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Innovative Strategies for Clinical Microscopy Instruction

Virtual Versus Light Microscopy

McDaniel, M. Jane MS, MLS(ASCP)SC; Russell, Gregory B. MS; Crandall, Sonia J. PhD, MS

The Journal of Physician Assistant Education: June 2018 - Volume 29 - Issue 2 - p 109–114
doi: 10.1097/JPA.0000000000000198
Brief Report

Purpose The purpose of the study was to compare virtual microscopy with light microscopy to determine differences in learning outcomes and learner attitudes in teaching clinical microscopy to physician assistant (PA) students.

Methods A prospective, randomized, crossover design study was conducted with a convenience sample of 67 first-year PA students randomized to 2 groups. One group used light microscopes to find microscopic structures, whereas the other group used instructor-directed video streaming of microscopic elements. At the midpoint of the study, the groups switched instructional strategies. Learning outcomes were assessed via posttest after each section of the study, with comparison of final practical examination results to previous cohorts. Attitudes about the 2 educational strategies were assessed through a postcourse questionnaire with a Likert scale.

Results Analysis of the first posttest demonstrated that students in the video-streamed group had significantly better learning outcomes than those in the light microscopy group (P = .004; Cohen's d = 0.74). Analysis of the posttest after crossover showed no differences between the 2 groups (P = .48). Between the 2 posttests, students first assigned to the light microscopy group scored a 6.6 mean point increase (±10.4 SD; p = .0011), whereas students first assigned to the virtual microscopy group scored a 1.3 mean point increase (±7.1 SD; p = .29). The light microscopy group improved more than the virtual microscopy group (P = .019). Analysis of practical examination data revealed higher scores for the study group compared with 5 previous cohorts of first-year students (P < .0001; Cohen's d = 0.66). Students preferred virtual microscopy to traditional light microscopy.

Conclusion Virtual microscopy is an effective educational strategy, and students prefer this method when learning to interpret images of clinical specimens.

M. Jane McDaniel, MS, MLS(ASCP)SC, is a lecturer and the director of admissions in the Yale Physician Assistant Online Program at Yale School of Medicine, New Haven, Connecticut.

Gregory B. Russell, MS, is a senior biostatistician and associate director of the Design and Analysis Unit in the Department of Biostatistical Sciences, Wake Forest School of Medicine, Winston-Salem, North Carolina.

Sonia J. Crandall, PhD, MS, is a professor and the director of research and scholarship in the Department of Physician Assistant Studies at Wake Forest School of Medicine, Winston-Salem, North Carolina.

Correspondence should be addressed to: M. Jane McDaniel, Director of Admissions, Yale Physician Assistant Online Program, P.O. Box 208004, New Haven, CT 06520-8004; Telephone: (336) 314-7002; Email:

The authors declare no conflict of interest.

Copyright © 2018 Physician Assistant Education Association
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