Come On Get HAPI: Moving Beyond Identification to Integration and Interpretation
Authors: Sondreal Abigail , Moore Kathryn B. , Morton David A. , Putnam Angelica R. 
Published: May 2022

PURPOSE

Identifying microscopic images is a critical skill for histology and pathology; moving beyond identification to interpretation is integral to understanding pathophysiology. Students struggle with recognizing pathology’s valuable connection with anatomy and histology, a problem reinforced by the fact that these disciplines are often taught prior to and separate from pathology in medical curricula. Based upon previous studies demonstrating the value of integrated learning, we created the Histology, Anatomy and Pathology Initiative (HAPI). Our hypothesis was that early linking of selected pathologies to normal organs and tissues, coupled with a hands‐on investigation of harvested cadaveric specimens, would help first year medical students develop an appreciation of how these three disciplines can together inform a diagnosis.

As part of HAPI, we integrated short teaching sessions into histology labs where a pathologist compared and contrasted gross organs, with and without specific diseases as well as the corresponding normal and histopathologic images that corresponded to the normal histology topics. Next, the three disciplines were linked by having students identify tissues/organs of interest from their anatomy cadavers, harvest the tissue and propose a hypothesis about the sample. Students then examined the histological specimens to test each hypothesis.

METHODS

In Fall 2019 and 2021 (MS2023, N=126; MS2025, N=129), dissection groups collected tissue samples from their assigned cadaver with faculty assistance. Tissue samples were processed at the ARUP Histology Research laboratory. Groups then examined their samples, analyzed the sections for both normal and abnormal features, identified any pathological features and correlated their histological findings with their observations from the gross organ examination, and the donor’s medical history provided by the Body Donor program. Students also completed a qualitative survey to assess their attitudes via MCQs and open‐ended response questions.

RESULTS

99% (N=106) of students found the pathology sessions effective as an introductory tool to learn how tissue analysis is used by pathologists in patient diagnosis; it allowed them to connect gross anatomy, histology and pathology and highlighted the value of understanding normal anatomy and histology to better understand disease. For the cadaver experience, 80% (N=106) of students agreed that “harvesting tissue from my cadaver and analyzing the section in histology lab allowed me to better understand how tissue analysis is used by pathologists in patient diagnosis” and 81% (N=106) agreed that “harvesting tissue from my cadaver and analyzing the section in histology lab allowed me to better connect gross anatomy, histology and pathology.”

CONCLUSION

Integration of pathology within histology and anatomy lab was successful as an initial way for first‐year medical students to understand why recognizing normal anatomy and histology is foundational to understanding disease.