Exploring Biotechnology Using Case-based Multimedia

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The following was published in the American Biology Teacher 2006 68(2):77-82.

Exploring Biotechnology Using Case-based Multimedia
Bergland, M., Lundeberg, M.A., Klyczek, K., Sweet,J., Emmons, J., Martin, C., Marsh, K.,
Werner,J. Jarvis-Uetz, Michelle.

Update
: Since this article was written, new versions of the Case It! software have been made
available for downloading at the Case It! web site, free of charge for educational use
(http://www.uwrf.edu/caseit/caseit.html
). In addition to the DNA capabilities described below,
the simulation now includes ELISA, Western blot, and 96-well PCR tools for the analysis of
infectious disease cases including SARS, influenza, West Nile, and HIV. Video cases for HIV in
the U.S. and Africa are also included with the free download.

Today, teachers face more challenges than ever, and biology teachers face a special challenge.
As technology continues to expand, biology teachers have a responsibility to keep students
informed of technological and scientific advances. Biology teachers must also address ethical
issues associated with these advances. Here we describe our experiences using case-based
molecular biology simulations in high school and introductory college biology classes. This
software enables teachers to meet several national science standards, such as connecting science
to real-life situations and encouraging students to think about the relationships among science,
technology and society. The realistic simulation also encourages students to explore careers in
molecular biology and genetics, and gives students experience both in building web pages and
Internet conferencing.

Another important feature of the Case It! project is its focus on the underlying genetics of the
cases. Even at an introductory level, it is important that biology students understand the science
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of genetic testing. The media reports genetic findings almost daily but, in an attempt to simplify
the information, fails to make distinctions between concepts such as genetic probability and
genetic certainty (Trumbo 2000). Students need the information necessary to critically analyze
what the media reports and to use scientific facts to determine whether a report is factual or has
been affected by over simplification or sensationalism (Anderson 1998). For example, the
Human Genome Project has led to understanding the underlying genetics of various conditions,
and further advances in the science of genetic testing are being made (Jegalian 2000). With an
understanding of the science behind genetic testing, students will have the tools necessary to
make informed decisions about the applications and ethics of genetic testing.

The issue of ethics is an extremely important component of high school and university science
curricula. Both the American Association for the Advancement of Science and the National
Research Council recommend that ethics be included in the science curriculum (American
Association for the Advancement of Science 1993). Students will need to understand the
possible ethical ramifications of future technological advances so that they can make informed
decisions about the use of these technologies. If students are introduced to the topic of ethics as
they explore scientific topics, instead of during a separate course in college or graduate school,
they may be better prepared to handle ethical issues later in life (Barden, Frase, Kovac 1997).
By teaching students ethics, we can hopefully instill critical thinking and responsible decision-
making into our students.



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Standards
As a science teacher, it may be useful to know how Case It! aligns with some of the goals for
school science that underlie the National Science Education Standards (National Academy of
Sciences, 1995). For example, goals such as” understanding the …world”, using “scientific
processes and principles in making personal decisions”, engaging “intelligently in public
discourse and debate about matters of scientific and technological concern” are met by
incorporating ethics, genetics, technology, and personal and social perspectives into the
curriculum (p.1). The Unifying Concepts and Processes Standard is addressed throughout Case-
It. The Case-It environment enables students to use evidence, models and explanations through
simulations, making posters and conferencing. Case-It addressed the Assessment Standards by
providing authentic assessment tasks, giving students opportunities to demonstrate their
achievement, and it helps develop self-directed learners as students do research, make posters,
and role play. After researching information, students hold Internet discussions relating current
health issues to the study of genetic diseases and ethical decisions. Our research has shown that
50% of students chose a specific disease to research because someone in their family had been
affected by it (Lundeberg, Bergland, Klyczek & Hoffman, 2003). Case It! incorporates the
Standard on History and Nature of Science by requiring students to assume the roles of a
genetics counselor and a research scientist. Through these roles, they investigate and evaluate
information to construct a Web poster that forms the basis for discussing the molecular and
genetic basis of heredity and diseases. Completion of the simulation may lead a student to
identify a personal interest he/she was unaware of before assuming these roles. The environment
also enables students to carry out practical exercises which otherwise are too expensive to be
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done in a normal lab, thus enhancing the standard on Science as Inquiry. .These applications also
fit nicely into the Content Standard on Life Science (genetics, biotechnology) and the Content
Standard related to Science and Technology.

Overview of the Case It! Project

Case It! is a National Science Foundation-sponsored project initiated by participants in the
BioQUEST Curriculum Consortium. The goal of Case It! is to enhance case-based learning in
high school and university biology courses worldwide via molecular biology computer
simulations and Internet "poster sessions." Schools in Wisconsin, Massachusetts, North
Carolina, England, and Zimbabwe, among others, have participated in the project.

