Case It! is a project to enhance case-based learning in university biology courses worldwide through the use of molecular biology computer simulations and Internet conferencing. In class testing, university students who volunteered to participate in this project developed more awareness of ethical issues associated with genetics than did the nonvolunteers.

Many nonscience majors have difficulty envisioning events of molecular metabolism—and who can blame them. It is also easy to imagine why these students fail to see how molecular events impact their everyday lives. Given the increasing social and ethical implications of DNA research in biotechnology, medicine, and genetic engineering, however, students, especially nonscience majors, need to develop an understanding of these topics and the way they will shape students’ lives beyond the college campus.

Pressed for time, many introductory biology instructors focus on science facts and ignore the ethical dilemmas associated with DNA research. Other instructors, who believe in introducing students to the social consequences of biological discoveries, offer students models of ethical decision making (Johansen and Harris 2000) and engage students in discussions of controversial applications of scientific discoveries (Anderson 1998; Dooley 2000; Eckdahl and Malone 2000).

Case studies are another vehicle for presenting science concepts (Herreid 1999). Cases are being used in science classrooms to teach students to think critically about specific relationships between science and society. They are particularly valuable for encouraging students to explore ethical dimensions of situations (Lundeberg, Levin, and Harrington 1999) and for fostering students’ problem-solving skills through investigations of real-life dilemmas (Barrows 1998; Lundeberg, Levin, and Harrington 1999; Stepien and Gallagher 1993).

One of the strengths of case studies is their reliance on written work. Writing is an important tool for developing student understanding of science (Ambron 1987; Koprowski 1997; Petersen 2000; Stewart 1989; Trombulak 1989). Rather than assigning a traditional research report as part of the case study, students can craft multimedia papers that other students can access, read, and evaluate, forging a collaborative, peer-review process (Francek 1999; Henderson and Buising 2000).

In our classroom we combined the potency of human genetics case studies with the rigor of research reports to create an assignment in which a group of student volunteers—using software and tools from the Case It! website—conduct a DNA electrophoresis simulation of a human genetic disease, consider the ethics of their scientific results, and present the results to their peers. A major focus of this assignment was to assess whether using a case-based simulation and having students conduct research and discuss their projects over the Internet with peers increased students’ awareness of the ethics associated with the scientific results they obtained.

Case It! Tools

Case It! is a National Science Foundation-sponsored project to integrate molecular biology computer simulations into a framework for case-based learning for introductory biology students worldwide. Students can use investigative simulation tools to study problems in human genetics, forensics, or phylogeny. Case It! is modeled after the 3-Ps approach of the BioQUEST Curriculum Consortium: problem-posing, problem-solving, and peer persuasion (Peterson and Jungck 1988). The BioQUEST Consortium promotes undergraduate biology curriculum reform through collaborative development of curricula (bioquest.org).

The goal of Case It! is to enhance case-based learning in high school and university biology courses via molecular biology computer simulations and Internet “poster sessions” (Klyczek and Bergland 1996; Bergland 1997; Bergland and Klyczek 1998). The website includes three software tools: Case It! Investigator to gather background information and to access the hypothetical human genetic disease case scenarios; Case It! Simulation to analyze DNA from the cases; and Case It! Launch Pad to access a webpage editor and Internet conferencing system.

Although Case It! Simulation works with any DNA sequence, we have concentrated on human genetic disease cases because of the high degree of student interest in these cases and the ethical ramifications that make them particularly well suited for spirited discussion and debate. Cases developed and class-tested to date include Alzheimer’s disease, breast cancer, sickle-cell disease, muscular dystrophy, cystic fibrosis, phenylketonuria, Huntington’s disease, and Fragile X syndrome.

Students use Case It! Investigator to glean background information on cases and search for additional information from relevant websites (Figure 1). After gathering their background information, students use Case It! Simulation to run analyses for DNA sequences associated with their particular case. The program is capable of performing restriction enzyme digestion, DNA gel electrophoresis, Southern blotting, dot blotting, and PCR.

Figure 1. A portion of sample screen from Case It! Investigator showing a customizable menu of websites.

After using the Case It! Simulation to analyze DNA, students create “posters” for counseling via a custom webpage editor accessible from the Case It! Launch Pad. This editor enables students to add and edit the various sections of their webpages and incorporate gel/blot photos and other images. The Launch Pad also organizes links to each group’s discussion forum and published webpage, and provides a feature for compiling messages sent by individual students. The integrated webpage editor/conferencing system is designed for ease of use, even if students have had no experience building webpages or conferencing.

We used the case scenarios involving genetic diseases in a nonmajors’ introductory biology course, which meets for one-hour lectures twice a week and two-hour labs once a week. Genetics is only one of the topics taught in this biology course. Other topics include experimental design, evolution, photosynthesis, respiration, and ecology. In the lecture portion of genetics, students learn about transcription, translation, and mutations. In the lab portion, students isolate DNA and perform both PCR and forensics experiments.

