2013. Vol.4, No.10A, 6-17
Published Online October 2013 in SciRes (http://www.scirp.org/journal/ce) http://dx.doi.org/10.4236/ce.2013.410A002
Copyright © 2013 SciRes.
The First South American Free Online Virtual Morphology
Laboratory: Creating History
Rodolfo E. Avila1, Maria E. Samar1, Kapil Sugand2, David Me t cal fe3,
Jessica Evans4, Peter H. Abrahams3
1Faculty of Medicine & Dentistry, National Univer s i ty of Cordoba, Cordoba, Argentina
2MSk Lab, Imperial College London, London, UK
3Warwick Medical S ch o ol , University Hospital Coventry & Warwickshire, Coventry, UK
4Department of Surgery, Kingst on Hosp ital , Kingston upon Thames, UK
Email: avilacongre so @gmail.com, samar email@example.com, kapil.sug a nd 0 firstname.lastname@example.org
Received July 19th, 2013; revised August 19th, 2013; accepted August 26th, 2013
Copyright © 2013 Rodolfo E. Avila et al. This is an open access article distributed under the Creative Commons
Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the
original work is properly cited.
Background: Biomedical teaching has been revolutionized through multimedia and global collaboration.
In a joint effort between Argentina and the UK, a Virtual Laboratory has been created for teaching mor-
phological topics interactively pertaining to cell biology, histology and embryology intended for Health
Science students at the National University of Cordoba, Argentina. Aim: To observe whether the online
resource has changed the attitudes of student-users and offers a suitable replacement to traditional labora-
tory work. Methods: Through a central website that has evolved for almost a decade and most likely the
first of its kind on the continent, the virtual laboratory program was launched and students were recruited
to participate in a basic survey on the significance of the virtual laboratory program to their learning needs,
attitudes to using electronic media and whether they agreed that classroom teaching should be obsolete
altogether. Results: 291 student-users were recruited in the academic year of 2010. 267, of whom 92%
used the virtual laboratory as a principal tool for learning. The online virtual practical work-guide de-
signed by faculty was the most commonly used supplementary resource. A minority of students still pre-
ferred to supplement their learning by traditional methods such as books and classroom notes as well as
external online resources. Conclusion: Our interactive virtual program was unanimously preferred as the
principle learning tool for morphological sciences. The Virtual Laboratory, using popular electronic mul-
timedia and inter-continental partnership, will enhance all aspects of biomedical education as a unique
teaching resource in South America.
Keywords: Anatomy; Embryology; Microscopy; Onli ne; South America; Virtual Laboratory
Straightforward Teaching of a Complicated Topic:
Definitions & Outlines
Biomedical education has been revolutionized through mul-
timedia and global collaboration. Integration of technology in
basic science education can contribute to a better understanding
of both human and social dimensions which are essential to the
creation of new learning cultures. Education is a fundamental
objective in continuing professional development for health
Advances in communication and information technology
have drastically altered delivery and quality of education. Now-
adays, most students have access to personal computers and
internet connections to learn from medical literature databases
and online resources to consolidate curricular learning objec-
tives. The web combines hy pertext and hypermedia (e.g. audio
and digital video imaging stores large volumes of information
and offers user-choice interactive learning environments).
Tele-education, an integral part of tele-medicine, provides
useful services such as: 1) a central online platform for the
provision of pertinent study material with enhanced graphics
(e.g. micrographs, diagrams, videos, etc.); 2) development of
both real-time and fragmented interaction between teachers and
students as well as peer-peer communication independent of
geography, race and culture; and 3) hosting schedule consulta-
tions outside classroom hours.
Morphology education (histology, anatomy and embryology)
is essential in biomedical curricula in order to fully appreciate
concepts in physiology and pathology. The subject is a re-
quirement within international medical education frameworks
and usually studied during pre-clinical years in greater detail.
Unfortunately, there is very little focus given to the subject
afterwards until a minority specializes in post-graduate labora-
tory research, anatomy instruction or pathology. Learning mi-
croscopic anatomy depends crucially on the correct interpreta-
tion of images but requires frequent practice. Yet, it is difficult
to revise for such subjects due to biological variations of slides
in which some structures may be sub-optimally visible or hav-
ing only a limited time in the laboratory with limited demon-
The core principle of teaching embryology consists of ana-
R. E. AVILA ET AL.
lyzing developmental stages. Orthodox teaching is based on
explanatory and illustrative methods developed on a biological
paradigm (Samar et al., 2001). Tele-education has potential in
morphology education where complicated abstract ideas can be
more easily taught with the use of high resolution visual imag-
ing aids. Recent research and subsequent scientific contribu-
tions in embryology, and molecular embryology in particular,
have led to significant progress in the scientific basis for de-
velopment (Carlson, 2002). In addition, the successful emer-
gence of assisted fertilization techniques, manipulation of em-
bryos and manually reconstructing the human genome, have
introduced new bioethical issues and the demand to re-evaluate
the teaching of embryology (Samar & Avila, 2002; Avila et al.,
Current Educational Concerns of the Nation:
Need for Reform
Health Science subjects like Medicine, Dentistry and Veteri-
nary sciences on the South American continent are facing grave
problems due to relying solely on teaching and learning in
classrooms. Major concerns include a decline in academic per-
formance throughout the course with no protected revision time
in later years. Also, there is a high student dropout in pre-
clinical years due to poor access to information to consolidate
knowledge gained in the laboratory. Latin America is also suf-
fering the effects of a brain drain and with students seeking
higher quality education elsewhere. Regional universities are
under pressure to keep updated with contemporary curricular
requirements whilst also providing equally high standards in
In Argentina the National Assessment and Accreditation
(CONEAU, 1999), under the Ministry of Education Regula-
tions, approved the criteria for the national undergraduate
medical curricular framework. Within this document, Annex I
sets out the basic contents of the materials required within a
medical career, and the curriculum is considered uniform to all
accredited medical schools. Sections on “Medical Use of In-
formation” and Annex I highlights that higher educational es-
tablishments should provide access to computers and informa-
tion networks for teachers and students by means of acquiring
basic educational skills. Computer resources should support the
educational programs of the Faculty of Medicine at all appro-
Based on these recommendations, the Faculty of Medical
Sciences at the National University of Cordoba (Argentina)
proposed the creation of the first ever continental Virtual
Laboratory in collaboration with the United Kingdom, provid-
ing e-learning modules for teaching cell biology, histology and
human embryology and their biological, social and ethical im-
plications to students in Health Sciences. Through a central
online website, we present research projects from the Anatomy
and Medical Embryology unit as well as advertising external
websites to international institutions. Advertising our projects
will allow future leaders to keep updated and to participate in
the advancement of medical literature.
