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Outbreak! Scenario-Based Instruction in Microbiology

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Outbreak! Scenario-Based Instruction in Microbiology Tested Studies for Laboratory Teaching Proceedings of the Association for Biology Laboratory Education Vol. 34, 5-25, 2013 Outbreak! Scenario-Based Instruction in Microbiology Jan Blom1, Angela M. Seliga2, Xiaojuan Khoo3, Matthew L. Walker4, Nathan Rycroft5 1,2,4,5 Boston University, Department of Biology, 5 Cummington Mall, Boston MA 02215 USA 3 Boston University, Department of Biomedical Engineering, 44 Cummington Mall, Boston MA 02215 USA ([email protected]; [email protected]; [email protected]; [email protected]; [email protected]) With recent outbreaks of swine flu and the emergence of superbugs, it is important to introduce students to the organisms responsible for infectious diseases and how easily they are spread. In this scenario-based learning (SBL) module, students will take part in a simulated epidemic and model the outbreak of an unknown pathogen. Through a six-part series of guided investigations, students will identify the “pathogen” responsible for the epidemic using simple microbiological assays and determine the best treatment to eradicate the pathogen. At ABLE, two of these activities were presented, as well as the development of this module. Firstpage1 Keywords: Infectious disease, synthetic epidemic, antibiotic testing, bacterial morphology, bacterial physiology Page 1 Spacer Introduction The Outbreak! module is a multi-part laboratory exercise cal situation and exposed to relevant issues, challenges and designed to provide students the opportunity to participate dilemmas. They are then expected to apply their knowledge in active, collaborative, and inquiry-based learning in infec- and skills relevant to the situation to navigate through the tious disease epidemiology and microbiology. This mod- exercise. Students will play the role of prospective trainees ule was developed and offered as part of the Biology In- at the fictional “Boston University Center for Disease Con- quiry & Outreach with Boston University Graduate Students trol” (BUCDC). During the course of the trainee orientation, (BIOBUGS) program, an educational outreach program unidentified “pathogenic” bacteria are accidently “released” sponsored by the BU Learning Resource Center (LERNet). into the lab, causing an outbreak of an infectious disease. The mission of the BIOBUGS program is to encourage Bos- Through a series of six hands-on lab activities (Table 1), stu- ton-area high school students to become excited about sci- dents will simulate the release and transmission of the patho- ence by (i) exposing them to sophisticated scientific equip- genic bacteria, and attempt to characterize, identify, and treat ment, (ii) providing interaction with senior undergraduate the “unknown” pathogen. Each activity is designed around and graduate students, and (iii) introducing students to a the overall scenario to maintain engagement and achieve the university campus. More information on the BIOBUGS pro- program objectives. Besides introducing major concepts in gram is available at: http://www.bu.edu/lernet/biobugs/ infectious disease and microbiology, this module also ex- index.html. Although Outbreak! was designed for a high poses students to basic, but essential, microbiology labora- school audience, the laboratory exercises as well as the sce- tory skills including microscopy, catalase testing and gram nario can be easily adapted for undergraduates. staining (Brown, 2012). The Outbreak! module adopts a scenario-based learning (SBL) approach in which students are placed in a hypotheti- © 2013 by Jan Blom, Angela M. Seliga, Xiaojuan Khoo, Matthew L. Walker and Nathan Rycroft 5 Blom, Seliga, Khoo, Walker and Rycroft Table 1: Six-part format of the Outbreak! module. room to adapt the depth and length of instruction and dis- # Activity Description cussion to audience needs. Sample pages from the student packet are included in Appendix A. 1 BUCDC Ice breaker activity for students. The Materials section lists the necessary reagents and Ice-breaker/ Simulate “unknown” pathogen trans- equipment required for each session. Generally, the lab ac- Synthetic mission and highlight key concepts in tivities require minimal preparation and utilize affordable Epidemic infectious disease epidemiology. consumable materials which can be ordered in bulk for sev- 2 Introduction Teach students to mount samples eral laboratory sections. Specialized materials and equip- to the Light onto slides and how to operate a basic ment (e.g., microscopes) can be borrowed from existing un- Microscope microscope. dergraduate labs. Several bacterial cultures need to be grown 3 Gram Stain- Compare morphological and structur- 18-48 hours before the day of the lab. Preparation details are ing al differences to distinguish between provided in Appendix B. different types of bacteria. First step The Notes for the Instructor is an abbreviated version of to identifying “unknown” pathogen the detailed protocols (including classroom prep instruc- 4 Catalase Test Compare physiological differences to tions) distributed to all instructors and volunteers at an hour- distinguish between different types of long pre-lab prep session. Modifications are included within bacteria. Second step to identifying the descriptions of the activities in this section. Generally, “unknown” pathogen each session will have one graduate student assigned as the lead instructor to present the slides, manage the timing of 5 Identifying Summarize data from Activities 3 activities and improvise according to the audience. Addition- the Unknown & 4 to conclusively identify “un- ally, there will ideally be one senior undergraduate or gradu- Pathogen known” pathogen. Illustrate pathogen ate student volunteer at each bench of 6 high school students diversity. to guide the students through the procedures, facilitate mini- 6 Antibiotic Compare bactericidal activity of three group discussions, and communicate with the instructor on Testing antibiotics. Identify the best drug to student progress. treat “unknown”. We have also prepared a Teacher’s Edition packet as a supplement to the Outbreak! module. This packet includes, The BIOBUGS Outbreak! module is typically offered for each of the six lab activities, an outline, background in- over one week of each semester, with a different group of formation, pre- and post-lab questions and activities, as well students in each daily session. Since its inception in 2009, the as relevant references and links. If desired, this packet can module has been held for ten sessions, with approximately be sent to the high school teacher before the lab to equip the 20 students per session. Completion of the module objectives teacher with helpful resources to better prepare students for can readily be accomplished in 3 hours; 2 hours for activities the module. The post-lab questions can also serve as a means and 1 hour for guided inquiry and discussion. However, the to assess student understanding or stimulate further discus- multi-part design of the module allows simple modification sion following completion of the Outbreak! module. to expedite or extend any activity to suit any audience. For The complete student laboratory packet, PowerPoint presen- example, BIOBUGS attendees have ranged from English as tation, materials list, instructor pre-lab protocols, Teacher’s second language students in 10th grade currently taking Biol- Edition packet, as well as teacher/student evaluations and ogy who have never had the opportunity to use microscopes volunteer surveys, are available at http://www.bu.edu/ler- to Advanced Placement Biology students in 12th grade who net/biobugs/outbreak/index.html. have covered infectious diseases. Outbreak! has also been extended to a 6-hour module for high school students in the Upward Bound Math Science program at BU, which is a federally funded TRIO program to prepare low-income and first-generation college bound students for success in post- secondary degrees in these subjects (Fields, 2001). The Student Outline is an abbreviated version of the work- sheets included in a 27-page laboratory packet given to stu- dent participants. Detailed protocols are not found within the original worksheets, nor provided to the students in ad- vance of the module. Due to the variation of the population of high school students who are invited to participate in the BIOBUGS program, the prior background and skills of the students are unknown to the instructors in advance. There- fore, background information, detailed protocols, and discus- sions of results and implications are presented in the form of a PowerPoint slideshow. This gives the module leader some 6 Tested Studies for Laboratory Teaching Major Workshop: Outbreak! Student Outline Activity 1: BUCDC Ice Breaker 1.1 Activity Objective We will create a synthetic epidemic to show the ease with which microorganisms can be spread across a population, an ever-present problem in the clinical area. One employee will unknowingly act as the epidemic initiator. His/her glove is con- taminated with an infectious pathogen. The process of shaking hands will simulate the contact that is necessary for an epidemic to spread. By the end of this activity, you should be able to track down the original source of the “infection” using deductive reasoning, an approach similar to that used by public health officials and epidemiologists. Table 2. Employee ID numbers of possible infected individuals after handshaking. ID # Round 3 Round 2 Round 1 Round 0 1 1 1 1 1 2 2 2 2 2 3 3 3 3 3 4 4 4 4 4 5 5 5 5 5 6 6 6 6 6 7 7 7 7 7 8 8 8 8 8 9 9 9 9 9 10 10 10 10 10 11 11 11 11 11 12 12 12 12 12 13 13 13 13 13 14 14 14 14 14 15 15 15 15 15 16 16 16 16 16 17 17 17 17 17 18 18 18 18 18 19 19 19 19 19 20 20 20 20 20 21 21 21 21 21 22 22 22 22 22 23 23 23 23 23 24 24 24 24 24 Number Infected 1.2 Results Circle the employees that were infected for each round in Table 2. 1.3 Discussion Questions 1. Who is Patient Zero? 2. What is the most likely route of transmission for this pathogen? Explain.
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