Content_Cases_ACS_2005

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Using Case Studies to TeachContent in an Introductory

Biochemistry Course

Kathleen Cornely

Department of Chemistry and Biochemistry

Providence College

Providence, RI 02918

This slideshow is posted on my website at

http://www.providence.edu/chm/kcornely/Casebook.htm


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Why use case studies? The case study method involves teaching

scientific theory and content in a framework

that students can relate to in their own world. Students develop analytical problem-solving

skills and higher-order thinking skills.

Students practice oral and written

communication skills. Uses collaborative/cooperative (rather than

competitive) learning strategies.

Involves ambiguity.


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Why use case studies? The intellectual exercises carried out

by a student engaged in case-studyanalysis are similar to the activities ofa research scientist.

These exercises are good preparation

and training for students who wish tobe scientists.


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Why use case studies in

biochemistry?

The difficulty of engaging learners in the

processes and problems of science is mostlikely to occur in the first year coursesdealing with fundamental topics, as the

learners are not yet prepared to perceivethe relationship between these topics andthe practice of their careers.

Rivarola, V., and Garcia, M. B. Biochemical Education 28 (2000), p. 30-31.


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Three types of biochemistry case

studies Metabolic case studies

Inborn errors of metabolism

Analysis of real scientific data Taken from introductory biochemistry concepts

found in the current literature

Case study projects involving current events Thalidomide Genetically modified foods (Ann Taylor, Wabash

College) Olestra Anthrax


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1. Metabolic case studies Each case describes the symptoms of a

patient who is under the supervision of a

physician. In most cases, the disease suffered by the

patient is an inborn error of metabolism; iea particular enzyme in a metabolic pathway is

deficient or nonfunctional. Students diagnose the patient and determine

the missing enzyme; explain why the enzymeis responsible for the observed symptoms.


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Goals and limitations Goals

Provides an exercise which will allow the

students to synthesize informationregarding intermediary metabolism.

Show how analytical problem-solvingstrategies are used in a clinical situation.

Limitations Its difficult to find such exercises for the

other content areas covered in the course.


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Expand the case study method Use the case study method throughout

the course, not just during the study ofintermediary metabolism.

Concerns

Where do I find such cases?

Would using the case study method detractfrom covering essential content area inbiochemistry?


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The process vs. content

debate Core knowledge

Boyer (BAMBED 28 (2000), pp. 292-296) has

suggested a list of core topics that should becovered in an intro biochemistry course.

Or core skills? Ross Feldberg (BAMBED 29 (2001), pp. 222-

224) suggests that instructors make up a skillset.

Then address how each topic contributes to theacquisition of that skill.


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One mans skill set How to carry out quantitative calculations related

to pH, buffering, spectrophotometric analysis,

kinetics, dilutions and thermodynamics. How to place the various topics covered into an

overall context.

How to understand and evaluate the nature of

scientific evidence. How to read scientific literature to learn more

about specific topics.

How to read a biochemistry textbook.

Feldberg, R., Biochemistry and Molecular Biology Eduation 29 (2001) 222-224.


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Content or directed case

studies First described by physiologists Cliff and Wright (Am. J.

Physiol. 270: S19-S28 (1996)) They wrote clinical cases designed to teach students basic

principles of anatomy and physiology. The cases were built around very specific learning objectives,

rather than being open-ended.

Questions are straightforward and emphasis is on informationthat is available to the student.

The case study method is used as an alternative to thelecture to convey scientific content to the students. Some instructors are reluctant to use the case study method

because they feel that doing so would decrease the amount ofcoverage of the material.


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2. Analysis of real scientific data

Use the biochemical literature to writecase studies, or problem sets that askthe students to analyze scientific data.

The case study is used as a vehicle toconvey content; at the same time,

students develop higher-order analyticalproblem-solving skills.


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3. Case study projects

These types of case studies follow the formatsuggested by Clyde F. Herreid.

Case studies were traditionally used in business and

law; in 1997 Herreid published an article in JCST andencouraged scientists to do the same. Case studies are stories with a message. Case study problems involve class discussion;

instructor guides students toward the solution of a

problem. The goal of the case study methods is not so

much to teach the content of science (althoughthat does happen), but to show how the processof science works.