Goals & Aims
The National University of Cordoba (Argentina), in an inter-
national collaborative effort with the United Kingdom, pro-
posed to create the first ever virtual laboratory in South Amer-
ica using the World Wide Web to enhance the education of
morphological sciences. Alongside web pages, both e-mail and
discussion boards were also utilized in enhancing the learning
process. Since 2000, the institution has conducted a pilot study
of remote education surrounding various virtual activities in the
fields of cell biology, histology and embryology (Avila et al.,
2002, 2009a, 2010; Samar et al., 2004; Avila & Samar, 2008).
The proposed virtual program allows users to update their
knowledge on biomedical sciences while interactively partici-
pating in activities supervised by staff, thus enriching their
learning throughout their course.
Albeit, the university still integrates orthodox techniques.
Based on the use of new technology and new-age communi-
cation media, the university took on the challenge to produce
educational material in the form of electronic multimedia (e.g.
online virtual practicals and interactive CD-ROMs since not
everyone may have easy access to Internet services). This pro-
ject has successfully spanned multiple campuses, making up
one super electronic portal between the Faculty of Agriculture
and Veterinary Medicine of the National University of Rio
Cuarto and the Faculty of Medical Sciences at the National Uni-
versity of Cordoba, Argentina. In 2009, intra-continental col-
laboration with Cuba led to the development of online medical
education exchange between experts, educators and students
(Iglesias et al., 2009). Much like the reformed program set up
by Pinder et al. (2008) in Canada, the unique Latin American
network is set to use video-conferencing for real-time interac-
tion across multiple sites, thus maximizing on the expertise of
more teachers for the ultimate benefit of more students.
Similarly, the latest English CD-ROM projects include
“Junqueira’s Basic Histology” (Mescher, 2009) and “Histology:
A Text & Atlas” (Ross & Pawlina, 2010). Such software de-
pends on integrating the basic principles of histological struc-
ture with function, hence allowing students to reinforce difficult
and abstract concepts through visual models. Universal access
to information and communication enabled by the Internet and
use of ICT has led to the emergence of an innovative program
in morphological sciences (Samar & Avila, 1999; Avila &
Another aim is to illustrate the experiences of virtual educa-
tion in our online morphology laboratory. This research will be
one of its kind as no other publication to date comments on
virtual laboratory teaching on the continent that draws from
evidence-based research from international peer-reviewed jour-
nals in multiple languages. This is a unique analysis on the first
and only virtual morphology laboratory in South America. Si-
milar programs have drastically evolved for over two decades
and has been successfully introduced, if not fully converted to,
on other continents including Australasia (Kumar et al., 2006),
Europe (Boutonnat et al., 2006; Bertheau et al., 2008; Merk et
al., 2010), Asia (Raja, 2010), Africa (Pagni et al., 2011) and
North America (Blake et al., 2005; Krippendorf & Lough, 2005;
Michaels et al., 2005; Bloodgood & Ogilvie 2006; Mikula et al.,
2008; Pinder et al., 2008; Braun & Kerns, 2009; Dee, 2009;
Husmann, 2009; Weaker & Herbert, 2009; Weinstein et al.,
2009; Triola & Holloway, 2011).
The aims of the virtual laboratory are: 1) improving the
teaching quality by using multimedia modalities; 2) increasing
exposure of embryology during a time of increased relevance,
(e.g. stem cells); 3) offering easier access to information and
glossary of terms, thus breaking barriers of distance or posses-
sion of study material on the biological basis of heredity, and
genetic components of evolution and disease; 4) reinforcing
Copyright © 2013 SciRes. 7
R. E. AVILA ET AL.
visual learning of complex subjects, given that the website
contains colorful animations and microscopy imaging to aid the
understanding of organogenesis; and 5) offering an accurate
overview of human development at different time intervals.
New technologies of information and communication (ICT)
have demonstrated great potential for the development in edu-
cation to support conventional teaching and learning ideas.
With the use of the Internet comes a new teaching paradigm
based on a socio-constructivist approach to learning (Mattheos,
2007). Moreover, conventional educational frameworks for a
core curriculum related to morphological sciences have their
difficulties because it is performed in a given space and time
with pre-established services (Avila et al., 2009b). Currently
there are new opportunities in distance learning on medical
informatics using ICT and the Internet whilst breaking commu-
nication barriers between Spanish and English speaking nations
(Otero et al., 2010).
