Comparison of virtual microscopy and glass slide microscopy among dermatology residents during a simulated in-training examination

Background: Virtual microscopy is increasingly being used in dermatopathology educational settings.

Objective: The objective is to evaluate diagnostic accuracy and attitudes between virtual microscopy and traditional glass slide microscopy among dermatology residents.

Methods: A 48-question dermatopathology examination was administered to 35 dermatology residents at three different dermatology residency training sites during the 2011-2012 academic year with half (n = 24) of the questions using the gold standard of glass slide microscopy and half (n = 24) using whole, scanned virtual slides. Correct number of questions using glass slides and virtual slides was evaluated. Participants were surveyed regarding previous experience with digital slide imaging; quality, ease of use, and speed of slide review; and overall microscopy preferences.

Results: Overall, diagnostic accuracy was better with glass slides than virtual slides (p = 0.01). However, no statistically significant difference was found in diagnostic accuracy of first-year trainees (p > 0.99) or trainees with exposure to virtual microscopy greater than two times per month (p = 0.27). There was no overall personal preference for glass slide vs. virtual microscopy.

Limitations: Different cases and questions were used for glass slides and virtual microscopy.

Conclusions: Diagnostic accuracy with virtual microscopy is dependent on year of residency training and prior experience with virtual microscopy.