Additionally, the technology allows students to copy a slide, which couldn’t be done at the student level on lab-based optical microscopes, she notes. “They can do all sorts of wonderful things with slides now, like incorporate them into their learning objectives for the week, or put them into the case presentations or handouts.”

Another major advantage of the virtual microscope is what it does in the classroom. (See page sidebar on next page.)  “We’re the beneficiaries of being able to take one slide, say, a perfect example of a disease or several perfect examples of normal variation, and every single student in the classroom has equal access to those images,” Sens explains.   “That’s a lot different from before, when no two slides were identical and there weren’t enough microscopes for each student in the class. Back then, even if the differences were subtle, no one was on exactly the same page. Now, with virtual microscopy, everyone is.”

Cost is also an advantage with digital, Sens and Dunlevy note.  A diagnostic quality optical microscope costs $30,000 or more, while a student microscope costs roughly one-tenth that amount. Then there’s the individual slide, at a cost of $25 to $50, and supplying enough slides for a whole medical school class.

So far the medical school has spent about $50,000 on its virtual microscope system, including the two-terabyte servers that handle the images and the software that supports image storage, retrieval and delivery. Since a given sample only needs to be made once for limitless digital access, the cost per view and per students goes way down. The school is in the process of upgrading to an 8-terabyte (8,000 gigabyte) server. The system also will allow the scanning of slides using new technology with a 100x lens. The school also is acquiring an innovative software program that provides a searchable virtual slide database, organizes multiple file formats including virtual slides into patient cases. It’ll provide Internet access to the medical school’s bank of virtual slides.

The new digital reality in the school’s histology and pathology labs is that students learn the material better, Sens says. 
“The students see a normal lung, then lung tissue with tuberculosis (TB), TB in a lymph node, TB in the liver—what a really great way for students to learn,” Sens says. “You’re talking the difference between an old car and a new BMW. It’s really revolutionized how we bring this critical information to our medical students.”

Students also can get a much broader spectrum of pathology and histology views than with the now-outmoded optical microscope.

“Previously, for example, students were limited in their access to special cases, such as being able to see the estrogen receptors in breast cancer cases. The receptors tell you whether the cancer cells would respond to chemotherapy. Such slides were cost prohibitive, up to $100. And with rare diseases like rabies, with very small biopsy, you couldn’t make 60 sections for the class, the sample would be gone.”

Now, with digital slides, students can view a whole range of things previously outside the range of the standard school lab. With one digitally scanned slide, students can see a lesion that’s diagnostically significant, Sens points out.

 “This technology allows you to create a total education package in a manner that’s patient-oriented and strongly reflective of our patient-centered curriculum,” she says. 

Dunlevy agrees.   “This generation of students learns how to use electronic resources so quickly,” she says. “In fact they teach us things. I’ve been told that the software isn’t Mac-compatible. But sure enough, there are the students in the lab with their Apple Macintoshes—they know how to figure this stuff out.”