Case It! includes three software tools: Case It! Investigator
to gather background information on
genetic diseases; the Case It! simulation
to analyze DNA related to these diseases, and the Case
It! Launch Pad
to access a web page editor and Internet conferencing system. Although the 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 ethical ramifications which
make them particularly well suited for spirited discussion and debate.

Use of Case It! Software

The capabilities of the Case It! software allow teachers to use the program in a multitude of
ways, adapting the project in the manner that best suits their classrooms. Teachers might use the
software and cases to add a realistic dimension to genetics. The Case It! program can be
demonstrated by the teacher to support lecture material on a variety of topics relating to genetics
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and genetic testing. The software could also be used by students in conjunction with a gel
electrophoresis or PCR lab. The Lab Bench feature of the Case It! simulation allows students to
virtually set up the gel by pipetting the DNA into the wells, connecting it to a power source, and
running the gels for an appropriate amount of time. This allows students to become familiar with
the equipment and procedures before using expensive lab materials (Figure 1).

Figure 1. Sample screen shot from the Lab Bench screen of Case It!.

The Case It! simulation could also be used in place of a lab, saving money on equipment while
giving students a general knowledge of equipment and procedures involved in genetic testing.
Case It! could also be combined with other multimedia technology. For example, a teacher may
choose to have the students run and interpret the gels or blots, research the genetic disease, then
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present the information in a PowerPoint presentation. Or, students might construct web pages so
that others in the class (or students in other states and countries) can view and critique their web
posters through the web conferencing system that is another feature of the Case It! system. If a
teacher did not want to take the time to engage students in conferencing, the web conferencing
could be replaced with a class discussion of the posters and/or genetic diseases. These are just a
few examples of possible ways to incorporate the Case It! software into a biology class. This
software offers teachers considerable flexibility so that each teacher can decide how Case It! can
be best used in his or her classroom.

Example of Class Use
In our own classes, we have incorporated role-playing, collaboration and peer review into the
assignment. Only a brief overview is possible here, but details of class testing, including
examples of student work, can be accessed via the Case It Home Page
(http://www.uwrf.edu/caseit/caseit.html). To summarize, the procedure we have used can be
divided into four steps:
(1) Use Case It! Investigator to read the case itself and also to assist in gathering background
information on cases from Internet sources.
(2) Use the Case It! simulation to test for the presence or absence of genetic mutations in
hypothetical "family members" using RFLP analysis, Southern blotting, or dot blotting, and then
save the graphic results as .GIF files.
(3) Use the Case It! web editor to combine background information with results of genetic
testing (.GIF file images) to create web page "posters" for use during Internet conferencing.
Each group's poster is linked to a discussion board accessed via the Case It! Launch Pad.
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(4) Conference with other students, playing the roles of genetics counselors and family members
discussing the results of genetic testing.

First, students use Case It! Investigator to provide background information on cases and to assist
in the search for additional information from relevant web sites. Students begin in Case It!
Investigator by reading the case of choice and a synopsis of the disease, such as the following
scenario for breast cancer:
Case A: While Elizabeth is reading the morning newspaper, she notices an ad for a free genetic
screening for breast cancer at the clinic next week. The ad specifically invites women of
Ashkenazi Jewish ancestry to participate. According to the newspaper ad, subjects will be tested
to see whether they have mutations in the BRCA1 gene which would predispose them to breast
cancer. Elizabeth, age 27, had heard about the discovery of the gene and about the mutation
linked to Jewish women. Her paternal grandmother had been diagnosed with breast cancer at age
51 and died two years later, and Elizabeth worried that she had inherited the disease. She also
worried about her mother, age 52 and apparently cancer-free so far, and her 7-year old daughter.
Her daughter is not allowed to participate in the screening, but Elizabeth convinces her mother to
go with her to get tested.

Students also research symptoms, treatments and resources for the hypothetical “family
members” in the case they have chosen. When students click links or use the button bar to
access pull-down menus of links, Case It! Investigator will automatically open their web browser
to those Internet sites, and keep track of them for future reference. The information they gather
during this phase of the process will be used later in building a web-page "poster" in preparation
for Internet conferencing (see the section entitled "Case It! Launch Pad").

Next, students play the role of a lab technician as they use the Case It! simulation to analyze
DNA sequences associated with their particular case (Figures 2 and 3). Capabilities of Case It!
Version 4.02d include restriction enzyme digestion, DNA gel electrophoresis, PCR, Southern,
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and dot blotting (the new Version 5.0 adds Western blotting, ELISA, and 96-well PCR). After
running analyses, students use the simulation to take “photos” of the resulting gel blots and save
them for later incorporation into web pages via the web page editor.

