Pathology residents' use of a web-based tutorial to improve Gleason grading of prostate carcinoma on needle biopsies

Joseph D. Kronz, Mark A. Silberman, William C. Allsbrook, Sheldon I. Bastacky, R. Tucker Burks, Steven J. Cina, Stacey E. Mills, Jeffery S. Ross, Wael A. Sakr, John E. Tomaszewski, Lawrence D. True, Thomas M. Ulbright, Michael W. Weinstein, Rhonda K. Yantiss, Robert H. Young, Jonathan I. Epstein

Research output: Contribution to journalArticle

38 Scopus citations

Abstract

Little is known about pathology residents' ability to Gleason grade or their ability to learn surgical pathology using Internet-based technology. A free Web-based program (available at www.pathology.jhu.edu/prostate) was developed that consisted of 20 pretutorial images for grading, 24 tutorial images, and the same 20 posttutorial images for Gleason grading. The grading images were selected from cases that had a consensus Gleason grade from 10 uropathology experts. In 2.5 months, 255 residents visited the website, and 151 (59%) completed it. Of those who completed the website, their year in training was known in 85 (56%): 1st year, 25.8%; 2nd year, 20%; 3rd year, 22.3%; 4th year, 14.1%; 5th year, 15.3%; and 6th year, 2.4%. Eighty percent learned Gleason grading in residency versus being self-taught, and 66% were male. In a multivariate analysis, higher pretutorial scores were associated with both their year in training (P = .001) and their hospital size (P = .003). Improvements in grading posttutorial were not related to the residents' year in training. Overall, the website significantly improved grading in 11 of 20 images and had no effect in 9 of 20 images. Improvements were noted in 1 of 1 Gleason score 4; 2 of 7 Gleason score 5 to 6; 2 of 6 Gleason score 7; and 6 of 6 Gleason score above 7 tumors. In summary, a Web-based tutorial improved Gleason grading accuracy by pathology residents to an equal extent regardless of their year in training. It is more difficult to teach residents to grade Gleason scores 5 to 7 tumors, and additional training should be concentrated in this area. (C) 2000 by W.B. Saunders Company.

Original languageEnglish (US)
Pages (from-to)1044-1050
Number of pages7
JournalHuman pathology
Volume31
Issue number9
DOIs
StatePublished - Jan 1 2000

Keywords

  • Education
  • Gleason grading
  • Internet
  • Needle biopsy
  • Prostate cancer

ASJC Scopus subject areas

  • Pathology and Forensic Medicine

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    Kronz, J. D., Silberman, M. A., Allsbrook, W. C., Bastacky, S. I., Burks, R. T., Cina, S. J., Mills, S. E., Ross, J. S., Sakr, W. A., Tomaszewski, J. E., True, L. D., Ulbright, T. M., Weinstein, M. W., Yantiss, R. K., Young, R. H., & Epstein, J. I. (2000). Pathology residents' use of a web-based tutorial to improve Gleason grading of prostate carcinoma on needle biopsies. Human pathology, 31(9), 1044-1050. https://doi.org/10.1053/hupa.2000.16278