Image credits: NUS, Yong Loo Lin School of Medicine, In-Vivo, A Labour of Love, 1 August 2018

Image credits: NUS, Yong Loo Lin School of Medicine, In-Vivo, A Labour of Love, 1 August 2018

How Singapore’s NUS is digitising the study of pathology

In years past, NUS taught pathology manually – using specimens. Medical students would inspect samples in transparent containers or pots. Each student would await their turn to inspect the pot, which gradually made its way around the lecture room.

By the time the last student at the back had a chance to inspect the sample, the teacher had already moved on to another topic.

Then, in a different session, the class will then learn, from a separate tutor, how these diseases look on microscopic slides.

Today, however, NUS’s newsletter proudly reported that the learning of pathology has been enhanced and aided through technology, thanks to the efforts of Associate Professor Nga Min En and colleagues at the Department of Pathology.

Painstakingly, one specimen at a time, the team has rendered more than 700 specimens in digital format, making more than 250 specimens available online for medical students.

This labour of love began more than six years ago and is still ongoing; scheduled to end when the last and final specimen has been digitised, said Assoc Prof Nga, who is a consulting pathologist at the National University Hospital.

The benefits are greatly appreciated by students, who no longer have to wait for their turn in class to view the specimens, nor borrow them from the department to study for examinations.

The digitised specimens of the diseased body parts can also be viewed alongside microscopic slie images of the same disease, which helps students better understand the morphology of diseases with more clarity.

Moreover, classes do not have to be split into two groups too, since both the images of the disease and the specimens can be viewed concurrently during lessons.

The digitisation process

‍ Photographing specimens for digitisation

Photographing the samples and then converting them to digitised images is done by a team of non-academic staff at the Department of Pathology adept at IT and photography.

The team also consists of students as well as NUHS Pathology residents.

The latter help to check the teaching materials for the online platform, provide ideas for improvement and make value-added contributions such as annotations, adding links or cases.

The digitisation process involves a carefully orchestrated photoshoot.

Staff position the specimens on a turntable inside a lightbox, then photograph them with an 18-megapixel camera at multiple angles.

A total of 24 photos are taken of each specimen.

Assoc Prof Nga then edits each image with the Photoshop software, while another team member combines these 24 images into a single file. The end result is a clear 360-degree view of the specimen in its container.

This labour-intensive process takes about 45 minutes per specimen.

Moving online

Seeing the potential in going digital, Assoc Prof Nga uploaded these materials online in 2015. Doing so enabled her students to access them for their own learning.

While Assoc Prof Nga uses both physical and virtual pots in her classes, she says that the digital pots offer greater flexibility in terms of their use – students can study them any time they want to.

The updated web resource is called Pathweb and has two main sections.

In one section called the ‘Virtual Pathology Museum', students can find both virtual microscopy slides and pots categorised into both general pathology and systemic pathology, according to their curriculum.

Another section entitled ‘Pathology Demystified’ features mind maps, live videos, talking slides and quizzes, all hand-written, drawn or produced by Assoc Prof Nga.

These materials provide students with an approach to studying pathology and allow them to engage in self-directed learning.

Pathweb and Assoc Prof Nga’s work have received acclaim and appreciation from students and colleagues around the world.

The pathology department is home to more than 5,000 dissected and preserved specimens of human organs and tissue.

While more than 700 of these pots have been digitised since 2012, Assoc Prof Nga hopes to digitise a further 1,000 specimens by the end of 2019, with the help of her team.

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