Teaching Spotlight – Creating Engaging and Real-world Case Studies for BIOL 155 Tutorials

Lindsay Pallo and Lorenzo Lindo

This term in BIOL 155, instructors Agnes Lacombe and Irene Ballagh collaborated with TAs Lindsay Pallo and Lorenzo Lindo to develop engaging case studies for the weekly tutorial sessions. In addition to creating the case studies, Lindsay and Lorenzo also created pre-tutorial videos to help students develop some content knowledge of the case studies before they came to class.

The case studies have been instrumental in making the tutorial content more relatable and interesting for students, and have brought a real-world context and perspective to the course. As Lorenzo said, “From my own experience with learning anatomy and physiology, I really enjoyed when my instructors would throw in case studies to show the application of what we’re learning. So it is really nice to be able to provide this kind of learning to the students.”

Keep reading to learn more about how the case studies were created, how students have responded to them, and what the team learned along the way.

What motivated you to develop case studies for the BIOL 155 tutorials this term?

During the first term of the course we could see that many students were struggling with the material and losing interest during the tutorials, so the four of us met early in the term to talk about how we could modify the tutorials to improve the students’ experience. We quickly realized that we all shared some common goals: 1) we wanted to make the course more interesting, relevant, and engaging for students, 2) we wanted to bring in a real-world perspective, and 3) we wanted to convey the course material in an effective and accessible way.

To meet these goals, we decided to develop and teach the tutorial content through medically-themed case studies, similar to situations featured in popular medical TV shows, such as Grey’s Anatomy and House. The decision to use case studies, and then to develop accompanying pre-tutorial videos, was largely informed by Lindsay and Lorenzo’s prior learning experiences.

How did you do it?

Lorenzo and Lindsay took the lead in creating the case studies. Lorenzo first developed a set of case studies on immunology and lymphatics, and then Lindsay developed a series of cases based on COVID. They share their processes for creating the case studies below:

Lorenzo: To generate case studies, I reflected on what I’ve seen and experienced in my own work and throughout my education over the years. I would first come up with a main learning objective or take-away that I would like the students to have. Once I had this goal in mind, I’d jot down any interesting diseases or conditions. From there, I would narrow things down to a select few and then work backwards to generate “guiding questions” to help lead students to the answer.  From there I would then pick the case (and its set of questions) that would be the most pertinent to the topic at hand and the one that the students would be able to solve given their level of understanding. I found this quite enjoyable as it helped test my own knowledge – which definitely kept me on our toes about the material.

Lindsay: For me it was a little bit easier having Lorenzo go first because I got to see the format of his tutorial and how successful it was with the students, and then I was able to make my tutorial sort of as a continuation of it. When creating my tutorial case studies, I read for about a week straight trying to figure out the basic science behind COVID and the more interesting points that students might be more inclined to learn about. I really wanted to emphasize points that students may have heard about through social media or through the news, such as losing your sense of taste or sense of smell. After I identified the popular ideas surrounding COVID, I then had to choose which ones would best serve to compliment the anatomy portion of this course. A lot of it was just reading, looking at online figures and images and recreating them in a way that emphasized the points that I thought would be more important for the students to notice. In terms of how I did it, a lot of it came down to the collaboration between the four of us and a lot of the success came from feedback from Lorenzo, Agnes, and Irene. I owe a lot of the outcome to them. Having three pairs of eyes that could look over the case study is quite the luxury. That’s a big resource I had while creating this.

What factors did you consider when creating the sets of case studies?

When creating sets of case studies, there were a number of things to consider. We wanted to make sure that the case studies were both interesting and at an appropriate challenge level for students in the course. BIOL 155 is a first-year level course and is meant to be a gentle introduction into the human body, so some key aspects may be simplified, which makes identifying an appropriate case all the much harder. We needed to provide enough detail, but not too much that the students would get bogged down. We also needed to make sure that the cases were complex enough to be interesting, but could fit in our limited tutorial time.

Additionally, we wanted to include diversity in our case studies, so we chose to feature several different patients and medical conditions across different age groups and sexes. This was done to make the case studies more inclusive and relatable to students. We wanted the students to be able to make personal connections, and maybe even see their relative who’s gone through a similar procedure that’s being outlined in the case study. We also tried to reflect diversity in the initials that make up the patients’ names. For example, we intentionally use letters that aren’t necessarily only found in Anglo last names.

How have students responded to the case studies?

The feedback we’ve received from students has been resoundingly positive – from messages in the Zoom chat, to Canvas messages, to conversations during office hours. Students are more engaged and there is greater participation during discussions than before we started using case studies. We’ve also noticed that the case studies themselves seem to drive more questions from the group. As we work through problems and unravel the rationale for treatments, considerations, or mechanisms for particular diseases, students tend to ask more questions.

