Webconference mixed with virtual slides as a pedagogical tool to improve pathology practice in the French Midi-Pyrenees area

Abstract

Background The pathology is a discipline located between basic science and clinical practice. Tissue and / or cellular injury could be seen as a triptych with in upstream pathophysiological mechanism and in downstream the resulting symptoms. In recent years, pathology, an essential step of clinical diagnosis, is being more complex integrating complementary technics (e.g. molecular biology), creating new classifications or new recommendations. So pathologists’specialization in one field is becoming a necessity. Unfortunately, since 1999, the French pathologists growth rate is negative and demographic previsions estimates that in 2050 pathologists’ population should decrease by 50%. This crisis in vocations obliged pathologists to provide continuing education to their peers, share experiences but also to reform the teaching of the discipline during medical studies to make it more accessible and attractive. The development of digital imaging in this both areas has been a greatly helpful. In France, a group of pathologists established in 1977 under the name ADICAP (“association for the development of informatics in pathology”) helped the creation of adequate informatics tools [1]. Worldwide, the pathologists were among the first to use tools of telemedicine, especially in countries with difficult geographical conditions such as Norway or Canada. However, for 25 years, the difficulties of digital transmission and the static and selective state (selection bias in the sent fields) of numeric photography had left this technology underutilized [2]. In the 2000s, development of the virtual slides technology (virtual slides scanner) and of telepathology, allowed diversification and wider use of digital imaging in pathology. It had been now widely used in Canada to exchange views particularly in cases of diagnostic emergency as extemporaneous examinations [1]. In 2010, physicians in three Northern Ontario communities had been virtually linked at all times to pathology specialists allowing frozen section examination on line [3]. It had been also used for teaching and universities, particularly in the U.S. and Switzerland, where virtual imaging have replaced conventional microscope. In France these technologies are progressively taking place both in the field of education and in the exchange of expertise. In Toulouse-Rangueil hospital, the pathology department has chosen to focus on education as the training provided to senior pathologists and to medical students.