Figure 2 from the breast cancer disease case illustrates the dot blot capability of Case It! V4.02d.
In this example, Elizabeth, her mother, and an unrelated woman have been tested for the
presence or absence of three genetic mutations associated with a greater probability of
contracting breast cancer. Results indicate that Elizabeth's mother and the unrelated woman test
positive for the 185 and 4184 mutations, respectively, but that Elizabeth does not test positive for
any of the three mutations. The other positive results on this image are controls for the three
mutations.


Figure 2. Results of dot blot testing for the breast cancer case.

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In addition to breast cancer, cases developed and class-tested to date include Alzheimer's disease,
breast cancer, sickle-cell anemia, Duchenne’s muscular dystrophy, cystic fibrosis,
phenylketonuria, Huntington's disease (Figure 3), and fragile-X syndrome. We originally
downloaded the appropriate DNA sequences for the various disease conditions from Genbank, a
government repository of genetic information, then modified the sequences to create multiple
scenarios involving hypothetical "family members" being tested for the presence or absence of
disease mutations. Thus, cases included with the simulation are reasonably realistic and give
results similar to what would be obtained analyzing actual DNA samples.



Figure 3. Results of Southern blot testing for the Huntington's disease case.
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Case It! Launch Pad

After using the Case It! simulation to analyze DNA, students create "posters" via a custom web
page editor accessible from the Case It! Launch Pad. This editor enables students to easily add
and edit the various sections of their web pages and to incorporate gel/blot photos and other
images. The integrated web page editor/conferencing system is designed for ease of use, even if
students have had no prior experience building web pages or conferencing. After creating their
posters, students begin web conferencing. Students play the role of genetics counselors when
responding to questions concerning their own poster, and play the role of family members when
sending messages concerning other groups' posters.

Numerous ethical issues can be discussed at these "counseling sessions," including questions
regarding the molecular biology of the disease, symptoms, treatment, and ethical issues that
might arise. The Launch Pad organizes links to each group's discussion forum and published
web page, and provides a feature for compiling messages sent by individual students, which
makes it easier to grade student participation in conferencing.

As an example of how posters are graded, we include the rubric used for this purpose in Figure
4:
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Rubric for evaluating web posters: Poster #: Total score =

Quantity of Information 1 2 3 4
Just gel blot gel blot &
background info
Blot, info & small
statement to family
Blot, info, statement to
family & explanation

Quality of Information related to disease 1 2 3 4
Major
inaccuracies
Some
Inaccuracies
Correct basic
information
Correct info and some in-depth
investigation is apparent

Accuracy of gel blots 1 2 3 4
Gel blot is
missing

Gel blot is
wrong

Gel blot is slightly wrong
Not all blots are present or
labeled
Gel blot labeled
correctly and
done correctly

Interpretation of gel blots 1 2 3 4 5
No
interpretation
Some
Inaccurate
interpretation
Slight misconception of
meaning of gel blot, e.g.,
confusing terms;
over interpreting results
some
interpretation

Understanding
and
interpretation
is clear

Statement to Family 1 6 9 12 15
No diagnosis or
counsel given

gives
poor/vague
counsel
Correct diagnosis but
offers no counsel for
family
Correct diagnosis &
presents ethical issues
or treatment or
resources to family
Mentions
ethical issues,
treatment &/or
resources to
family

Creativity and Design 1 2 3 4
No background

Background not
pertinent
Background pertinent to
topic, but difficult to read the
text
Background pertinent to the
topic and text can be read easily

Pertinent Photos and Animation 1 2 3 4 5
No photos or
animation
Some photos
and animation,
but not
pertinent to the
topic
Photos and
animation pretty
good, but some not
pertinent to the
topic
Pertinent photos
and animation, but
not used to clarify
info in the text
Photos and
animation pertinent
to the topic and used
to clarify
information in the
text
Grammar 1 2 3
Many organizational, spelling
or grammar problems
Some problems Good organization of information,
few spelling or grammar errors

Figure 4. Rubric used for evaluating posters.
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As the rubric illustrates, as part of their poster students interpreted results and then wrote a
statement to the family. For example, here is the statement written by two high school students
to the family in the breast cancer case scenario:

Dear Elizabeth,

This is the follow-up letter that was promised to you after completing the counseling session.
You were concerned by the fact that your paternal grandmother died of breast cancer at age
51, and your ancestry, Ashkenazi Jews, have a history of developing breast cancer. Though
you and your mother have not developed any symptoms of the disease, your concern for the
possibility of breast cancer is understandable.

