Conventional light microscopy or digital slides: a study to evaluate the effectiveness and acceptance of digitized histological sections in teaching

Abstract

Digital learning formats are increasingly used in medical education. In histology, virtual microscopy offers a flexible alternative to conventional light microscopy, but its impact on learning outcomes and student acceptance remains debated. This study compared digital and conventional microscopy in terms of learning performance, usability, and student preferences. First-year medical students participated in a practical histology course using either digital slides or light microscopy in a crossover design. Cohort A studied muscle tissue digitally and bone tissue conventionally, while Cohort B followed the reverse arrangement. Learning outcomes were assessed using 14 image-based examination questions. Student perceptions and preferences were evaluated through a questionnaire addressing navigation, efficiency, collaboration, enjoyment, and perceived importance of technical basics. Students rated digital microscopy significantly higher (all p < 0.0001). Overall, 79.9% preferred digital slides for future courses. Higher technological affinity was associated with preference for digital microscopy, with male students reporting significantly higher affinity than female students (p = 0.0063). Examination performance did not differ significantly between learning modalities. Digital microscopy was preferred by students and perceived as more efficient, collaborative, and enjoyable than conventional microscopy. As learning outcomes were equivalent, digital microscopy represents an effective alternative and supports its broader integration into undergraduate histology education.