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The Scientist, 28 February 2005


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Case study projects: Content

and conflict Cases are used to convey scientific principles to

biochemistry students.

The issues chosen also involve a conflict that thestudents must grapple with.

The case studies described here are timelytheyaddress issues currently in the news. FDA approval of thalidomide The use of Olestra as a fat substitute

Genetically modified foods (Ann Taylor)

The anthrax scare of 2001


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Case teaching method Students are given the following materials:

A fictional story describing characters on different sides of the dilemmaposed in the case study.

Scientific background information about the topic. Copies of relevant papers and web site references.

The class is divided into three groupseach interestgroup has a certain point of view. Students read papers and are given specific questions to answer from the

point of view of their assigned interest group. Evaluation

Students hand in written answers to questions posed in the case study.

Each group prepares a short presentation to the class using the point ofview of their interest group.

There is time allowed for class discussion. Students are given grades for

their participation.


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Thalidomide makes a comeback Case Synopsis

An FDA official must decide whether to shut

down buyers clubs which importedthalidomide from foreign countries anddispensed it to their members for thetreatment of AIDS.

AIDS activists were pressuring the FDA toapprove thalidomide, since it had shownpromise in the treatment of AIDS andcancer.

Bennett, N., and Cornely, K. J. Chem. Educ.78

(2001), p.75

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1.


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Thalidomide makes a comeback Description of interest groups and assignments

Scientific consultants to the thalidomide victims

Draw R/D enantiomers of thalidomide. Analyze teratogenicity of the pure isomers and a racemic

mixture.

Medical researchers Deduce the role of TNF-E in HIV.

Assess role of thalidomide in changes of TNF-E. Drug designers

Write mechanism for the acid hydrolysis of thalidomide.

Assess ability of chemical analogues to inhibit TNF-E.production.

Design analogues that will effectively TNF-E production.


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Thalidomide makes a comeback Class discussionissues to address

Who is this case of importance to, and what are

their interests? Is thalidomide effective for the treatment of AIDS

and cancer?

What is societys responsibility to thalidomidevictims?

Is it possible to design a distribution protocol thatis entirely risk-free?

Should the FDA official use her authority to shutdown the buyers clubs?


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Is Olestra an effective weight

loss aid? Case synopsis

Olestra was approved by the FDA after a very

lengthy and expensive study process. The FDA required Proctor & Gamble to place

warning labels on Olestra-containing foodpackages, and to monitor possible ill effectssuffered by users of the product.

There are groups (most notably the Center forScience in the Public Interest) and individualswho oppose the use of Olestra and would like theFDA to rescind its approval of this food additive.


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loss aid? Description of interest groups and assignments

Proctor & Gamble scientists

Explain why the Olestra formulation was changed fromliquid sucrose polyester (SPE) to a semisolid form.

Analyze biophysical data of different forms of SPE.

FDA Scientists Analyze plasma values of lycopene and F-carotene in

control and Olestra-fed volunteers.

Address the addition of fat-soluble vitamins to Olestra-containing products.

Consumer groups Discuss FDA approval process.

Address issues of concern to consumers for this foodadditive.


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loss aid? Class discussionissues to address

Describe the chemistry of Olestra and the

physiology of the fat digestion process. Is physical discomfort a serious problem for

Olestra users? Is vitamin depletion?

What issues did the FDA need to address in its

approval process? Is Olestra safe?

Will the use of Olestra really help individuals loseweight?


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The anthrax scare of 2001 Case Synopsis

Following the terrorist attacks on the World Trade

Center and the Pentagon, a number oforganizations and individuals were the targets ofbioterrorism involving weaponized anthraxcontained in letters.

Scientists have yet to conclusively identify all of

the strains involved. The response by public health officials was

inadequate.

Antibiotic prescription by physicians and use bymany individuals was almost certainly

inappropriate in most cases.


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The anthrax scare of 2001 Description of interest groups and assignments

Microbiologists Describe the mechanism of antibiotics in general and

Ciprofloxacin in particular. Address the ramifications of large-scale antibiotic therapy.

