting. This video was also made available online for further review at any time from any location. Fresh tissue was obtained as part of the autopsy orientation which involved the dissection of sheep and/or pig organ blocks obtained from a local meat packer. Each Resident was required to identify and embed 12 different tissue types including liver, spleen, kidney, heart, thymus, pancreas, esophagus/ stomach, adrenal, gonads, lung, bronchus, and lymph node. The use of the different tissue types allowed the resident to experience the different cutting characteristics exhibited by the divergent tissue types. Using proper technique involving the use of OCT embedding medium and the heat extractor, the trainee was shown several methods to obtain complete sections of the tissue. This allowed each Resident to develop the technique that worked best for him/her. After two proper sections were obtained using a cryostat microtome, the sections were fixed and stained using the standard H&E procedure. The sections were cover-slipped, and all cases were collectively reviewed, discussed and graded by the Residents and a group of Attending Pathologists. This allowed for recognition and analysis of various artifacts that can be present.
Results: Each trainee was assessed on his/her ability to obtain complete sections with proper staining patterns for each of the 12 tissue types. This exercise allowed the Residents to select the technique that worked best for them. The Resident also had time to become familiar with the frozen section equipment and procedure as well as tissue artifacts without the time and stress constraints of providing quick diagnoses to the operating room.
Conclusions: Residents exhibited increased confidence and proficiency with the frozen section procedures while handling actual patient diagnostic tissues during service work after completion of the frozen section practicum.
Tuesday, March 20, 2012 9:30 AM
Poster Session III # 124, Tuesday Morning