Virtual biomedical laboratories have been applied to distance
education and Monge-Nájera et al. (1999) define them as simu-
lated and manipulative practices that can be created for students
physically away from a university and teachers. These digital
labs are reduced to a computer screen with two or three dimen-
sional simulation or strictly speaking, to a more realistic depth
of field and binocular vision, which places the user in a virtual
reality. Kumar et al., (2004) illustrates how using appropriate
software can transform specimen slides onto a web browser in a
manner that closely simulates examination of glass slides with a
Paulsen et al. (2010) reviews international online virtual
laboratories which may either be freely accessible or require an
institutional subscription for exclusivity. Silva & Monteiro-Leal
(2003) created a digital library for histology and anatomy
specimens in Brazil which was the first step to closing the
technological gap between less and more economically devel-
oped countries. Digital images are frequently added onto an
ever-expanding database to increase availability and variations
accessed easily over the Internet. Yet, no virtual interactive
laboratories or portable media (e.g. CD ROMs) of histology,
embryology and anatomy atlases exist in Latin America until
Virtual laboratories may consist of differing complexities
(Monge-Nájera et al., 1999). The simplest level consi sts of static
texts and drawings, whereas the next level consists of those that
use animations using JPEG/Bitmap/GIF formats, compatible
with HTML web pages. The consequent level corresponds to
the use of videos which demonstrate practical procedures, but
the most complex laboratory model displays objects or depicts
scenes that can be controlled by users as part of real-time digi-
tal interaction to allow user-choice. Additionally, integration of
a virtual laboratory with the Internet offers diverse tools of
communication such as e-mail, chat forums, courses and hyper-
links to internal and external resources.
Traditional versus Virtual Teaching: Why Do We
Have to Pick Sides?
Significance of Virtual Modality
A 2007 survey by the American Association of Anatomists
calculated that just over 70 hours on average are reserved for
microanatomy teaching, more or less equally divided into di-
dactic lecturing and laboratory work (McBride & Prayson,
2008). Bloodgood & Ogilvie (2006) and Sugand et al. (2010)
highlighted the long-term trend of declining total laboratory
teaching hours in both US and UK medical schools, with a
parallel reduction in hours of faculty time devoted to teaching.
To overcome such challenges, computer-aided instruction (e.g.
digital atlases, virtual microscopy etc.) has been employed to
maintain the quality of education. Optimally annotated and high
resolution magnified images can now be accessed in a virtual
laboratory at any time, thus reducing time required in the labo-
ratory to learn the same information (since instructors can
swiftly direct students to focus on particular structures without
the need for individual attention; McBride & Prayson, 2008).
Accounting for biological variation, virtual microscopy can
now finally level the playing field as optimal specimens can not
only be shared but also better studied online using zoom func-
tion. Crucial annotations will allow better understanding of the
visual aids and hence a better grasp of morphology, macro-
scopic anatomy, embryology and then physiology as well as
pathology. Physicians will only be able to identify abnormali-
ties if the norm has been well established at the beginning of
their medical education.
In an attempt to teach from an inter-disciplinary approach
(Figure 1), the faculty frequently invites numerous departmen-
tal Chairs and Heads of related services (e.g. Gynecology, Ob-
stetrics, Pediatrics, Family Medicine etc.) to provide teaching,
exercises and other resources on the website. Some related
pertinent topics also discussed include epidemiology of con-
genital disorders, bioethical implications (Figure 2) as well as
the role of genetic counseling for couples. With a high patient
burden, educators are able to teach in real-time from remote
locations via video-conferencing across multiple campuses or
Change in Attitudes to Learning
Students were also observed progressing more rapidly
through the content and interacting more within the group. Vir-
tual education teaches fostering of communication and team-
work skills which are crucial qualities in medical and veterinary
education (Downing, 1995; Cotter, 2001; Dee & Meyerholz,
2007; Braun & Kerns, 2008; Sugand et al., 2010). Maybury and
Farah (2009) point out the consequent educational reformation
from teacher-directed learning to student-centered learning,
thus redefining pedagogy as andragogy in which university
pupils make a crucial leap into becoming independent adult
learners. In a technology-driven society, multimedia teaching
modalities should help to generate interest in students too.
The benefits of a virtual laboratory include the reduction in
the need of instructors, lab equipment, especially if institutions
convert to virtual study solely (Boutonnat, et al., 2006; Kumar
et al., 2006), and having no excuse to accommodate for global
curricula reformation (Cotter, 2001; Sugand et al., 2010). Vir-
tual microscopy has also been successfully implemented within
summative examinations (Kumar et al., 2006; McBride & Pray-
son, 2008; Pinder et al., 2008; Triola & Holloway, 2011); simi-
larly, Higazi (2011) found a statistically significant average
increase in exam performance by 16% with the introduction of
live digital imaging and smart board magnification in classroom
teaching. Conveniently, there has not been a predictable de-
crease in the number of institutions that depend on traditional
microscopy teaching but instead wisely blend with instructional
Copyright © 2013 SciRes.
R. E. AVILA ET AL.
Copyright © 2013 SciRes. 9
External learning resources recommended by a multi-disciplinary team of educators for teaching congenital
Bioethical issues were also discussed such as the “anencephaly & interruption of pregnancy” case. Furthermore,
multimodal imaging incl u d i ng u l t rasound was included.
