Improving anatomic pathology in sub-saharan Africa to support cancer care

Objectives: Cancer care requires both accurate pathologic diagnosis as well as pathologic cancer staging. We evaluated three approaches to training pathologists in sub- Saharan Africa to perform pathologic cancer staging of breast, cervix, prostate, and colorectal cancers. Methods: One of three training methods was used at each workshop: Didactic, case-based testing (CBT), or a blended approach. The project involved 52 participants from 16 pathology departments in 11 countries in East, Central, and Southern Africa. Evaluation of each method included preand postworkshop knowledge assessments, online pre- And postworkshop surveys of practice changes at the individual and institutional levels, and selected site visits. Results: While CBT resulted in the highest overall average postassessment individual scores, both CBT and blended approaches resulted in 19% increases in average scores from pre- to postworkshop assessments. Institutions that participated in the blended workshop had increased changes in practice as indicated by the institutional survey. Conclusions: Both CBT and a blended approach are effective methods for training pathologists in pathologic cancer staging. Both are superior to traditional lectures alone.