The positive trend in acceptance of VM by students was evident also in following year evaluations. Based on students' responses, our digital-learning format brought several benefits to our teaching practice. The young population of students represents a computer-trained generation that is in compliance with new modern PC technologies. More than half of students claimed that they benefited from using the supporting documents slide guides,.
The new digital format using virtual slides and supporting materials was well accepted by teachers as well.
Histology Technician Program (Arizona, Florida and Minnesota)
Teachers benefited from a uniform high quality of presented virtual slides and also from more flexible personal communication with students in the class when individual guidance and explanation were needed at the student's monitor. This feature improves communication between students and teachers and improves their mutual understanding.
Students from both study programmes, General Medicine GM Figure 5A and Dentistry D Figure 5B also admitted that they benefited from the in-course electronic testing that motivated students to more systematic individual study. They unequivocally preferred electronic forms of examinations over oral ones. There were also some drawbacks recognized during the hours of histology practicals, like a tendency of some students to passively follow the demonstration of digital slides.
This should be minimized by the proper interactive engagement of students in the practical histology session. Using the screen printing function of the Olyvia viewer, students create their own presentations. They are able to screen-copy to a clipboard selected areas of virtual slides and paste them directly into their own-created. Simultaneously, students watch projected virtual slides by means of the overhead projector on a wide screen accompanied by a teacher's explanation. Access to virtual slides at any time, not only during scheduled practical sessions, is provided through the external login intranet, internet, multiple browsers to the database of virtual slides Olympus, NIS-SQL which correspond to those in practical sessions Figure 6 .
The open-access database contains short annotations of typical histology structures that are essential for identification of slides.
Unlimited access to the database allows students to revise histology structures themselves. From our point of view, the inclusion of classical histology observing methods using light microscopes depends on the organization of teaching lessons. We do not underestimate the importance of classical microscopy in the didactic procedure. Our students also have the possibility to use light microscopes during or at the end of their regular histology sessions. Classical binocular light microscopes are available for each student in the class to revise and compare both image qualities of histology structures.
Digital-learning format enabled us to introduce new models of practical teaching histology. At the Faculty of Medicine and Dentistry in Olomouc, the new digital format using virtual slides and supporting study materials represents a fundamental innovation in didactic principles of classical morphology sciences. Recent findings based on the long-term evaluation of computer-assisted teaching histology follow and extend our previous already published data presented in MEFANET reports 04 a 05 [16,21].
According to the long-term experience, our system runs faultlessly and it is easy to be used by students and teaching staff. Students considered virtual microscopy system comfortable and more efficient tool for study. Students also appreciated the better resolution and better image quality of virtual slides compared with conventional microscopes.
This is the main statement highlighted also in other studies dealing with the application of VM [3,7,8,10,12,22,23]. The uniform set of virtual slides of the same quality was used for all students and they benefited from high-quality scans of histology slides available equally to all students in the class.
They allowed them to study and discuss various details of cellular and tissue arrangements clearly at various magnifications.
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- Histology Technician Program (Arizona, Florida and Minnesota).
When using the virtual slides, the classical glass slides no longer need to be stored in hundreds of sections, and also some rare samples or slides prepared with special staining and expensive methods can now be safely presented to students. Digital slides prevent loss or breakage of this valuable teaching material. Student's self-created. The active participation in creation of own presentations increases student's interest and attention during sessions and, on the other hand, this didactic method provides a good tool for teachers for their concurrent control of a student's activity in large groups.
Despite the engagement of teachers during practical sessions, implementation of E-learning format based on digital technology requires supplementary documentation such as precise description and annotations of VS that is essential for later self-study and revision. Students greatly appreciate the unlimited access to the online NIS-SQL database of annotated virtual slides , which correspond to those in practical sessions, at any time and place with external login intranet, internet, multiple browsers.
The external practice with VS allows students to study slides that have otherwise been restricted to the classroom equipped with conventional optical tools and sets of glass slides. These findings are also supported by the study of Tian Y at all .
New Approach to Teaching Histology
The new teaching format also fulfils students' expectations to use innovative technologies PC, laptops, and tablets during their study. The previously mentioned benefits are also reported in other studies concerning virtual teaching programmes [1,22]. E-learning format, delivering virtual slides is an efficient didactic tool which supports active student's approach and their engagement in group activities on virtual slides.
The observation with Olyvia viewer is highly interactive and user-friendly, making the orientation in the VS at various magnifications easy. It enables students to quickly follow teacher's demonstration of the same slide simultaneously projected on the central projection screen and to better concentrate on the comments given by the teacher. This is a highly beneficial feature of this system that helps to manage ever-increasing numbers of students at our faculty. The number of students attending the 1st year of the Faculty of Medicine and Dentistry at the University in Olomouc is more than three hundred in the General Medicine programme and about one hundred in Dentistry study programme.
The current trend at other universities is to organize histology sessions in large practical labs of 50 and more students at once [1,10]. PC-networked classroom also provides an easy environment for computerized testing of student's practical knowledge. Our digital learning system seems to be an efficient tool for computer-based assessment of student's practical knowledge of histology structures displayed on monitors.
Students found the use of the electronic testing easy and friendly. Sequences of questions, as well as all distracters, were shuffled in the quiz randomly on monitors of student's PCs. Despite the fact that all students answered the same set of questions; lateral communication between students was limited to the minimum. The results were automatically evaluated and displayed at the end of the test. The properties of the electronic application of tests considerably contributed to the objective and quick evaluation of student's practical knowledge. In view of the fact that teacher's PC serves as a server, it is very important to secure the access to teacher's PC as well as students' PCs and prevent them from hacking and illegal downloading data when the teacher's PC is logged on.
The e-learning format of delivering virtual slides brings the substantial changes in the methodology of teaching morphological subjects like histology to students of medicine. Because of the use of modern technology, this system attracts the attention of students and makes this subject more interesting to study. It stimulates the engagement of students during practical sessions and their independent work. Most of the discussed drawbacks of the VM can be prevented by a proper organization of practical sessions. Authors of this paper claim no conflicts of interests with this research.
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Electron Micrograph 4: Simple Columnar Epithelium; goblet cell and absorptive cell; rat intestine. The luminal epithelium of the intestine is a simple columnar epithelium. In this micrograph one goblet cell is situated between two absorptive cells. The lumen of the organ is the empty appearing area in the upper left of the plate.