R. E. AVILA ET AL.
technologies. A survey by Braun and Kerns in 2008 indicated
that 50% of the respondents preferred having both optical and
virtual microscopes but the key message is that web-based his-
tology resources have consistently produced high user-satisfac-
tion rates (Boutonnat et al., 2006; Kumar et al., 2006; Patel et
al., 2006; Pinder et al., 2008; Merga et al., 2010; Sugand et al.,
Online education lowers the cost of materials. Scanning and
storage of images is straightforward and can be regularly up-
dated to improve the content of the website with a minimum of
effort, compared to printing (Juri et al., 1991). The web can in-
stantaneously disseminate knowledge, insights and results of
research projects and thus promote international partnerships,
debate and advancement of professional practice (Avila et al.,
2010). The initial establishment of a virtual laboratory maybe
expensive, in the long-term it is of note that little maintenance
is required and need for numerous optical or electron micro-
scopes reduced. In fact, it may be more economical to invest
into the supply of desktops and laptops for students who can
then access the virtual laboratories at any time.
Materials & Methods
The virtual project has now spanned for a decade on a feasi-
ble budget for a developing medical school. All content has
been produced in Spanish with an aim to translate into English
for an international audience in the near future. Free online
support is designed for student-users. Digital images of human
histological sections were obtained using an image analyzer
(Image ProPlus), connected to an Olympus BX50 photomicro-
scope (for both optical and electron microscopy imaging) and a
video camera which were then converted into JPG and GIF
extensions and uploaded onto our online library. Furthermore,
we compiled multiple databases for histology and histopathol-
ogy which led to the publication of several virtual atlases in
CD-ROM format (Samar et al., 2005a, 2005b) for both class-
room teaching while dispersing information easily for continu-
ous personal learning.
To develop the website (http://www.histologiavirtual.fcm.
unc.edu.ar/) the following design tools and programming soft-
ware were utilized to create the Cordoba Model:
Microsoft Office Share Point Designer: a program allowing
a complete view of a web project. This program creates
dynamic web pages through scripting while at the same
time allowing global management of the entire project (e.g.
hyperlinks, navigation, directories, etc.)
HTML (HyperText Markup Language): formatting hyper-
text documents by means of labels (tags) subsequently
leading to browsers (e.g. Netscape Navigator, Firefox or
Internet Explorer) and redirecting hyperlinks.
Dynamic HTML (DHTML): the language that permits in-
teractivity with web pages.
tive of Java that allows web pages to add effects and addi-
tional functions to those provided in standard HTML.
The images used belong to the university laboratory research
faculty. Images on the website contain either JPG or GIF exten-
JPG format that supports 24 × 8 bits per pixel gray scale
images used for photographs.
GIF (Graphics Interchange Format) format that supports up
to 256 colors. It is used for titles, logos and graphics with
less than 256 colors.
Video: digital video files uploaded on the website are AVI
(Audio Video Interleaved) format or consist of continuous
video frames (in bitmap formatting) to generate moving
Support: e-mail, chat forums and video-conferencing after
recording laboratory sessions were used for providing on-
line contact. This free online support acted as a backbone
for consolidating knowledge and revision when suitable for
students outside laboratory time. The Faculty also promotes
external links to other university laboratory sites to em-
power self-learning and an international perspective. Our
online virtual laboratory is freely accessible and is mainly
intended for undergraduate and graduate biomedical stu-
dents, as well as complementing auxiliary careers within
Online library: the website has frequently been updated
with more content and virtual activities (i.e. drawings, im-
ages of histology sections and videos) which can all be
freely accessed online at the following address: http://www.
histologiavirtual.fcm.unc.edu.ar/. The main portal shall soon
implement traffic counters to measure the popularity of
user-content and analyze those desired characteristics to in-
tegrate within all study material.
For students to qualify for certification and accreditation on
the course, one ought to download and work through our com-
plimentary virtual practical work-guide, electronically record
evaluations of the virtual laboratory services and then finally sit
a summative assessment ( Figure 3) based on the online content.
Having taken full advantage of the communication capacity on
the web, laboratory staffs are easily contactable vi a ch at forums
The virtual atlases share one home page with links to other
pages consisting of theory and clinical significance, clip art and
literature references. The atlases (Figures 4 and 5) were awarded
“mention for best national production’ in the fourth Interna-
tional Film Festival for Physicians & Scientists in 2003 and
again in 2005 (organized by the Medical Council of the Prov-
ince of Cordoba and World Association of Medical & Health
Films) and our online resource was honored with a special
mention in e-learning and education category at the World
Summit Award (World Summit Online, 2005) and by the In-
ternational Telecommunication Union which is a United Na-
tions specialized agency. Both resources still play a pivotal role
in teaching students today all over the continent as both vir-
tual microscopic imaging and online guidelines are supplied for
free. Worksheets have been created for different levels of diffi-
culty in order to promote continuity in education (Figures 6
The main online histology portal hosts another two hyper-
links: ODONTOWEB and PIMEG. Each site covers various
pertinent topics in anatomical sciences and practicals corre-
spond to separate screens with multiple thumbnail images and
assessments. Each image has a brief text that identifies struc-
tures as well as the original color and degree of staining all
under optical and electron microscopes in the following topics:
1) Introduction to Tissues, 2) Co-ordination systems, 3) Trans-
port & Defense, 4) Alimentary canal, 5) Respiratory and 6) Uri-
nay system which are all found on ODONTOWEB (Figure 8). r
Copyright © 2013 SciRes.
R. E. AVILA ET AL.
Formative interactive assessments with both digital photographs and videos allow stu-
dents to drive independently their own revision and reinforcement of learning objec-
tives. As students learn at their own pace, quizzes and self-assessments can be carried
out at their leisure outside laboratory time.
Selected images on the contents of the Atlas Virtual de Histología CD-RO M (Samar et al., 2005b).
Copyright © 2013 SciRes. 11
R. E. AVILA ET AL.
Selected images on contents of the Atlas Virtual de Anatomia, Embriologia e Histologia Oral CD-ROM (Samar
et al., 2005a).
