Development of a Hands-On and Virtual Simulation Training Module To Teach Microtomy

Background: Microtomy is a risky procedure that medical laboratory technologists (MLTs) use to cut tissue samples for microscopic examination. Due to the safety concerns and the potential to destroy tissue samples, it is critical for learners to perform the procedure correctly. To allow for safe and controlled learning, this procedure should be acquired in a safe and controlled simulated setting before being attempted on human tissues. The overarching purpose of this work is the development of a virtual training module for undergraduate students to learn from. However, because of the heterogeneity in the steps required to successfully complete the procedure from the MLTs as well as in the literature, the aim of this study was to reach a consensus from a panel of experts about identifying the steps of the procedure using the think-aloud and modified-Delphi methods. Methods: First, we conducted a think-aloud protocol with a single MLT expert trained in microtomy to generate the list of steps of the microtomy procedure objectively. In order to remove any idiosyncratic steps, next, we asked eight experts that were trained in histology to rate the criticalness of each step using a (1-5) Likert scale and provide evaluative feedback. Results: The think-aloud protocol generated 10 steps for the microtomy procedure. During the subsequent two rounds of the Delphi exercise, the experts agreed to modify one step of the 10 steps. Conclusions: Through this work, the 10 steps of the microtomy procedure have been validated by experts in the field. Following that, a virtual simulation training module was built to instruct learners on the microtomy procedure. The virtual simulation training module may be used for further research in microtomy.