Improving student learning outcomes and perception through a blended learning strategy based on virtual microscopy for teaching a histology laboratory course

While light microscopy (LM) and virtual microscopy (VM) are valuable pedagogical approaches in histology education, studies comparing their effectiveness have primarily emanated from North America. This research aimed to compare the performance, satisfaction, and perception of Chinese undergraduate dental students enrolled in a histology laboratory course using a blended learning approach (LM + VM) versus traditional LM learning. A total of 182 first-year students were divided into two groups with similar age, gender, and academic backgrounds. The LM + VM group received a blended learning curriculum combining LM and VM, while the LM-only group participated in traditional LM-based learning. The students in the blended learning group achieved a significantly higher mean score on the laboratory exam than the students in the traditional learning group [LM + VM 79.36 +/- 10.11 vs. LM-only 74.76 +/- 14.71; degrees of freedom (df) = 180, P = 0.01]. Additionally, the LM + VM group had a lower failure rate [i.e., grade F for students scoring below 60; 3.23% (LM + VM) vs. 13.48% (LM-only), P = 0.02]. The implementation of VM was well received by students in the LM + VM group, who, while disagreeing that VM could entirely replace LM, overwhelmingly preferred the blended learning model (93.55%). Furthermore, students in the LM + VM group reported higher satisfaction levels compared to the LM-only group (t = 8.49, df = 180, P < 0.001). Overall, blended learning with LM and VM resulted in significant improvements in student performance, satisfaction, and perception compared to traditional LM learning.