Collaborative Case-Based Study of Genetic and InfectiousDisease via Molecular Biology Computer Simulations and

Internet Conferencing

Mark BerglandKaren Klyczek

Mary Lundeberg

VOLUME 13

INTERNATIONAL JOURNAL OF LEARNING http://www.Learning-Journal.com First published in 2006 in Melbourne, Australia by Common Ground Publishing Pty Ltd www.CommonGroundPublishing.com. © 2006 (this paper), the author(s) © 2006 (selection and editorial matter) Common Ground Authors are responsible for the accuracy of citations, quotations, diagrams, tables and maps. All rights reserved. Apart from fair use for the purposes of study, research, criticism or review as permitted under the Copyright Act (Australia), no part of this work may be reproduced without written permission from the publisher. For permissions and other inquiries, please contact <cg-support@commongroundpublishing.com>. ISSN: 1447-9494 (print), 1447-9540 (online) Publisher Site: http://www.Learning-Journal.com The INTERNATIONAL JOURNAL OF LEARNING is a peer refereed journal. Full papers submitted for publication are refereed by Associate Editors through anonymous referee processes. Typeset in Common Ground Markup Language using CGCreator multichannel typesetting system http://www.CommonGroundSoftware.com.

Collaborative Case-Based Study of Genetic and Infectious Diseasevia Molecular Biology Computer Simulations and InternetConferencingMark Bergland, University of Wisconsin-River Falls, United States of AmericaKaren Klyczek, University of Wisconsin-River Falls, United States of AmericaMary Lundeberg, Michigan State University, United States of America

Abstract: Case It! is a National Science Foundation-sponsored project to promote collaborative case-based learning inbiology education, via free molecular biology computer simulations and Internet conferencing. In this session, we willdemonstrate how Case It! Software can be used to enhance understanding of molecular biology techniques for analyzingcases based on genetic and infectious diseases, as well as awareness of ethical issues associated with these diseases. Studentsfirst use the Case It! simulation to analyze DNA and protein sequences for cases involving genetic diseases or infectiousdiseases such as SARS, HIV, West Nile, and influenza, among others. Simulated tools for case analysis include DNA andprotein electrophoresis, Southern blotting, Western blotting, dot blot, PCR, and ELISA. After analyzing the cases, studentsconstruct web-page "posters" using the Case It! Web Editor. They then play the roles of counselors, medical personnel,"family members", and others as they ask and answer questions about the case results using a custom Internet conferencingsystem hosted on our web site. Class-testing involving students in the U.S., the U.K. and Africa have validated this approachto case-based learning - see http://www.uwrf.edu/caseit/caseit.html for details. Workshop participants will discuss how theCase It! system can be adapted to their home institutions.

Keywords: Case-based Learning, Collaborative, Internet Conferencing, Computer Simulations, Molecular Biology, GeneticTesting, Protein Diagnostics, HIV, SARS, Influenza, Disease

Introduction

CASESTUDIESCAN be powerful motivat-ors to engage students in the scientific andsocial issues associated with biologicalconcepts (1). The Case It! software package

provides an electronic framework for students to in-vestigate case studies that utilize molecular biologylab techniques, and to share their results with peersvia internet conferencing.We have developed severalcases that focus genetic and infectious diseases. Ge-netic diseases include Sickle cell disease, Hunting-ton's chorea, breast cancer susceptibility, and cysticfibrosis; infectious diseases include HIV/AIDS, in-fluenza (avian and human), West Nile, SARS andEbola. The software and cases may be downloadedfree of charge for educational purposes from the CaseIt! Home page, http://caseit.uwrf.edu (2).

