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Release: March 2, 2001

Virtual Microscope aids study for UI medical students

IOWA CITY, Iowa -- Medical students at the University of Iowa College of Medicine have a new learning tool at their fingertips: a "virtual microscope" that lets students study magnified images of human tissues and cells with the click of a mouse.

Traditionally, students use a microscope to examine normal and diseased tissues and cells, which are preserved on glass slides and viewed at various levels of magnification. The Virtual Microscope Laboratory is a UI project that makes use of a newly emerging technology to capture the information contained on glass slides, digitize that information and deliver it over the Web.

"The slides would ordinarily be viewed using a microscope but in this case they can now be viewed using a computer," said Fred R. Dick, M.D., UI professor of pathology, and principal investigator on the Virtual Microscope project. "It is possible to zoom in and move around to different fields on the digitized slide, all in real time. It is just like using a real microscope, but the slides are of the best quality and are always in focus."

The technology used to create the virtual slides has recently been developed by MicroBrightField, Inc. of Colchester, Vt. To make a digital image, up to 1,200 contiguous microscopic pictures of a slide are captured. These individual fields are tiled together into one seamless image that contains a gigabyte of information. A second technology, FlashPix, developed by Kodak, compresses the gigabyte file down to 100 megabytes, which can be placed on a file server. UI students can access the Virtual Microscope from any campus computer or home computer that has a cable modem.

With support from the UI College of Medicine Educational Development Fund and a UI student Computing Fee Project Award, Dick and his UI collaborators in the Departments of Pathology and Anatomy and Cell Biology tested the usefulness of the Virtual Microscope as a teaching device. They digitized slides from the spring 2000 histology (the study of human tissues) course for UI medical students. The students had access to both the Virtual Microscope and real microscopes with glass slides. At the end of the course, the students completed an evaluation of the Virtual Microscope.

For the most part, the two systems were comparable in the eyes of the students who used them, but in two areas the Virtual Microscope came out ahead. The students found that campus computers, available 24 hours a day, 7 days a week, made the Virtual Microscope more accessible than the real microscopes, which were in a lab with set daytime hours. Also, the students found the Virtual Microscope to be a more efficient use of their time. The results of these evaluations were published in the February issue of the journal Anatomical Record-The New Anatomist.

"The students loved this technology," Dick said. "The accessibility of the Virtual Microscope was especially appealing. They say that they can use it anywhere, anytime."

In addition to the digitized slides of tissue sections, the units also contain images of the gross anatomy of the tissue that indicate where the tissue sections come from within the organ.

"Everything is right there," Dick said. "The students don't have to check out a box of slides, they just sit down and click and there it is."

Peter Densen, M.D., UI associate dean for student affairs and curriculum and professor of internal medicine, is also an enthusiastic proponent of the Virtual Microscope.

"This is an example of the innovative educational programs faculty at the UI College of Medicine have been developing," Densen said. "The Virtual Microscope harnesses technologic advances to improve delivery and integration of educational material for our students."

"Through this kind of effort, the College has emerged as a leader not only in the development and implementation of this type of program but also in their use for formative and summative assessment of student knowledge, skills and attitudes," Densen added. "Our students benefit from being on the forefront of these applications."

Following the success of the pilot program, Dick and his colleagues digitized all slides from UI histology and pathology courses and introduced the Virtual Microscope into both courses this year.

In a second, related project, funded by a grant from the National Library of Medicine, Dick is developing a public-domain set of virtual teaching slides. The long-term goal is to produce a comprehensive set of high-quality virtual slides showing every adult human organ and tissue. Dick hopes that this electronic slide box will be used by histology and pathology course directors around the country to augment or replace microscopes and glass slides.

Many of the slides currently used to teach students are commercially purchased and therefore cannot be used in a public database, so Dick has been collaborating with colleagues at other medical schools to obtain a full set of high-quality slides to be digitized.

"With the Virtual Microscope you can take the very best slide anyone has and make it available for everyone to see," Dick said.

Dick sees several other areas of potential for the Virtual Microscope. In particular, he suggests that the Virtual Microscope could be used by pathologists and cytopathology screeners (people who read Pap smear tests) for continuing medical education (CME) and to standardize proficiency testing.

"Certifying exams and continuing medical education are areas where I think great things will happen in the next five years," Dick said. "This technology allows more realistic and uniform testing."

Michael B. Cohen, M.D., UI professor and head of pathology agrees with Dick's assessment that this technology could have much wider applications.

"As well as CME, this technology could enhance online textbooks and be used to establish morphologic databases available to investigators worldwide," Cohen said.

Dick also hopes that high schools students studying biology eventually will use the Virtual Microscope. However, although local high schools are well equipped with computers, their processing speed and bandwidth are currently too small to transfer the large amounts of data for the virtual slides fast enough.

University of Iowa Health Care describes the partnership between the UI College of Medicine and the UI Hospitals and Clinics and the patient care, medical education and research programs and services they provide.