Address issues concerning vaccinations.

Biochemists Interpret experimental data from Nature Biotechnology(2001)

19,

958-96 in which a polyvalent inhibitor of the anthrax toxinwas designed.

Describe why antitoxins are preferable to antibiotics.

Geneticists Design various protocolsfor example, how to prepare a

library for one of the anthrax plasmids. Assess the effect of mutations of various toxin proteins.


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The anthrax scare of 2001 Class discussionissues to address

Detailed biochemical mechanism for anthraxinfection.

Using what you know about the mechanism, howwould you design drugs to treat anthrax-infectedindividuals?

What are the responsibilities of (a) physicians and(b) the public concerning antibiotic use?

What kinds of measures should be put in place toprevent bioterrorist attacks? What should be theappropriate response when the attacks do occur?

Is the attention paid to these issues appropriate?


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Summary Well-designed case studies can convey

scientific content as well as addressing

societal issues. The instructional goals of the case study

exercises were met by the students. Written work was of high quality.

Oral presentations were well-researched andeffectively delivered.

Students report a high level of enjoyment ofthe case study exercise.


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SummaryInstructors reflect on the teaching-

learning process and design newproblems that exercise their studentshigher order thinking skills as well astheir own.

White, H. B. BAMBED 28 (2000) P. 211.


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Metabolic case studies

resources Scriver, C. R., Beaudet, A. L., Sly, W. S., and Valle, D., eds. (consulting

eds. Stanbury, Wyngaarden and Fredrickson) The Metabolic Basis ofInherited Disease, 1989, McGraw-Hill.

Montgomery, R., Conway, T. W., and Spector, A. Biochemistry: A

Case-Oriented Approach

(1990),Th

e C. V. Mosby Company, St. Louis. Devlin, T. M. (ed.) Textbook of Biochemistry withClinical Correlations

(1992) Wiley-Liss, NY. Halperin, M. L., and Rolleston, F. S. Clinical Detective Stories: A

Problem-Based Approach to Clinical Cases in Energy and Acid BaseMetabolism (1993) Portland Press, London.

Luduea, R. F. Learning Biochemistry: 100 Case Oriented Problems

(1995) Wiley-Liss, NY. Higgins, S. J., Turner, A. J., and Wood, E. J. (1994) Biochemistry for

the Medical Sciences: An Integrated Case Approach, Wiley and Sons,NY.

Glew and Ninomiya. Clinical Studies in Medical Biochemistry (1997),Oxford Publishing.

Write your own using The Metabolic Basis of Inherited Disease (ed

Stanbury, Wyngaarden and Frederickson), McGraw-Hill, as a resource.


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Analysis of scientific data

resources Cases in Biochemistry, published in 1999

by John Wiley & Sons, has been updated

and can be found athttp://www.providence.edu/chm/kcornely/Casebook.htm

Jozsef Szeberenyi regularly publishes these

types of exercises in Biochemistry andMolecular Biology Education; these are inmultiple-choice format.


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Case study projectsresourcesHal White has compiled a list of articlespublished in Biochemistry and Molecular

Biology Education (formerly BiochemicalEducation) and has posted the citations on hisweb site:

http://www.udel.edu/chem/white/teaching/BiochEd/articles.html


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Case study projectsresources Clyde Herreid and Nancy Schiller have compiled a list of

case studies developed at their annual case-writingworkshops held at University of Buffalo.

http://ublib.buffalo.edu/libraries/projects/cases/case.html

P. K. Rangachari of McMaster University has postedseveral of his case studies on his web site.

http://www.fhs.mcmaster.ca/pbls/writing/


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Interested in other cases? Case-study and problem-based learning

exercises are regularly featured in

columns in these journals: Biochemistry and Molecular Biology

Education (BAMBED)

Journal of College Science TeachingJournal of Chemical Education


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Have you written your own

cases? Submit to the above-mentioned journals

and web sites.

Consider publishing on BioMoleculesAlive, the new ASBMB and BEN-sponsored digital library.

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