Abstract

Background: Following transition to digital microscopy for primary diagnosis in dermatopathology at our institution, dermatology residents have reduced exposure to glass slides. Additionally, glass microscopy is no longer evaluated in standardized examinations. However, it is important for trainees to maintain competency in glass slide microscopy, as a subset may require this skill in future practice. Objective: Evaluate residents’ diagnostic accuracy when utilizing digital versus glass microscopy and assess experience and attitudes towards these modalities following this practice transition. Methods: 21 dermatology residents were administered a 64-question dermatopathology examination (32 cases each on whole scanned slides versus glass slides) in June 2023. Diagnostic accuracy was measured using the number of correct diagnoses for each modality. Participants were surveyed regarding experience with both modalities and their preferences.  Results: Diagnostic accuracy was higher with digital slides than glass slides (22/32 versus 18/32, p < 0.001). Residents with prior experience with glass microscopy achieved an average score of 19/32 on glass, as compared to 10/32 for those without experience with glass microscopy (p = 0.039). Personal preference was overwhelmingly skewed towards digital slides (18/21, 85.7%). Limitations: Although efforts were made to equilibrate case difficulty in each modality, unique cases were used for digital and glass portions of the assessment. Conclusions: Trainees had better diagnostic accuracy with digital microscopy, in addition to having a strong preference for this modality. Although practices are transitioning to digital microscopy, the majority continue to use glass slides; thus, competency with traditional glass microscopy in pathology education should be maintained.