WebPath: The Internet Pathology Laboratory for Medical Education on CD-ROM

Abstract

WebPath: The Internet Pathology Laboratory for Medical Education on CD-ROM is one of the most complete single-subject medical education programs the reviewer has encountered. The CD-ROM version of WebPath contains over 3,100 images, 2,700 exam questions, 28 case-based laboratory exercises, and 35 tutorials. Version 4.0 also includes over 400 correlative radiographs complementing the slides. A freely available sister Web site exists at http://www-medlib.med.utah.edu/WebPath/webpath.html. The Web site contains far fewer images and questions and does not include several areas covered on the CD-ROM, such as clinical pathology and neuroanatomy. WebPath's primary audience is medical students learning about the pathologic basis of disease. A secondary function of the program is as a continuing education resource for health care workers who wish to increase their knowledge of disease processes and develop better diagnostic skills. WebPath is also an excellent resource for students of cell biology and microbiology. The images, text, and examination questions cover all subject areas on the pathology section of Step 1 of the United States Medical Licensing Exam (USMLE). The program is organized into seven primary divisions: general pathology, dealing with the basic mechanisms of disease; organ system pathology, centering on site-specific images and text; laboratory exercises, offering case-based problems in both general and organ system pathology; examinations, including over 2,600 questions (single answer, short matching, extended matching, short answer, and essay); mini-tutorials, focusing on a specific subject area and including text supplemented by hypertext-linked images; clinical pathology, presenting images that deal with clinical laboratory medicine; and histopathology, featuring diagnostic techniques, procedures, and correlative exercises illustrated with images, text, and tutorials. An eighth, bonus segment, Utah landscapes, offers glimpses of the natural beauty of the State of Utah. Throughout the entire program the quality of the images is superior. Clear and clean navigation buttons and links allow users to view images sequentially or to navigate quickly throughout the multiple layers of this rich program. WebPath CD-ROM version 4.0 is designed for use with a Web browser. Thus, locally loaded files appear in the browser window. This design contributes to the program's ease of use; one feels as though one is clicking through a Web site. On a more technical note, files are in ISO 9660 format, which means that they are accessible on Macintosh, Windows, or Unix operating systems (OS). WebPath files total 260 MB in size but require more space when copied onto a hard drive, depending on the OS. A Web browser with the functionality of Netscape 4.5 or greater is recommended. The browser must be able to support the display of inline images in jpeg (.jpg) and gif (.gif) formats. The browser must also be able to support JavaScript programming, including the use of external .js script files. Image file sizes are small (.gif or .jpg files range from 20 K to 250 K in size) and images load quickly. A display with a resolution of 800 × 600 or higher is suggested for optimal viewing. Site license pricing is very reasonable and makes it possible to offer this unique resource widely throughout an institution. Advantages of purchasing the CD-ROM version versus accessing the free WebPath Web site include the faster speed of image loading from a local server and the additional resources available on the CD-ROM. These resources include over 1,200 more images and 1,100 more examination questions, as well as nine additional areas that are not available at the University of Utah Web site. WebPath on CD-ROM is a robust program with many outstanding features. Each of the principal divisions outlined previously is further subdivided, providing a hierarchical format that is both informative and user friendly. For instance, the organ system pathology section is divided into 18 segments each ranging in size from 23 to 156 images. A brief description of what is covered in each section is provided. Within specific subsections, further delineation is made. Coverage within the cardiovascular pathology area, for example, includes normal heart, myocardial infarction, and cardiomyopathies. Additionally, there are links on the top of the page to tutorials on myocardial infarction and vasculitis. The list of images includes a brief description, noting whether the view is gross or microscopic, as well as a link to other corresponding images, such as a computed tomography (CT) image, an angiogram, or an X-ray image, when available. Once an image is selected, such as “Normal heart, gross [CT],” a vivid slide is presented along with a link to the available CT image. In the more complete description of the image at this level, links are available that allow users to place markers identifying anatomical and microscopic landmarks. Perhaps most helpful to students are the examinations provided with WebPath on CD-ROM. Here, one can choose from among over 2,100 questions in multiple choice and extended matching formats in the areas of general pathology, organ system pathology, and clinical pathology. Under organ system pathology, for example, there are 126 questions alone covering gastrointestinal and liver pathology. In addition to examination questions, there are the Quizzes with Images, Short Answer Items, Potpourri of Subjects, Essay Questions, and Case of the Week (C.O.W.) sections. For review purposes students can click on multiple answers until the correct one appears. In all instances, a brief explanation of the answer is provided. Students may also take the exam without looking at the results until they have completed a specific section, thereby simulating the computerized USMLE test. Onscreen instructions are available throughout the various sections. An area on the screen keeps running scores based on the number and percent of correct answers. In the section entitled Quizzes with Images, one can select from general or organ system pathology. Each set consists of a series of questions accompanying a gross or microscopic image from among the superior images indexed within the site. One of the very few shortcomings in WebPath is in the Quizzes with Images area: one cannot see the image and corresponding questions and answers together on one screen. One has to scroll back and forth between the image and the questions in order to analyze the material presented. One can adjust the frames in which each of these items exists, but viewing all of the materials concurrently is difficult. WebPath: The Internet Pathology Laboratory for Medical Education on CD-ROM is highly recommended and should be a core resource in any collection that supports the study of pathology.