The Case it! ProjectCase It! is an NSF-sponsored project that was initi-ated at a BioQUEST (3) faculty workshop in 1995.The goal of the project is to facilitate collaborativecase-based learning in biology classes via molecularbiology simulations and internet communication.The software that has been developed includes threemain components:

Case It! simulation. The simulation softwareincludes tools for DNA and protein analysis.The current version (v. 5.03) includes DNAelectrophoresis (Fig. 1), restriction enzyme di-gestion, PCR, Southern blot, dot blot, proteinelectrophoresis,Western blot, and ELISA. Anynucleotide or amino acid sequence can beopened and analyzed, but we have included se-quences associated with the case scenarios thatare part of the software download. The casesthat are currently available emphasize geneticand infectious diseases.

INTERNATIONAL JOURNAL OF LEARNING, VOLUME 13, 2006http://www.Learning-Journal.com, ISSN 1447-9494 (print), 1447-9540 (online)

© Common Ground, Mark Bergland, Karen Klyczek, Mary Lundeberg, All Rights Reserved, Permissions: cg-support@commongroundpublishing.com

Fig 1: The lab bench feature in the Case It! simulation software, demonstrating agarose gel electrophoresis. Theprogram keeps track of which DNA samples, restriction enzymes, PCR primers, or probes have been opened,

how DNA samples have been modified, and which samples are loaded into the gel

Case it! Investigator. Investigator is a separatesoftware program that functions as an electronic re-source manual and helps students gather backgroundinformation about their cases. The most recent ver-sion includes video cases for HIV/AIDS that are setin both the U.S. and Africa. Investigator is customiz-able, so instructors can add their own resources.Case it! Launch Pad. The Launch Pad is a web

site that organizes the collaborative components ofthe project. It includes a web page editor and bulletinboard system. Instructors can set up a class wherestudents can work individually or in teams to builda web page “poster”. Each poster has a bulletin boarddiscussion associated with it to facilitate communic-ation via virtual “poster sessions”.

Classroom ImplementationWe have used the Case It! Software extensively withintroductory biology classes for non-science majors.Students play the role of lab technicians as theyanalyze the DNA or protein sequences associatedwith their case. They use Investigator to gather addi-tional background information about the case. They

then prepare a web page that is linked to the Case It!Lauch pad. In addition to interpreting the lab testresults, students are asked to include a statement tothe family members. They then play the role offamily members or other stakeholders as they usethe conferencing system to ask questions of the otherweb page authors. They answer questions posed totheir ownweb page in the role of genetics counselors,AIDS counselors, or other role appropriate for theircase. Alternatively, the simulation software couldbe used on its own, with students presenting the res-ults of their cases in the form of written reports, oralpresentation, or other formats.We now have several years of experiences using

the genetic disease cases in classes. In addition toaddressing biological concepts, these cases bring upmany ethical and social issues regarding genetictesting, confidentiality, and treatment options (4).For example, in one of the cases involving Hunting-ton's chorea, a 23-year-old woman with a familyhistory of the disease encourages her 17-year oldbrother to be tested along with her. Students run theSouthern blot simulation to determine whether thebrother or sister test positive for the disease, and then

INTERNATIONAL JOURNAL OF LEARNING, VOLUME 13

write a statement that explains the test results. Duringthe internet conferencing, students raise questionsabout the ethics of such testing, such as whethersomeone as young as John should be tested, or aboutthe value of tests for late-onset diseases with nopreventative treatment. Over 90% of participatingstudents indicated that the cases encouraged them tothink about ethical decisions they might face in thefuture (5).Cases involving infectious diseases were recently

developed to utilize the new protein analysis simula-tions added to the Case It! software. Several casesfocus on HIV and AIDS. We obtained permissionto use videos published by the Discovery Channelin the U.S. andMedia for Development Internationalin Africa. These videos are incorporated into Invest-igator as part of the case scenarios (Fig. 2). The

variety of case scenarios allows students to comparethe circumstances faced by HIV-positive people indifferent parts of the world. For example, one caseis about Anna, an U.S. immigrant from Guatemala,who finds out that she is HIV positive during herpregnancy. She is surprised, since she thought thatshe and her boyfriend were in a monogamous rela-tionship. To analyze the case, students run an ELISAto test the blood of Anna, her boyfriend, and her babyfor antibodies to HIV proteins (Fig. 3). They thenrun a Western blot to confirm any positive ELISAresults (Fig. 4). These results can be save as graphicalimages and uploaded to the web editor system. Stu-dents would write a statement to Anna explaininghow shemay have been infected andwhat the implic-ations are for her health and the health of her baby.

