Histology education requires students to identify tissue types, recognize microscopic structures, interpret staining patterns, and apply organ-system-specific terminology. Prior research has shown that students often struggle with comprehension and identification of histological images, highlighting the need for improved instructional approaches and practical presentation methods (Garcia et al., 2018; Moammedsaleh, 2024). Students have also demonstrated improved learning when modern education technologies are used instead of traditional tools (Lee et al., 2020). However, limited research has examined whether black-and-white histologic images, which emphasize shapes and tonal patterns rather than color cues, affect student learning, confidence, and examination performance. Findings from this protocol study may help guide histology image presentation, curriculum design, and resource allocation, particularly in low-resource settings. This protocol abstract describes a randomized three-group between-subjects study evaluating black-and-white histologic images as a supplemental learning tool. A target sample of 150 volunteer first-year medical students with no prior histology experience will complete a pre-study survey and then be randomly assigned to one of three groups: color images mixed color/ black-and white images, or black-and-white images. The pre-study survey will collect baseline demographic and study-habit information to assess group comparability. We anticipate that students assigned black-and-white images will perform better because they cannot rely on stain color and instead must focus on structural features and tonal patterns. Primary outcomes will include histology practical examination performance, perceived usefulness, confidence in image identification, and study time. Anticipated limitations include volunteer selection bias and limited generalizability to a single institution.
