PATHOLOGY

Department of Pathology & Laboratory Medicine Magazine

Virtual Gross Pathology Rounds

Nicole Herbers Develops Virtual Gross Pathology Seminar Series for Anatomical Pathology Residents

— Nicole Herbers, BSc, MCISc, PA (ASCP)CM (CCCPA-CCCAP)
Lead Pathologists’ Assistant
Clinical Instructor, Department of Pathology and Laboratory Medicine, UBC

The Anatomical Pathology Residency Training Program has had a strong tradition of providing their residents with extensive training and exposure to the macroscopic assessment of neoplastic and non-neoplastic tissues. Although pathologists’ assistants (PAs) have become more prevalent in hospitals of various sizes, pathologists at both large and small sites may still be called upon to gross the surgical specimens. Gross pathology still plays an important role for AP residents from an examination point of view, where a component of the RCPSC Exam continues to test candidates on their gross pathology skills. Although residents often learn gross pathology on the job, pathologists at Vancouver General Hospital have been providing specific teaching sessions on this topic which have been well received. Luckily, the UBC DPLM has not only engaged pathologists, but PAs as well who teach at the bench-side. One PA, Nicole Herbers from St. Paul’s Hospital, has developed a fantastic virtual seminar series that has supplemented the AP resident’s learning opportunities in gross pathology. I asked Nicole to tell us a little bit about this program.

  • - Nicole, can you tell us a little bit about your background and what brought you to being a PA at SPH?

My training includes a Bachelor of Sciences from the University of Alberta and Master of Clinical Sciences Pathologists’ Assistant from Western University. I pursued this career at SPH because of the great opportunities to become involved in leadership and teaching – recently being appointed as a Clinical Instructor for the Department of Pathology and Laboratory Medicine at UBC. As a PA at SPH, I am hands-on with a wide range of specimens, working at the center of disease diagnosis, and ultimately helping patients.

  • - What is a typical day for you at SPH in terms of gross pathology work?

As a PA, I am responsible for macroscopically examining, describing, and dissecting surgical specimens, in a process known as "grossing." A typical day for me includes grossing a wide range of simple to complex surgical specimens that are removed for benign or malignant conditions. Some of the most common specimens I gross in a day include colectomy, mastectomy, hysterectomy, and thyroidectomy specimens. Scattered throughout the day I also open specimens that come down from the ORs, teach bench-side grossing to techs and residents, follow up with cases, and create new educational content.

  • - What is your favorite, and least favorite, specimen to gross (and the correct answer to both can be placenta!!!)?

My favorite to gross is a radical nephrectomy specimen. My least favorite to gross is a post-neoadjuvant total mastectomy specimen.

  • - Can you tell us how the idea for a virtual gross pathology rounds was devised?

As a student (and Netflix binge-watcher), I always craved more video content relevant to pathology and grossing. Now as a Clinical Instructor with the support of UBC/SPH, I am leveraging the rise of virtual meeting platforms and social media as an educational tool. I thought it would be useful to combine the demonstration of real live specimens with written text and spoken word, to both showcase how interesting the gross specimens are and help teach an audience with as many different learning styles as possible. I wanted to ensure these are an enjoyable, worthwhile experience for all attendees, so I included live polling questions to reinforce learning and the rounds are accredited with the Royal College for 1 CME credit per session (Section 1 group learning activity).

Nicole's latest Virtual Gross Pathology Rounds

  • - Currently, who typically attends the rounds, what sessions have you done so far, and what sessions do you have in the future planned?

Right now, 50-70 residents, PAs, MLTs, and pathologists from across Canada attend regularly. So far, I have presented sessions on right hemicolectomy for colon cancer, total mastectomy for breast cancer, total mesorectal excision for rectal cancer, prostatectomy for prostate cancer, polycystic kidneys, and placenta. I don’t want to give too much away but I have sessions on a few more complex GU, GI, and GYN specimens coming up within the next few months.

  • - You provide questions during the rounds that are RC-exam based. What led to that choice and have you received any feedback on this?

The polling questions are a great way for the attendees to practice multiple choice questions, stay engaged, and test their knowledge in a low-stakes environment. The questions are geared towards pathology residents and PAs studying for board exams. The questions have been well received – I’ve gotten feedback that they cover high yield topics for exams.

  • - If anyone is interested in joining who do not already have this on their calendar, how can they be added? When and where do the sessions occur?

Please email me at nherbers@providencehealth.bc.ca indicating that you are interest in attending the sessions. I will then add you to the monthly invite list. The sessions are all virtual though Zoom and occur every third Friday of each month at 8am to 9am PST. If you miss the live rounds, recordings are posted at https://www.youtube.com/@surgpathpa.

  • - For anyone thinking about developing educational opportunities, do you have any words of advice for them?

Do it – it’s a wonderful way to give back and share your knowledge. Prepare early and stay organized. Find people that support your ideas; I would not be able to do these sessions without the support from the technical and professional staff at SPH.

The AP program greatly appreciates Nicole for developing this series and working with our program to ensure that our residents would be a key audience for these sessions. I would also like to take this time to thank all medical, technical, and professional staff who help make the UBC AP program such a success story. If you have any ideas on ways to further support the program, through revamped or novel sessions or topics, please do not hesitate to reach out!

Jon Bush, AP Program Director

Jonathan.bush@ubc.ca