URL: http://www.histologiavirtual.fcm.unc.edu.ar/guia_practica_virtual_04.htm. Screen image showing the pictures in
thumbnail featured next to questions within the v i rtual practical workbook.
Copyright © 2013 SciRes.
R. E. AVILA ET AL.
Online virtual imaging showing a selection of 24 pictures as thumbnails featured in the virtual practical work guide on oral
cavity. Clicking on them will take the user to another screen with the image magnified, thoroughly annotated and
opportunities to test oneself with questions.
A screen with thumbnail images of epithelial tissue in their natural and stained states with clear labeling of structures.
Copyright © 2013 SciRes. 13
R. E. AVILA ET AL.
Copyright © 2013 SciRes.
2010_01.htm) aims to improve research and education in oral
sciences. Virtual practicals consist of displaying images of oral
cavities belonging to different species along with questions
(Figure 7). User-friendly interaction also fosters interests and
encourages users to explore the content for themselves to take
responsibilit y ultimatel y fo r t h eir own learning potential.
Finally, it is up to the user-students to ultimately judge the
virtual programs and offer feedback on its necessity. They
evaluated the incorporation of new methodologies to support
usual teaching practices. Students were recruited anonymously
throughout the academic year of 2010 and out of 291 in the
School of Medical Sciences in the National University of Cór-
doba, 267 participated in the questionnaire survey to comment
on various aspects of the usefulness of the web resources of-
Using the online resources as the primary learning tool was
unanimously favored as seen in Table 1. Learning was supple-
mented with practical guides available on the website, own
notes and textbooks. The faculty will be conducting further
extensive surveys and end of year evaluations to observe
whether students who participate in virtual exercises perform
better in standardized exams in lieu of using printed practical
work-guides. To date the majority of students have welcomed
the online educational services. They perform better in exams
since the interactive online portal not only teaches new topics
but importantly allows users to revisit the interactive virtual
tutorials, practicals and workshops to reconsolidate knowledge
Student-users particularly appreciated the ease of access to
hundreds of slides online which also highlighted all the learning
objectives in each virtual slide. There was no longer a need to
carry heavy atlases, revise from dense texts and have no point
of reference to the printed practical work-guides on offer. All
pertinent information was finally collated onto one accessible
interactive online source which would continuously expand and
improve to accommodate for varying levels of studying mor-
Harris et al. (2001), Heidger et al. (2002) and Dee et al.
YES NO Total
Students willing to
participate in survey 267 (92%) 24 (8%) 100%
Used the main website as a
primary l earning resource 245 (92%) 22 (8%) 100%
Relied on the following as a
secondary learning tool:
a) online practical work guide
b) classroom notes, textbooks,
other sources of images & videos
c) printed practical work guide
(20ilizing virtual images in teaching
maits similarly inherent in using a real
mts tond better the omplex
abstract concepts of morphologyin label-
gsted tual micrographs and
ares, wiven an unlimited
ntioned that histological images rendered
y imaging, therefore, retaining many useful tradi-
eedback in order consistently to
work set by teachers;
6) Estimated commitment time required is at least 8 to 10
03) discovered that ut
intains educational benef
icroscope and allow studen
rams online, students are te
y. After studg ed dia
hilst being ge tested on micro-structur
number of opportunities to test themselves and monitor per-
sonal progress. Advantages mentioned consist of an unlimited
number of users, independent from time and place, who can
examine specimens with superimposed references and explana-
tions to an ever-expanding digital archive. Online tests with
virtual slides integrated into case studies can offer good exam-
ples of early physiology as well as immediate feedback to the
student on progress.
Those investigating the use of computers in education are
well aware of its potential as a tool to enhance the learning
process. Personal computers and others mechanisms such as
integrated technical environments offer enormous potential to
enrich various educational situations (Maiztegui et al., 2002).
Blake et al. (2003) me
a CD-ROM allow students to view the pictures at anytime
and anywhere with the use of portable laptops in which the
benefits were originally emphasized by Ogilvie (1995). Hence,
both students and teachers showed a strong support for the use
of CD-ROMs and online libraries for teaching morphology.
The Web provides students a greater degree of active learning
experiences, whilst facilitating student participation in projects
that promote collaborative investigating, solving research prob-
lems and developing strategies to provide them with better
preparation and understanding for their future professional
The aim is not to replace didactic classroom teaching but to
enhance, interact and consolidate key educational messages
with the option of revising outside sessions as the user sees fit.
Cotter (2001) and Michaels et al. (2005) also encouraged use of
light microscopy in conjunction with web-based resources with
nal and contemporary aspects of a fundamental biomedical
subject. In developing nations virtual education is advantageous,
as high-quality electronic microscopes are expensive and not
available at all times for students to use. A virtual laboratory is
a feasible framework to provide high standard education at any
place and time with little restrictions on students and faculties
(Goldberg & Dintzis, 2007).
Our online program has relied on different types of virtual
laboratories that have been adapted to the core learning objec-
tives of cell biology, histology and embryology as well as per-
mitting self-evaluation by student users. As our students are the
most frequent users of the virtual labs, it is vital to empower
them to provide constructive f
prove the software for future generations of users. Students
who wish to perform well in the course are expected to achieve
the following aims:
1) Regularly access virtual classrooms for Q & A sessions
with laboratory demonstrators;
2) Read and study materials recommended by lecturers;
3) Participate in online forums with instructors and class fel-
lows to discuss the content;
4) Comply with the
5) Send at least six feedback forms to evaluate the course,
content and teachers;
R. E. AVILA ET AL.
fr onstrated the overwhelming inter-
es ories as a principal
to is a flexible and enjoyable resource that
ty to understand the material
virtual microscopy may very well eventually, if not
ed data which ultimately then leads to a
to revolutionizing biomedical education, re-
e of both traditional and technological input
into their education. Most importantly, a feasible step-by-step
model has been construher laboratories in de-
istología y embriología.
