XMLBased Virtual Slide Box for Teaching Histology and

XML-Based Virtual Slide Box for Teaching Histology and Pathology Jeffrey Fine, M. D. Cleveland Clinic Foundation

Background • Virtual Microscopy (VM) – Use of digital imaging to produce “digital slides” that simulate light microscopy • Delivery of slides most common via web browser software (Internet or CD-ROM) • Increasing use in medical education

Background II • Cleveland Clinic Lerner College of Medicine – Innovative Problem-Based Learning curriculum • Web based • Students have laptops and wireless campus – Histology curriculum utilizes virtual microscopy

Challenges • Organization of digital slides (~730 slides) – Includes slides from University of Iowa (93%) • Maintenance of virtual slide boxes – Study resource for students – Curriculum management for faculty Digital Slides (730) Medical Student Other sources (books, etc. )

Technology • VM Software – Neuroinformatica (Micro. Bright. Field, Williston, Vermont) • Digital slide database, Annotation software, and Java-based viewer software • Web-based Curriculum – Windows Server 2003 – HTML and Active Server Pages (ASP)

Technology II • Both VM and Curriculum support XML – XML file export of VM database – Script-based support of XML on Web server

Design Digital Slides (730) XML Medical Student ASP XSL Virtual Slide Box Other sources (books, etc. )

Naming Convention • Consistent keywords for curriculum topics – Neuro, Renal, Cardiovascular, etc. • Keywords for histology versus pathology • Other words – Site – Diagnosis – Technical details (special stain, etc. )

Generation of XML file • Export the VM database into XML file – After changes to the database (new slides, etc. ) • XML file is transferred to a directory on the server – XML Slide Boxes requires no further effort to update – Amenable to automation via script in the future

XML (excerpt)

Utilizing XML • “XML does not DO anything” – W 3 Schools (http: //www. w 3 schools. com) • e. Xtensible Stylesheet Language (XSL) – Analyzes XML file and outputs HTML – Each slide box has a unique XSL file • XML Path Language (XPATH) – Syntax for addressing parts of an XML file

XSL XPATH

XML

Check each slide Slide labeled as “Neuro”? NO YES Slide labeled as normal? NO Add slide to list YES Example: List of normal neurohistology slides

Utilizing XML, XSL, and XPATH • Active Server Page (ASP, . asp) – Executes the script on the server – End user browser sees only HTML

Example http: //cclcm. ccf. org/vm/slide_box/neuro/slidebox_neuro_main. htm

XML Slide Box ASP XSL XML ASP XSL Virtual Slide Box (Neuro) Virtual Slide Box (Renal) Virtual Slide Box (Skin)

Future Directions • Expansion – Resident education – Additional study sets • Improvement – Student Feedback – Usage Information

Conclusions • Provided simple solution to a daunting problem – XML easy to learn and implement – Transparent technology for the end user • Facilitated VM for teaching histology and pathology • Gained valuable, real world XML experience

Acknowledgments • • • Dr. Henricks Dr. Prayson Pavel Ermakov (CCLCM Web team) Dr. Dee (U. Iowa) Doug Hoppes (Micro. Bright. Field)