Perceptual analysis of the reading of dermatopathology virtual slides by pathology residents

Claudia Mello-Thoms; Carlos A B Mello; Olga Medvedeva; Melissa Castine; Elizabeth Legowski; Gregory Gardner; Eugene Tseytlin; Rebecca Crowley

doi:10.5858/arpa.2010-0697-OA

Back

Perceptual analysis of the reading of dermatopathology virtual slides by pathology residents

Journal article

Open access

Peer reviewed

Perceptual analysis of the reading of dermatopathology virtual slides by pathology residents

Claudia Mello-Thoms, Carlos A B Mello, Olga Medvedeva, Melissa Castine, Elizabeth Legowski, Gregory Gardner, Eugene Tseytlin and Rebecca Crowley

Archives of pathology & laboratory medicine (1976), Vol.136(5), pp.551-562

05/2012

DOI: 10.5858/arpa.2010-0697-OA

PMID: 22540304

Files and links (1)

url

https://doi.org/10.5858/arpa.2010-0697-OAView

Published (Version of record) Open Access

Abstract

The process by which pathologists arrive at a given diagnosis-a combination of their slide exploration strategy, perceptual information gathering, and cognitive decision making-has not been thoroughly explored, and many questions remain unanswered. To determine how pathology residents learn to diagnose inflammatory skin dermatoses, we contrasted the slide exploration strategy, perceptual capture of relevant histopathologic findings, and cognitive integration of identified features between 2 groups of residents, those who had and those who had not undergone their dermatopathology rotation. Residents read a case set of 20 virtual slides (10 depicting nodular and diffuse dermatitis and 10 depicting subepidermal vesicular dermatitis), using an in-house-developed interface. We recorded residents' reports of diagnostic findings, conjectured diagnostic hypotheses, and final (or differential) diagnosis for each case, and time stamped each interaction with the interface. We created search maps of residents' slide exploration strategy. No statistically significant differences were observed between the resident groups in the number of correctly or incorrectly reported diagnostic findings, but residents with dermatopathology training generated significantly more correct hypotheses (mean improvement of 88.5%) and correct diagnoses (70% of all correct diagnoses). Two types of slide exploration strategy were identified for both groups: (1) a focused and efficient search, observed when the final diagnosis was correct; and (2) a more dispersed, time-consuming strategy, observed when the final diagnosis was incorrect. This difference was statistically significant, and it suggests that initial interpretation of a slide may bias further slide exploration.

Decision Making

Skin Diseases - diagnosis

User-Computer Interface

Internship and Residency

Humans

Pathology, Clinical - education

Physicians - psychology

Details

Title: Subtitle: Perceptual analysis of the reading of dermatopathology virtual slides by pathology residents
Creators: Claudia Mello-Thoms - Department of Biomedical Informatics, University of Pittsburgh, UPMC Shadyside Hospital, Cancer Pavilion, 5150 Centre Avenue, Pittsburgh, PA 15232, USA. mellothomsc@upmc.edu
Carlos A B Mello
Olga Medvedeva
Melissa Castine
Elizabeth Legowski
Gregory Gardner
Eugene Tseytlin
Rebecca Crowley
Resource Type: Journal article
Publication Details: Archives of pathology & laboratory medicine (1976), Vol.136(5), pp.551-562
DOI: 10.5858/arpa.2010-0697-OA
PMID: 22540304
NLM abbreviation: Arch Pathol Lab Med
ISSN: 0003-9985
eISSN: 1543-2165
Publisher: United States
Grant note: K01 HS018365-01 / AHRQ HHS R01 LM007891-05 / NLM NIH HHS
Language: English
Date published: 05/2012
Academic Unit: Roy J. Carver Department of Biomedical Engineering; Radiology
Record Identifier: 9984051515902771

Metrics

18 Record Views

24 Times Cited - Web of Science