Educación Hoy, 37, 37-46.
Avila, R. E., Alemany,etti, L. B., Juri, G., &
Juri, H. O. (2010). Aiateca digital de mues-
urs per week for students to optimize the learning pote
om the virtual online resources.
The survey responses dem
t that students had using our virtual laborat
ol for learning morphology. Mills et al. (2007) suggested that
a virtual microscope
uld be useful to enhance the learning of microscopic struc-
tures. Also, Husmann et al. (2009) found that increased acces-
sibility, ease of use, and the abili
ere important components of the virtual microscope for stu-
dents in their survey. An increase in collaboration was noted
because students were able to discuss specific learning objec-
tives after viewing an image simultaneously. Moreover, learn-
ing through a virtual lab allows for continuing education and
integration with clinical sciences as proposed by Kumar et al.
Long gone are the days where students spend a substantial
amount of their pre-clinical years in laboratories studying 35
mm slides using light microscopy. Novices will mostly not
know exactly what to look at (Patel et al., 2006) and how to
relate the function of histology to physiology. Disadvantages
are predominantly financial. There are also purists who may
evitably, be the death of an art but this has been contested
(Patel et al., 2006).
Education is selfless because it should be shared as a gift
rather than kept secretive. It is certainly a grave responsibility
of scientists, regardless of field specialization, to contribute to
the expansion of scientific literature. However, since dissemi-
nation of information is mostly dependent on technology, many
less economically developed nations have more difficulty to
duced rate in improving scientific infrastructure. Our online
laboratory does not only add to the virtual interactive experi-
ence for our students but will also have the potential to teach
international audiences as well as improve the quality of educa-
tion delivered in local institutions. The online program is a
great leap forward for our nation to interact and collaborate
with international establishments, much like what has been
accomplished by working together with Cuba and the UK on
With a high patient to physician ratio in most South Ameri-
can countries, especially in rural settings, more importance
ought to be given to training our doctors to deliver holistic and
evidence-based medicine, that is to say optimal management to
each individual patient with differing bio-psycho-social needs.
The laboratory will create a ground-breaking platform which
arch and training. Our website will soon feature social issues
related to reproductive health and post-partum care, integration
of family planning services and the prevention and treatment of
sexually transmitted infections intended for public access and
We conclude that the use of virtual laboratories to further
support conventional morphology education was positively
received and that using multimodal multimedia is more effec-
tive than simply using traditional methods. Students prefer a
cted to guide ot
ations into entering the twenty-first century with the
use of multimedia multimodal teaching.
Avila, R. E., & Samar, M. E. (2004). The Internet in the medical educa-
tion: Use of the virtual laboratory in the education of morphologic
sciences. Technology in Health Care, 12, 395.
Avila, R. E., & Samar, M. E. (2008). Actividades virtuales en la en-
señanza-aprendizaje de biología celular, h
L., Samar, M. A., Buzz
mpliaciones de una med
tras de laboratorio histopatológico. Internationl Journal of Morphol-
ogy, 28, 875-878.
vila, R. E., Alonso, I., Alemany, L., & Samar, M. E. (2009a). Her-
ramientas de gestión del conocimiento en educación médica virtual
histopatológica. Patología, 47, 374-375.
vila, R. E., Pelizzari, M., Sorokin, S., Kevin, L., Defagot, L. M., Cam-
pos, D., Recuero, Y., Quevedo, N., & Andrómaco, M. (2005). Las
malformaciones congénitas. Dictado de una unidad integrada básico-
clínica. VIII Conferencia Argentina de Educación Médica, CAEM.
AFACIMERA (Asociación de Facultades de Medicina de la Rep-
ública Argentina). Córdoba. Argentina.
Avila, R. E., Quirog a, M., Ciucci, R., Lucero , P., Caballero, E., Mo ntes
Tizca, A., Mineo, J., Maldonado, L., & Samar, M. E. (2009b). El la-
boratorio de investigación biomédica como “puente interactivo” en-
tre el proceso de enseñanza/aprendizaje y la investigación de las neu-
rociencias. Ini Inv 4:a2. http://virtual.ujaen.es/ininv/
vila, R. E., Samar, M. E., Chi esa, P., Camps, D., Salica, J. P., & Yary-
ura, G. (2002). The use of new technologies of information and com-
munication (NTIC) for teaching/learning of cell biology, histology
and embryology. Informedica Journal, 1 .
ertheau, P., Kussaibi, H., & Ameisen, D. (2008). Virtual slides: Tech-
nical aspects and an example of their use at a university hospital.
Annals of Pathology, 28, S98-S99.
Blake, C. A., Lavoie, H. A., & Millette, C. F. (2003). Teaching medical
histology at the University of South Carolina School of Medicine:
Transition to virtual slides and virtual microscopes. The Anatomical
Record, 275B, 196-206. http://dx.doi.org/10.1002/ar.b.10037
Bloodgood, R. A., & Ogilvie, R. W. (2006). Trends in histology labo-
ratory teaching in United States medical schools. The Anatomical
Record Part B New Anatomy, 289, 169-175.
Boutonnat, J., Paulin, C., Faure, C., Colle, P. E., Ronot, X., & Sei-
gneurin, D. (2006). A pilot study in two French medical schools for
teaching histology using virtual microscopy. Morphologie, 90, 21-25.