Fig. 2: Video cases in Case It! Investigator. Video cases are available for the HIV/AIDS cases. The "Anna"case, set in the U.S., is shown. A transcript of the video appears in the right window while the video plays. In-structors can opt to have the video interrupted with questions designed to get students thinking about what they

are viewing and how it relates to their understanding of HIV/AIDS

MARK BERGLAND, KAREN KLYCZEK, MARY LUNDEBERG

Fig. 3: ELISA results for the Anna case. The wells were coated with HIV proteins, and blood samples fromAnna (first and second trimester), her boyfriend, and her baby, as well as positive and negative control samples,were added to the wells and an ELISA was run. Samples containing antibodies to HIV proteins will producecolor. According to the optical density (O.D.) results, Anna’s first trimester sample (well C1) is negative, buther second trimester sample (D1) is positive. Her baby’s sample (E1) also tests positive, while the boyfriend’s

sample (F1) is weakly positive

Fig 4:Western blot results for the Anna case. HIV proteins were separated by polyacrylamide gel electrophoresis,and the blood samples described in Fig. 1 were used in a Western blot. The positive control sample (lane 1)binds to all six HIV proteins (left to right (largest to smallest), gp160, gp120, p55, gp41, p32, p24). To be con-sidered a positive result, two of the following proteins must be bound: gp120, gp41, p24. Anna’s second trimestersample (lane 4) and the boyfriend’s sample (lane 5) are positive. The baby’s sample (lane 6) is considered inde-

terminate, since it is not completely negative but it does not meet the requirements for a positive result

During the Spring 2005 semester, an IntroductoryBiology class at UW-River Falls interacted with aclass of pre-service science teachers at the Universityof Zimbabwe. Both groups of students worked

through HIV cases set in the U.S. and in Africa, andhad the opportunity to experience the cases fromdifferent perspectives through Internet conferencing.

INTERNATIONAL JOURNAL OF LEARNING, VOLUME 13

AssessmentStudent understanding of the biological conceptsunderlying the diseases and lab tests, as well as theirability to address the social and ethical issues associ-ated with the cases, have been assessed using pre-and post-testing, surveys, evaluation of the web pagesand discussionmessages, and focus group interviews(1,5,6). We have several years of class testing dataregarding the use of genetic disease cases (1, 5).Students using the simulations and participating ininternet conferences showed gains in conceptualknowledge compared to the control group (5). Fur-thermore, these students reported increased confid-ence in their understanding of the biology of geneticdiseases. They also reported that the questions askedduring internet conferencing prompted them to con-duct additional research in order to answer thequestions, which added to their understanding.Students in the Spring 2005 Introductory Biology

class improved their understanding of HIV/AIDSbiology, based on the results of pre- and post-tests(average score 13.3/20, compared to 8.1/20 on thepretest), which required interpretation of clinical testresults. They also self-reported more confidence intheir understanding of the disease. Both groups theUWRF students and the University of Zimbabwestudents reported that the cases made the issues seemmore real, as illustrated by these comments fromstudents in Zimbabwe:

“Tome it was an eye opener… Since Zimbabweis hard hit by HIV it is important to have this

project CASE IT since it affects the students’lives at large. The videos shown are touching.These can help students feel it.”“The programme was also very interesting

because it had cases of real people that got in-fected in different ways and situations … andthe counselling they were given and how someobserved the advice and some ignored this ad-vice got themselves into worse trouble.”

