Clinical Chemistry
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Clinical Chemistry 44: 1692-1700, 1998;
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(Clinical Chemistry. 1998;44:1692-1700.)
© 1998 American Association for Clinical Chemistry, Inc.

Special Report

Teaching the microscopic examination of urine sediment to second year medical students using the Urinalysis-Tutor computer program

Carla Phillips1, Paul J. Henderson1, Lynn Mandel2, Sara Kim2, Doug Schaad2, Mindy Cooper3, Claudia Bien1, Adam Orkand1, Mark H. Wener1, James S. Fine1, and Michael L. Astion1,a

Departments of
1 Laboratory Medicine and
2 Medical Education, University of Washington, Seattle, WA 98195.
3 Division of Nephrology and Transplantation, Virginia Mason Medical Center, Seattle, WA 98111.
a Address correspondence to this author at: Department of Laboratory Medicine, Box 357110, University of Washington, Seattle, WA 98195-7110. Fax 206-548-6189; e-mail astion{at}mail.labmed.washington.edu.

The microscopic examination of urine sediment is a common diagnostic tool taught to medical students, medical technologists, and others. The urine microscopic exam is difficult to teach because supervised instruction and textbook-based teaching suffer from numerous drawbacks. Here, we describe Urinalysis-Tutor, a computer program that uses digitized microscope images and computer-based teaching techniques to systematically teach the urine microscopic exam. In addition, we report the results of a 2-year study that evaluated the effectiveness of the program in 314 second year medical students who were required to use the program. The program contained two, 20-question exams. In the first year of the study (1996), one of the exams was chosen as the pretest and the other as the posttest; the pretest had to be completed before the students viewed the contents of the program, and the posttest was taken after finishing the tutorial. In 1997, the order of the two exams was reversed. In 1996, 159 students completed the study. The mean pretest score was 34% (SD, 14%), the mean posttest score was 71% (SD, 13%), and the improvement was significant (P <0.001, paired t-test). In 1997, 155 students participated. The mean pretest score was 41% (SD, 11%), the mean posttest score was 71% (SD, 13%), and the improvement was significant (P <0.001, paired t-test). The study shows that Urinalysis-Tutor helps medical students learn to interpret the microscopic appearance of urine sediment and that it is feasible to implement this tutorial in a medical school class.




The following articles in journals at HighWire Press have cited this article:


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R. Wald, C. M. Bell, R. Nisenbaum, S. Perrone, O. Liangos, A. Laupacis, and B. L. Jaber
Interobserver Reliability of Urine Sediment Interpretation
Clin. J. Am. Soc. Nephrol., March 1, 2009; 4(3): 567 - 571.
[Abstract] [Full Text] [PDF]

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S. Kim, M. Reeves, and M. L. Astion
Web-Based Method for Establishing National Competency Benchmarks in Fourteen Areas of Clinical Laboratory Services
Clin. Chem., April 1, 2004; 50(4): 753 - 755.
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M. L. Astion, S. Kim, A. Nelson, P. J. Henderson, C. Phillips, C. Bien, L. Mandel, A. R. Orkand, and J. S. Fine
A Two-Year Study of Microscopic Urinalysis Competency Using the Urinalysis-Review Computer Program
Clin. Chem., June 1, 1999; 45(6): 757 - 770.
[Abstract] [Full Text] [PDF]


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