Braun, M. W., & Kearns, K. D. (2008). Improved learning efficiency
and increased student collaboration through use of virtual micros-
copy in the teaching of human pathology. Anatomical Sciences Edu-
cation, 1, 240-246. http://dx.doi.org/10.1002/ase.53
Brisbourne, M. A., Chin, S. S., Melnyk, E., & Begg, D. A. (2002).
Using web-based animations to teach histology. The Anatomical Re-
cord, 269, 11-19. http://dx.doi.org/10.1002/ar.10054
arlson, B. M. (2002). Embryology in the medical curriculum. The CAnatomical Record (New Anatomy), 269, 89-98.
ONEAU (Comision Nacional de Evaluacion y Acreditacion Uni-
versitaria) (1999). Ministry of Education, Repu b li c o f Argentina.
Cotter, J. R. (2001). Laboratory instruction in histology at the Univer-
sity at Buffalo: Recent replacement of microscope exercises with
computer applications. The Anatomical Record, 265, 212-221.
ee, F. R., & Meyerholz, D. K. (2007). Teaching mDedical pathology in
Copyright © 2013 SciRes. 15
R. E. AVILA ET AL.
the twenty-first century: Virtual microscopy applications. Journal of
Veterinary Medical Edu c a tion, 34, 431- 436.
ee, F. R., Lehman, J. M., Consoer, D., Leaven, T., & Cohen, M. BD.
(2003). Implementation of virtual microscope slides in the annual
pathobiology of cancer workshop laboratory. Human Pathology, 34,
owning, S. W. (1995). A multimDedia-based histology laboratory
Gsiology and his-
course: Elimination of the traditional microscope laboratory. Medinfo,
oldberg, H. R., & Dintzis, R. (2007). The positive impact of team-
based virtual microscopy on student learning in phy
tology. Advances in Physiology Education, 31 , 261-265.
arris, T., Leaven, T., Heidger, P., Kreiter, C., Duncan, J., & Dick, F.
(2001). Comparison of a virtual microscope laboratory to a regular
microscope laboratory for teaching histology. The Anatomical Re-
cord, 265, 10-14. http://dx.doi.org/10.1002/ar.1036
eidger, P. MH., Dee, F., Con so er, D., Leaven, T., Dunc a n , J., & Krei ter,
C. (2002). Integrated approach to teaching and testing in histology
with real and virtual im a gi ng . The Anatomical Record, 269, 107-112.
ersh, W., Junium, K., Mailhot, M., & TidmarHsh, J. D. (2001). Imple-
mentation and evaluation of medical informatics distance education
program. Journal of American Medical Informatics Association, 8,
igazi, T. B. (2011). Use of interactive live digital imaging to enhance Hhistology learning in introductory level anatomy and physiology
classes. Anatomical Sciences Educat i on , 4, 78-83.
usmann, P. R., O’Loughlin, V. D., & Braun, M. W. (2009). Quantita- Htive and qualitative changes in teaching histology by means of virtual
microscopy in an introductory course in human anatomy. Anatomical
Sciences Education, 2, 218-226. http://dx.doi.org/10.1002/ase.105
lesias, R. B., Avila, R. E., Al meida, C. S., Ro drig uez, P. I., Samar, M. Ig
E., & Pomares, B. E. (2009). Intercambio colaborativo virtual en la
Educación Médica: Una experiencia Cubano-Argentina. Actas X
Congreso Virtual Hi spanoameric a no de Anatomía Patológica.
Juri, H., Sipowicz, O., Avila, R. E., Hernández, D., & Palma, J. (1991).
Propuesta para la enseñanza y aplicación de la informática en la Es-
cuela de Medicina Rev. La Facultad de Ciencias Médicas Córdoba,
ippendorf, B. B., & Lough, J. (2005). Complete and rapid switch
from light microscopy to virtual microscopy for teaching medical
histology. The Ana t o m i c a l Record Part B New Anatomy, 285, 19-25.
umar, R. KK., Freeman, B., Velan, G. M., & De Permentier, P. J.
(2006). Integrating histology and histopathology teaching in practical
classes using virtual slides. The Anatomical Record B New Anatomy,
289, 128-133. http://dx.doi.org/10.1002/ar.b.20105
umar, R. K., Velan, G. M., Korell, S. O., Kandara, M., De e, F. R., & KWakefield, D. (2004). Virtual microscopy for learning and assess-
ment in pathology. Journal of Pathology, 204, 613-61 8.
aiztegui, A. (2002). Papel de la tecnología en la educación científica: M
Una dimensión o lvidada. Revista Iberoamericana de Educación.
attheos, N. (2007). The Internet and the oral health care professionals:
Potential and challenges of a new era. International Journal of Den-
tal Hygiene, 5, 151-157.
aybury, T., & Farah, C. S. (2009). Perspective: Electronic systems of
knowledge in the world of virtual microscopy. Academic Medicine,
84, 1244-1249. http://dx.doi.org/10.1097/ACM.0b013e3181b1869e
McBride, J. M., & Prayson, R. A. (2008). Development of a synergistic
case-based microanatomy curriculum. Anatomical Sciences Educa-
tion, 1, 102-105. http://dx.doi.org/10.1002/ase.21
Merk, M., Knuechel, R., & Perez-Bouza, A. (2010). Web-based virtual
microscopy at the RWTH Aachen University: Didactic concept,
methods and analysis of
Anatomy, 192, 383-387. acceptance by the students. Annals of
escher, A. (2009). Junqueira’s basic histology (12th ed.). New York:
y, 284, 17-21.