Classroom Assignments

We started by administering a case analysis task to 53 students (both an experimental group (students who volunteered to do the Case It! assignment) and a control group (students who did not do the Case It! assignment but attended regular lecture and lab classes). The case analysis task was designed to measure students’ awareness of ethical issues before and after completion of the Case It! assignment.

The case analysis task included a human genetics case about a couple who are expecting their third child. They suspect that their oldest child may have Fragile X syndrome, so they undergo genetic counseling. The case offers background on this disease and results from gel electrophoresis and southern blots of the DNA fragments. (This case is included in appendix A.) Students interpreted the results and answered this question: As a genetics counselor, what would you advise this family about ethical issues raised by these results?

We first assessed awareness of ethical issues using this case analysis task after lectures on genetics but before any Case It! assignment work had been performed by the experimental group. Then we administered this case analysis task a second time to compare the knowledge gained seven weeks later, after the experimental group completed their Case It! assignment.

Students’ Case It! assignment consisted of the following activities:

1) In pairs, during a two-hour lab period with their lab partners, students visited the Case It! software website and chose one of the cases involving a genetic disease (sickle-cell anemia, Huntington’s disease, Alzheimer’s disease, cystic fibrosis, Duchenne’s muscular dystrophy, phenylketonuria, or breast cancer) to study. (To see an example of a case on cystic fibrosis, click here.)

2) Students went to selected websites (included in the Case It! Investigator) to research their disease for their web posters. They collected information on the molecular biology of the disease, symptoms, treatment, and resources for families. Next, students played the role of lab technicians with their lab partners in the computer lab using the electrophoresis simulation that is part of the Case It! website. They then went through the procedures involved in DNA testing for genetic diseases (e.g., obtaining DNA sequences and loading these DNA fragments into wells). Students saved these results and images to include on their web posters.

3) On their own time after class, students conducted additional DNA testing for genetic diseases on at least two of the case variations in the disease they selected. Most cases have more than one variation so that students can consider additional results. They also finished constructing their web posters, interpreting the gel blot results, and writing a statement to the family explaining these results and the attendant ethical issues.

4) For a two-week period, students shared their Internet posters with other students in different introductory biology sections after class. This gave students an opportunity to ask questions about one another’s posters and to revise their posters before the live poster conference, which took place during the last lab section. We have since allowed lab time for students to conference with introductory biology students in England, Australia, Massachusetts, and Colorado, and have found that students really enjoy having a distant audience for poster conferencing (Figure 2).

Figure 2. Example of discussion between two students.

5) During the live poster conference, students were put in the role of genetics counselors and were asked to consider ethical consequences when they interpreted results from the human genetics cases. Faculty played the part of family members involved in genetics counseling who were hearing the results of their DNA tests.

Data Analysis

A major focus of this assignment was to assess whether using a case-based simulation and having students conduct research and discuss their projects over the Internet with peers increased students’ awareness of the ethics associated with the scientific results they obtained.

Most of the students in our introductory biology course, in which this case study assignment was given, were nonscience majors in their second semester of college. In the seventh week of the course (after the case analysis task was first administered as a pretest), 39 students (15 men and 24 women) from Biology 100 (74 percent of the class) volunteered to participate in this case-based simulation for extra credit. Twenty-six percent (14 students: 6 men and 8 women) chose not to participate in the project. All 53 students participated in pre- and posttesting and these results are described in the next section.

An interdisciplinary team consisting of the authors and six preservice science teachers devised a scoring rubric to use with the case analysis task after reading 12 answers as a group and coming to a consensus on how these should be rated. After reading the 12 answers, the team discovered that it was consistent in the rating procedure, so the members divided into pairs to score the rest of the case analysis tests. The raters were not told whether students were in the experimental (volunteer) group or control group, nor whether students’ answers on the case analysis task were pre or post.

Students’ advice to the family about ethical issues raised by these results was evaluated on a scale of 0 to 3: (0 = no understanding of results; 1 = interpret results correctly and/or mention one ethical issue (e.g., abortion); 2 = interpret results correctly and/or mention two ethical issues (or one ethical issue in depth); and 3 = interpret results correctly and/or mention three ethical issues (or two ethical issues in depth). Only a few students had no understanding of the results, misinterpreted the data, or made extremely vague suggestions to parents about the ethical issues surrounding the case; their answers were scored 0. Students who received scores of 1 interpreted results correctly and mentioned an ethical issue (e.g., abortion). For example, one student wrote, “I would tell them that there is a good chance that the unborn baby will have Fragile X syndrome. I would tell them that there are definitely options but wouldn’t lean toward abortion.” The majority of students moved from discussing one ethical issue to discussing two issues, as this student did: “The unborn fetus has the Fragile X syndrome. Right now they have the choice of whether or not to have the baby, knowing that they already have one son with the syndrome. This also raises the question of whether or not to have more children knowing that they are both carriers of Fragile X syndrome.” Very few students scored results of 3, which meant they interpreted results correctly and mentioned three ethical issues (or two ethical issues in depth). For example, one student wrote: “You should be aware that if you decide to have more children, there is a good chance that you could pass the genes for the disease on to them. You could choose to terminate this pregnancy, but you should also be aware that there are other options. You should do some more research on the disease before you make your decision. You could also keep the baby or give it up for adoption.”

