Teaching third-year students MALDI-TOF using a combination of online interactive simulation and face-to-face practical inquiry

Identifying disease-causing microorganisms in patient samples is a cornerstone activity in clinical diagnostic microbiology laboratories. This process relies on traditional microbiological techniques alongside advanced technological methods, such as matrix-assisted laser desorption ionization-time-of-flight mass spectrometry (MALDI-TOF). Despite its growing prevalence in diagnostic settings, access to MALDI-TOF equipment remains limited in smaller laboratories, in regional centers, or in third-world nations. Consequently, many students in microbiology and related academic programs often lack opportunities for hands-on experience with this technology during their education. We overcame these limitations by implementing a blended teaching approach into an Infectious Diseases course, combining face-to-face practical inquiry with an innovative MALDI-TOF online simulation. The simulation enabled students to process patient samples from various body sites (e.g., swabs, cerebrospinal fluid, etc.) by selecting appropriate culture media and performing key microbiological tests. Students then confirmed preliminary identification by loading an individual colony onto a virtual MALDI-TOF target plate for analysis. The simulation then generated data mirroring a typical MALDI-TOF report, which uses a color-coded system to indicate confidence scores. The impact of this intervention on student learning was assessed through a written laboratory report and a questionnaire featuring Likert-scale and open-ended questions. Students demonstrated significant improvements in self-reported understanding, with nearly all participants successfully passing the written assessment. The approach was found to be enjoyable, interactive, and enhanced authentic learning. This study underscores the value of simulations as a cost-effective and scalable alternative for teaching advanced diagnostic techniques when access to expensive equipment is limited.