Michaels, J. E., Allred, K., Bruns, C., Lim, W., Lowrie Jr., D. J., &
Hedgren, W. (2005). Virtual laboratory manual for microscopic ana-
tomy. The Anatomical Record Part B N ew Anatom
ikula, S., Stone, J. M., & Jones, E. G. (2008). BrainMaps.org-Interac-
tive high-resolution digital brain atlases and virtual microscopy.
Brains Minds Media, 3, bm
ills, P. C., Bradley, A. P., Woodall, P. F., & W
Mildermoth, M. (2007).
raditional microscopy: A comparison of stu-
Teaching histology to first-year veterinary science students using
virtual microscopy and t
dent responses. Journal of Veterinary Medical Education, 34, 177-
onge-Nájera, J., Rossi, M. R., & Méndez-Estrada, V. H. (2002).
evolución de los laboratorios virtual
es durante una experiencia de
Oistology image-barcode manual
cuatro años con estudiantes a distancia. XI Congreso Internacional
sobre Tecnología y E d u c a c i ón a D i s t a nc i a. San José.
gilvie, R. W. (1995). An interactive h
for a videodisc image library. Medinfo, 8, 1698.
tero, P., Hersh, W., Luna, D., & González Bernaldo de Quirós, F.
(2010). A medical informatics distance-learning course for Latin
America. Translation, implementation and evaluation. Methods of
Information in Medicine, 49, 310-315.
agni, F., Bono, F., Di Bella, C., Faravelli, A., & Cappellini, A. (2011).
Virtual surgical pathology in underdeveloped countries: The Zambia
project. Archives of Pathology & Laboratory Medic
ine, 135, 215-
Pbert, H. W. (2006).
atel, S. G., Rosenbaum, B. P., Chark, D. W., & Lam
Design and implementation of a web-based, database-driven histo-
logy atlas: Technology at work. The Anatomical Record Part B New
Anatomy, 289, 176-183. http://dx.doi.org/10.1002/ar.b.20112
aulsen, F. P., Eichhorn, M., & Bräuer, L
copy—The future of teaching histology i
P. (2010). Virtual micros-
n the medical curriculum?
Annals of Anatomy, 192, 378-382.
inder, K. E., Ford, J. C., & Ovalle, W. K. (2008). A new paradigm for
Png histology laboratories in Canada’s first distributed medical
school. Anatomica l Sciences Education, 1, 95-101.
aja, S. (2010). Virtual microscopy as a teaching tool adjuvant to tradi-
tional microscopy. Medical Educati on , 44, 1126.
oss, M. H., & Pawlina, W. (2010). Histology: A text and atlas: With
correlated cell and molecular biolo
pincott Williams & Wilkins.
Rgy (6th ed.). Philadelphia: Lip-
S ). Problemática jurídica legal de la
So paradigma de
Sas, P., Brunotto, M., Llanes, M., &
S., Zárate, A. M., & Brunotto, M. (2004). Edu-
SL. (2003). Creating a histo-
Samar, M. E., & Avila, R. E. (1994). Propuesta: Formación de recursos
humanos en ciencias básicas biomédicas. Revista de la Facultad de
Ciencias Médicas, 52, 31-32.
amar, M. E., & Avila, R. E. (2002
fertilización asistida: La persona y el comienzo de la vida. Claves De
Odontologia, 34, 7-9.
amar, M. E., Avila, R. E., & Bonomi, L. (2001). Nuev
la enseñanza de la Embriología Humana. III Conferencia de Educa-
ción Médica. Córdoba: Asociación de Facultades de Medicina de la
República Argentina (AFACI
Samar, M. E., Avila, R. E., & Bozzatello, J. (2005a). Atlas virtual de
anatomia, embr i o lo g i a e h i st o l o g i a oral CD-ROM.
mar, M. E., Avila, R. E., Pon
Rabino, M. (2005b). Atlas virtual de histología: Biología celular y
amar, M. E., Avila, R. E
cacion biomedica on line: Una herramienta alternativa en la en-
señanza de la histologia medica y odontologica. Informedica Journal,
ilva Lópes, V. W., & Monteiro-Leal,
logy—Embryology free digital image database using high-end mi-
Copyright © 2013 SciRes.
R. E. AVILA ET AL.
Copyright © 2013 SciRes. 17
croscopy and computer techniques for on line biomedical education.
The Anatomical Record Part B N e w Anatomy, 273, 126-131.
ugand, K., Abrahams,S P., & Khurana, A. (2010). The anatomy of ana-
Tcal Education, 11, 4.
tomy: A review for its modernization. Anatomical Sciences Educa-
tion, 3, 83-93.
riola, M. M., & Holloway, W. J. (2011). Enhanced virtual microscopy
for collaborative education. BMC Medi
eaker, F. J., & Herbert, D. C. (2009). Transition of a dental histology
course from light to virtual microscopy. Journal of Dental Education,
acharyya, A. K., Yagi, Y.,
einstein, R. S., Graha m, A. R., Richter, L. C., Barker, G. P.,
ski, E. A., Lopez, A. M., Erps, K. A., Bhatt
& Gilbertson, J. R. (2009). Overview of telepathology, virtual mi-
croscopy, and whole slide imaging: Prospects for the future. Human
Pathology, 40, 1
orld Summit Award (2005). Proyecto histologia virtual (virtual his-
tology project). Premio mención especial en el rubro educación, en
el certamen de la cumbre mundial de la sociedad de la información,
capítulo argentino. Sitio Of
icial de la WSA-Capítulo Argentino.