Future DirectionsWe are continuing to add new features to the soft-ware. The most recent version of the software willopen entire bacterial genome sequences for analysis.New infectious disease cases are being developed,including malaria, Salmonella, and various sexuallytransmitted diseases, as well as additional geneticdiseases focusing on cancer. In addition, we areplanning to develop simulations of microarray ana-lysis and real-time PCR, and links to online bioin-formatics tools and databases. If you are interestedin contributing ideas for cases and/or having yourclass participate in the project, email Mark Berglandat mark.s.bergland@uwrf.edu .

AcknowledgmentsThis project was supported in part by the CCLI pro-gram of the National Science Foundation (DUEGrant 0229156). Opinions expressed are those of theauthors, and not necessarily those of the Foundation.

References

1. Lundeberg, M.A., Bergland,M., Klyczek, K., Mogen, K., Johnson, D. &Harmes, N. 1999. Increasing interest, confidenceand understanding of ethical issues in science through case-based instructional technology. Educational ResourcesInformation Center (ERIC) Clearinghouse on Assessment and Evaluation, document #TM029926.

2. Bergland, M. S. (2006) Case It! Home Page. http://caseit.uwrf.edu .3. Stanley, E., and Jungck, J. (2006) The BioQUEST Curriculum Consortium. http://www.bioquest.org.4. Lundeberg, M.A., Mogen, K.L., Bergland, M.S., Klyczek, K.K., Johnson, D.L. and MacDonald, E. (2002) Fostering

ethical awareness about human genetics through multimedia-based cases. J. of College Science Teaching, 23:64.5. Lundeberg, M.A., Bergland, M., Klyczek, K. (2002) Using pre-service science teachers as research assistants for an in-

ternational web-based project involving collaborative case-based learning. Proceedings of Pathways to Change:an international conference ontransforming math and science education in the K16 curriculum. STEMTECH,University of Massachusetts - Amherst.

6. Foster, A., Manakore, V., Phillips, M., Lundeberg, M. A., Gwekwerere, Y.,Bergland, M. S., and Klyczek, K. K. (2006)Understanding, Confidence, Perceptions, Constraints, and Affordances within a Case-BasedMultimedia Environ-ment. Paper presented at the ED-MEDIA World Conference on Educational Multimedia, Hypermedia, and Tele-communications, http://www.aace.org/conf/edmedia/sessions/index.cfm/fuseaction/PaperDe-tails?CFID=23417974&CFTOKEN=16980951&presentation_id=30114.

About the AuthorsMark BerglandMark Bergland is a Professor in the Biology Department at the University of Wisconsin - River Falls. He hasbeen PI for four NSF grants to developmolecular biology computer simulations for case-based learning involvinginfectious and genetic diseases. His software has been disseminated via the BioQUEST Library CD-ROM and

MARK BERGLAND, KAREN KLYCZEK, MARY LUNDEBERG

the Internet, and results of past projects have been presented at numerous professional meetings and workshops.He received the 1990 and 2003 Outstanding Faculty Member of the Year Awards and also the 2004 ScholarshipAward for the College of Arts and Sciences, Science Division.

Karen KlyczekProfessor Karen Klyczek is Chair of the Biology Department at UW-River Falls. She was the PI for two NSFTeacher Enhancement Awards to provide biotechnology in-service training for secondary life science and agri-culture education teachers. She has presented at numerous workshops and conferences dealingwith biotechnologyeducation, and has received NIH funding for the study of gene regulation in tumor cells. In 2000 she was namedthe University Distinguished Teacher at UW-River Falls, and is also a past recipient of the Outstanding FacultyMember of the Year Award for the College of Arts and Sciences, Science Division.

Mary LundebergMary Lundeberg is Chair of Teacher Education at Michigan State University. She has extensive experienceevaluating the use of case pedagogy for various National Science Foundation projects. She is a past recipientof the Wisconsin Teacher of the Year Award and the Teacher of the Year award for the College of Education,UW-River Falls.

INTERNATIONAL JOURNAL OF LEARNING, VOLUME 13

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