And as more students ask questions, we began to learn more about them – particularly with regards to their aspirations and career goals. Often those wanting to pursue dietetics or nutritional sciences would ask more questions about how nutrition plays into the cases; those wanting to pursue medicine or graduate studies tended to ask more mechanism-style questions; and those wanting to pursue nursing or other allied tended to ask more questions about clinical care. In the Zoom-era, it is more difficult to have informal side conversations to get to know students, so it was quite interesting that these case studies enabled us to get to know our students better.

Finally, students are telling us that they are using what they learn in class in their everyday lives. One student in particular stayed after the end of tutorial to let us know that she was sharing what she learned in class about COVID with her family and friends. She is the one science student in her family and she used to feel overwhelmed with questions from family and friends about COVID. After working through the COVID case studies, she now feels more confident in her ability to answer their questions and help them find information.

What have you learned or taken away from this experience?

The process of creating and implementing the case studies has helped us learn too! First, all of the research that goes into preparing a case study involves a lot of learning, but also, students’ questions are helping us to learn a lot as well. They bring up things that we haven’t thought about before. For example, during a case study on kidney transplants, someone asked, “Do they take the left or the right kidney?” We didn’t know the answer, so we looked it up (it turns out that some surgeons prefer one and some surgeons prefer the other for different reasons and it doesn’t affect your outcomes).

How did the team dynamic facilitate the production of your case studies?

The collaborative nature of our team was important for producing these case studies and also good for morale. It was really helpful to have a group of four people to share ideas, review materials, and provide feedback. We used a team Slack channel to communicate, and everyone was accessible and willing to help out. We all shared the common goal of making the course enjoyable for the students and making sure the students are gaining knowledge that they can take forward in their lives.

It also really helped that we all have different backgrounds. Lorenzo and Lindsay both conduct research in immunology, Irene’s background is in neurobiology, and Agnes has expertise in cardiovascular physiology. So we all have certain gaps and holes and strengths, and that was useful when proofreading the case studies. There was always someone who could say, “Wait, I don’t know enough about X to know what you are talking about, so maybe the students won’t either. Explain this a little bit more for us.” Having both the large range of collective knowledge among us, and certain gaps in knowledge in each team member helped to bring in a more rounded picture and also to catch some of the things that would be harder for students to understand.

Is there anything else you’d like to share?

This course has a really interesting and diverse student body, including students from pre-nursing, dietitian, and other medical technician and professional degree programs who work directly in the fields that we’re teaching about and who have a lot of hands-on experience with the course topics. In one of the COVID case studies, we were able to include a student’s experience as a health care worker in a long-term care home. Having that first hand testimony from a peer about their experience in the field was powerful and impactful for students.

What lessons have you learned that you want to share with your colleagues?

It’s not easy to do and it is very time consuming to create case studies, but we feel that it is very rewarding – it makes things fun and the students will be grateful for it. Here are some things that you might want to keep in mind if you decide to use case studies in your course:

  • Give yourself plenty of time to prepare. The more work you do upfront to prepare the case study, the better the experience will be for both you and your students. In particular, allocate lots of time to read and research the topic.
  • Include diversity in your case studies. For example, use names, images, conditions, and situations that represent different age groups, genders, ethnicities, etc. This will help students to relate to the case studies and will make the content more universal.
  • Include students’ own experiences in case studies. Ask students to draw on their own experience or include a student’s first hand experience in the case, if possible. It will help to bring relevance, create ownership, and spark interest.
  • Ask students to develop some content knowledge before engaging in the case study. We created pre-tutorial videos to emphasize specific points that the students should know coming into the case study. This set them up to better engage with the case when they got to class.
  • Put aside your bias. You may have strong opinions about the material in the case study, but putting your feelings to the side will create an open environment where students feel more comfortable asking questions and engaging in discourse.
  • Provide accessible resources so students can continue learning. We found that informational websites developed for the general public (e.g., WHO, Mayo Clinic) were helpful and accessible resources for students who were in the beginning stages of learning about these topics.
  • Utilize the unique strengths and experiences of each member of the team. Synergy happens when each member of the team is empowered to contribute according to their strengths and interests.
  • Develop a clear communication plan with your team. Decide on a communication strategy that will work for everyone on your team (e.g., Slack), and co-create a clear plan that outlines what needs to be done, by whom, and when.
  • Use BioRender to create your own figures. This is a great way to personalize the lessons. You can design your images in a way that emphasizes the points that you think will be most important for the students to notice.

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