524 Innovating Histology Education: Student Perspectives and Challenges Solutions in an Ecuadorean Public Medical School

Introduction/Objective Histology is a foundational yet challenging subject in medical education, often hindered by limited practical resources and outdated teaching methods—issues especially pronounced in public universities across Latin America. At Ecuador’s largest public medical school, Universidad Central del Ecuador (UCE), these challenges intersect with growing demands for digital learning and curriculum innovation. This study aims to explore student perspectives on histology education, identifying key barriers and opportunities to enhance learning outcomes. Using a cross-sectional survey of 369 first- and second-semester medical students, we analyzed perceived difficulty, resource usage, and demographic disparities. Particular focus was given to the role of digital tools, faculty engagement, and the evolving nature of histology instruction. To our knowledge, this is the first student-centered investigation of histology education in Ecuador and among the few in the region. The findings provide critical insights to inform evidence-based reforms, bridging global best practices—such as virtual microscopy and active learning—with the local context of large, resource-constrained public medical programs. Our goal is to contribute actionable recommendations to make histology education more effective, equitable, and engaging for the next generation of healthcare professionals. Methods/Case Report This cross-sectional study surveyed first- and second-semester medical students at Universidad Central del Ecuador (UCE) in February 2025 to explore perceptions of histology learning challenges. A 9-item questionnaire, developed in Spanish and distributed via Google Forms, collected both quantitative and qualitative data. The survey included Likert-scale difficulty ratings, multiple-choice questions on resource usage and learning barriers, and open-ended prompts for improvement suggestions. Informed consent was obtained electronically, and participation was voluntary. The final sample comprised 369 valid responses. Quantitative analysis involved descriptive statistics (mean, SD, frequencies) and cross-tabulations with odds ratios to examine associations between demographic variables (semester, gender, repetition status), digital resource use, and perceived difficulty. Qualitative responses were coded inductively into thematic categories (e.g., microscopic identification, textbook comprehension, interdisciplinary correlations), with subgroup comparisons performed to identify divergent trends. Triangulation of quantitative and qualitative findings ensured robust interpretation of results. Analysis was conducted using Excel for statistical computations and manual thematic coding to maintain methodological rigor. This mixed-methods approach provides a comprehensive, student-centered view of histology education at UCE, offering valuable insights to guide curricular improvements and inform regional pedagogical strategies.rigor. Results A total of 369 medical students (61.2% first-semester, 37.7% second-semester) participated in the survey. The overall perceived difficulty of histology was 6.5/10, with second-semester students reporting 23% higher difficulty (7.2 vs. 5.8/10) and repeaters showing the greatest challenge (7.8/10). Microscopic identification emerged as the primary obstacle (59.3%), followed by textbook comprehension (23%) and interdisciplinary correlations (16%). Foundational difficulties dominated first semester, while second-semester students shifted toward advanced integration challenges. Digital resource usage was reported by 65.3% of students, with users experiencing 42% lower difficulty in microscopy and 2.1 times more “easy” exam experiences. However, non-users were 3.4 times more likely to report textbook comprehension problems. Repeaters and male students underutilized digital tools and showed higher difficulty rates. Faculty ratings also influenced outcomes; students with high faculty ratings (≥7) reported greater digital tool adoption and lower difficulty. Qualitative feedback highlighted key gaps, including a “visual-spatial translation gap” between textbook images and microscope views and a need for more practical sessions and interactive teaching. Overall, students strongly favored experiential learning and better resource support to overcome persistent barriers in histology education. Conclusion This study highlights key challenges and opportunities in histology education at a large Ecuadorian public medical school. Students perceive histology as moderately difficult, with microscopic identification remaining the most significant barrier, particularly among early learners and repeaters. As students progress, difficulties shift toward integrating biochemical and physiological concepts, underscoring the need for adaptive instructional strategies. Digital tools clearly benefit learning—reducing perceived difficulty and improving exam experiences—yet access and usage remain uneven, especially among male students and repeaters. Importantly, faculty engagement strongly influences both digital resource adoption and perceived learning quality. Qualitative insights reveal a pressing need to bridge the gap between theoretical content and practical slide interpretation through increased lab time, interactive methods, and improved digital platforms. As the first student-centered study of histology education in Ecuador and one of few in Latin America, this research offers a valuable foundation for evidence-based curricular reform. Implementing blended learning models, enhancing faculty support, and ensuring equitable access to digital resources can revitalize histology education, fostering both competence and engagement. These strategies align with global best practices and can help address persistent resource disparities in public medical training across the region.