The Group for Research in Pathology Education (GRIPE) would like to congratulate Meghan Driscoll, winner of the 2016 John H. Holliman Resident Scholarship.
During the past eight months as co-chief resident I have worked to improve the basic pathology education for our interns, and have been instrumental in moving our resident unknown slide conferences to a digital platform. At first I was terrified about the daunting task of being chief resident, though as I settled in to the responsibilities of the position it became evident that I had tremendous support from the program directors to improve resident education.
On day two as chief, various attendings provided their insights on the poor level of knowledge our interns had for normal histology, and how this deficit delayed their ability to learn to distinguish normal histology from the spectrum of abnormal. These insights sparked my interest to make a meaningful change to our residency program. My parents raised me in such a way that I was expected to present them with solutions when I came to them with problems. Furthermore, in the jobs I held prior to medical school and residency I was an educator and supervisor of various groups of people. My mantra in these roles is that people cannot be held to specified standards of performance without first being trained or educated. The jobs of interns are no different in this regard. If an intern does not have a solid grasp of normal histology their progression to understanding how to discern abnormalities will not be efficiently developed. I organized a “Normal Histology Boot Camp” for our interns to guide this process.
The Boot Camp sessions entailed recruiting senior residents and faculty to provide a series of didactic lectures for each of the organ systems. These lectures discussed approaches to evaluate the normal cells and structures in each of the organ systems, and provided sample slides of normal histology. In the months after our first groups of interns have rotated through surgical pathology, some attendings made comments that our interns are catching on to normal histology and are showing large improvements in diagnostics on the surgical pathology rotation. While there is much room to continue to improve our Boot Camp, getting this educational tool started was a solid first step to provide our residents a framework for learning anatomic pathology. Our next step will be to determine measureable outcomes to understand whether these sessions are beneficial and solicit feedback about how to improve the delivery of this educational module.
The other change I have been working to implement is to have all of our slide conferences scanned to our already existent digital pathology platform. Our residency program has multiple rotation sites making it difficult to get to the one location to preview glass slides. Our department has a laboratory that performs whole slide scanning with the cases accessible through an online portal. Since beginning residency there have been hit-or-miss efforts to have our conference slides scanned in a timely manner to allow for preview and there has been no formal training on how to use the software program. I have been working with the director and assistant director of this laboratory to schedule a recurring morning conference series to introduce this technology to our residents and teach our group how to use the software. Another issue we have encountered is submission of slides in an appropriate time frame to be scanned and previewed. One way we are curtailing this confusion about scanning slides is adding “due dates” to our monthly calendar for the slides to be submitted for scanning. These changes will become effective in January 2016 and we anticipate increased aptitude with this technology and hopefully increased interest in digital pathology for research and teaching projects.
My goal with these changes is to prepare our residents for the future of pathology. In this ever changing world of medicine it is important to have a mastery of normal histology as well as abnormal histology, and to also develop a competency in new technologies to help us be leaders in the future of medicine.
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