The test results showed that you and your mother have the mutation 185delAG in the gene
BRCA1. In understandable terms, this means that you have a deletion of a section (AG) of
DNA after the 185 base pair on the q (long) arm of the 17th chromosome. These genetic
mutations have not been proven to cause breast cancer, but, it raises the risk of developing
the disease. Because you show no symptoms commonly associated with breast cancer, it is
our determination that you and your mother do not currently have breast cancer. However, in
the future, you still have a greater risk of developing breast cancer because of the mutation.
To catch breast cancer in its earliest stages, it is completely necessary to receive a
mammogram at least once a year. More importantly, it is necessary to complete a self breast
examination monthly to document any changes in the physical anatomy of the breasts. If
there are any changes, contact your personal physician immediately for further consultation.
We hope that your counseling session and this follow-up letter have been of great service to
you and your mother. If you or your mother have any further questions, please feel free to
contact us at your own convenience.


Summary of Evaluation Results
During the past several years, we have involved pre-service teachers in videotaping, observing
and interviewing introductory biology students as they use Case It! computer software to analyze
DNA sequences associated with cases involving genetic diseases. In the first year we focused on
understanding what biology students were thinking as they were cooperatively working through
the computer simulation (Lundeberg, Shearer, Bergland, & Klyczek, 1998). The conversations
students engaged in were primarily focused on five aspects of scientific methodology: problem
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interpretation, discussing procedures, performing experiments, interpreting results, and verifying
results and procedures. For example, students made sure that their wells were loaded correctly,
that they used the correct restriction enzymes and probes, and that the results they obtained made
sense. One important advantage of the simulation was that students could easily correct errors
and redo their work.

In the second year, we decided to evaluate whether students who engaged in the simulation
became more aware of the ethical implications of genetic testing than those who did not. In this
year, we included pre and post-tests to measure ethical awareness. We interviewed students and
began to examine the kinds of communication they were engaging in over the Internet when they
discussed the web posters they had created. Students were asked to put themselves in the role of
a genetics counselor and to describe any ethical issues associated with the results of a case.
Volunteers who experienced the simulation outperformed those who did not. During interviews
and open-ended written evaluations, 95% of the student volunteers reported gaining greater
understanding of biology: Significantly, students reported that they gained an understanding of
biology that was relevant to their future (Lundeberg, Mogen, Bergland, Klyczek, & Johnson,
2002).

In the third year, we investigated whether students learned more and preferred using web posters
and the associated Internet conferencing as compared to cardboard posters and live conferencing
(Lundeberg, Bergland, Mogen, Meirhofer, Sage, Moore, 2000). Data from interviews and open-
ended comments showed that the majority of students learned more and preferred the web-based
posters, although no group differences were found on tests. The majority of students thought they
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learned more (65.22%) from the Internet posters sessions, although some thought they learned
equally from both kinds of sessions (21.74%) and some thought they learned more from the live
poster sessions (13.04%). Students who thought they learned more from the web poster sessions
emphasized the value of gaining new perspectives from their peers’ questions and feedback:
“I had to think on my own and answer a question I hadn’t thought of before. It made me go into
depth about my project…”

Because of these results, we stopped using cardboard posters and live conferencing and instead
focused our evaluation on the effects of expanded Internet conferencing, including university and
high school students in the U.S. and university students in England. We observed high school
students daily for a month as they ran the computer simulation to analyze data, create their web
posters and conference with university and other high school students regarding their posters
(Lundeberg, Bergland, Klyczek & Hoffman, 2003). Results from the high school students
corroborated those we obtained from university students.

In sum, the results from these studies have shown that both university and high school students
developed more confidence in their understanding of genetic testing, became more aware of the
ethical dimensions of how such scientific problems affect society, and connected content in an
introductory science course with everyday life.

Conclusion

In contrast to Fabos & Young (1999), we found that students' Internet conferencing fostered
extended explanations and discussions of ethics in science. Based on our experience and
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evaluation results, Case It! software can help teachers incorporate real-life situations into the
classroom and relate them to molecular biology and genetics.

Case-based learning can also be an effective way to engage students in learning science. It
encourages problem-motivated investigations of biological phenomena (Stepien & Gallagher,
1993), especially if students first grapple with problem-based cases, then build on the ideas
presented in the cases (CTGV, 1997). Role-playing during Internet conferencing is one way to
accomplish this, although other approaches may be used as well.

Our goal is to expand the Case It! project to include high schools and universities worldwide,
and we cordially invite interested educators to participate. To download the latest versions of the
software, at no cost, visit the Case It home page at http://www.uwrf.edu/caseit/caseit.html
.

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