In addition to the case analysis data, six preservice science teachers involved in a seminar under the direction of the first author interviewed the students in the experimental groups at the live poster sessions, asking these questions: Do you think doing this project was valuable or not? Why or why not? Do you think doing a poster session like this is valuable or not? What about this project needs improvement? What was the most positive thing you learned from this project? Why?

Interviews were tape recorded and transcribed, and we constructed categories of analysis for the responses to interviews following Miles and Huberman’s (1984) approach to qualitative analysis. Raters sorted the data into similar ideas and formed initial categories of these ideas for the interview responses. Initial categories were condensed until there was consensus among raters and no new categories emerged.

Discussion of Results

Results from data of the case analysis task show that volunteers who participated in the simulation exercise outperformed those who did not. Students’ awareness of ethical issues increased significantly for those in the volunteer group, t = 2.24, p <.03, but not for those in the control group, t <1.

In addition, in interviews during the poster sessions and open-ended written evaluations, 95 percent of the student volunteers reported gaining greater understanding of one or more of these aspects of biology: DNA and human genetics, genetic testing, knowledge of particular diseases, and/or application of biology to their future lives. Of those who reported learning more, 35 percent reported gaining greater understanding of DNA and human genetics; 31 percent gained knowledge of particular diseases; 28 percent said they understood more about the processes of genetic testing; 18 percent of students valued interpreting results from gels; and 20 percent of the students reported that they gained an understanding of biology that was relevant to their future lives, as these comments illustrate:

• I learned a lot about DNA and genetic testing. I think it’s a good thing to be aware of the prenatal-testing opportunities available, should I ever want to take advantage of DNA testing when I decide to have children.
• I think that the Case It! project overall was valuable because it made me relate this to my actual life. It wasn’t just an experiment.
• Being a nonbiology major I learned a lot. This is what I will carry with me from this class.

Several students commented on the value of communicating with peers though Internet conferencing “to expand and enhance our poster,” and that it was helpful “because we [were] told how we could have improved our poster instead of just making a poster and handing it in.” During interviews, students reported that questions from other students prompted teams to do additional research. For example, two students acknowledged, “ . . . some people did ask good questions that we didn’t know and so we had to do some more investigating.”

In the Internet conferencing, students probed for information on ethical issues that a genetics counselor might face. For example, in responding to a poster on Alzheimer’s disease, a student asked: “What would you do if a loved one had the disease? Since the disease develops over time would you look at assisted suicide? How close are we to finding a cure?” The student team responded: “Yes, I agree it would be very difficult to find out that a loved one had Alzheimer’s. The best thing that I could honestly do would be to support them and to give them all of the love and care [possible]. No, I would not look at assisted suicide for a patient with Alzheimer’s disease, this disease comes on gradually and does not affect the person all of the time . . . I don’t think that it is worth ending someone’s life for this . . . .”

Finally, a few students commented on the value of learning communication skills in the context of role-playing a genetics counselor, for example:

• I think it helped the students interact with each other. Also, this gave us an important insight on what a genetic counseling job is like.
• I thought that this was a very valuable opportunity. It gave us as students a chance to experience firsthand the difficulties that come with DNA testing. It was also good because it taught us discussion skills because we had to tell the family what was going on.

There were no significant differences in students’ end-of-semester grades in the biology course between the experimental group (volunteers) and the control group (those who chose not to volunteer). Thus, we attribute performance gains on the case analysis task to the multimedia simulation and conferencing rather than differences between volunteers and nonvolunteers. Students in the volunteer group stated that the simulation should be used for everyone, so this experience is now part of the biology curriculum rather than an extra-credit project.

Use It!

As professors, it is always difficult to incorporate new ways of introducing material into an already overcrowded curriculum. Including cases on genetics and taking the time to show students how to use the multimedia simulation, create web posters, and use an Internet-conferencing system meant that other curriculum areas needed to be reduced. The gain the students made in connecting DNA and human genetics to their personal lives, however, is significant. In the long term, this is what we feel our students will remember. When they encounter genetic issues in their own lives—and undoubtedly many of them will—they will have a better understanding of both the science and ethical implications.

We invite interested educators to participate in the Case It! project. To download the latest versions of the Case It! computer simulation, at no cost, contact Mark Bergland (mark.s.bergland@uwrf.edu). Institutions willing to participate in the Case It! project are also welcome to use our integrated webpage editor and conferencing system. See the Case It! homepage for details (www.uwrf.edu/caseit/caseit.html).

Mary Lundeberg, department of teacher education, Kim Mogen, Mark Bergland, Karen Klyczek, and Doug Johnson, department of biology, Eric MacDonald, departments of teacher education and biology, University of Wisconsin-River Falls, 410 S. Third, River Falls, WI 54022; e-mail: Mary.A.Lundeberg@uwrf.edu.

Note

This project is supported by the Course and Curriculum Development program of the National Science Foundation (DUE Grants 9752268 and 9455425). Opinions expressed in this article are those of the authors and not necessarily those of the National Science Foundation.

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