Implementation of a fully digital histology course in the anatomical teaching curriculum during COVID-19 pandemic

During the COVID-19 pandemic, many medical schools are forced to switch courses of the mandatory curriculum to online teaching formats. However, little information about feasibility and effectiveness is available yet about distance teaching in anatomy. The aim of this study was to evaluate the implementation of a histology course previously taught in a classroom setting into an online-only format based on video conference software.

Our course design included theoretical introductions, an online-adaptation of virtual microscopy used previously in the classroom, and active learning elements such as collaborative learning in breakout rooms, annotation assignments and multiple-choice questions. Two preclinical semester cohorts of around 400 second and third semester students were taught in histology in parallel courses, using the Zoom software platform. We analyzed data about student attendance during the course, summative quantitative and qualitative evaluation of the students and results of a written test required to pass the course.

We observed that student attendance was high and stable during the 19 course days for both second and third semester, and only few students reported technical problems. There were no significant differences in examination results of second semester compared to the third semester, an unexpected result as the third semester already participated in the dissection course before. Similarly, no significant gender-related effects on the examination performance could be noted in both semesters. However, the age of students was negatively correlated with test scores in the second and third semester. Importantly, the overall evaluation of the digital version of the histology course was at least as positive as the in-person version over the past years.

Together, we experienced that the implementation of a curricular histology course in an online-format is technically realizable, effective and well accepted among students. We also observed that availability and prior experience with digitized specimen in virtual microscopy facilitates transition into an online-only setting. Thus, our study supports the positive potential of distance learning for teaching anatomy during and after COVID-19 pandemic but also emphasizes the need for a synchronous learning environment with partially personnel-intensive small group settings to overcome passivity and inequality aspects, and to foster active learning elements.