Stephen D. Cole

Louis Pasteur opened his famed essay Germ Theory And its Application on the Antiseptic Principle of the Practice of Surgery with a phrase that can be translated as “the sciences gain by mutual support.” The concept behind this statement is applicable in science and medical education as well. Not only can scientific fields support other fields, those studying a science can also support each other. Students in some science-based, professional programs (like ours at Penn Vet) may work in groups in certain types of clinical courses (e.g. problem-based learning discussion groups, clinical rotations), but they also spend a considerable amount of time in basic science and clinical lectures without active peer engagement. 

Alongside the logistical and time barriers that make integrating groupwork difficult into a busy basic science course, I recognize that it can be difficult for our students to engage with the relevance of the immune system when inundated with learning content covering seven different domestic animal species. It is not easy to make a mostly “invisible” (AKA microscopic) system stand out among the rhythmic beating of the heart or the rigid complexity of the skeleton or the dramatic gasps of the lungs. In this article, I will describe how, in a traditionally didactic course, I have used groupwork that integrates knowledge and skills from other parts of our curriculum to make immunology, one of the basic science courses in the curriculum, feel more relevant to our students’ career goals. 

Our immunology course is team taught by ten dedicated and brilliant faculty with expertise across a wide range of every major aspect of the immune system. Each lecture is dynamic, top notch and cutting-edge. However, the disadvantage to this team-taught approach is that the course can feel like a high-end lecture series that doesn’t flow smoothly. When I became the course organizer, it was my goal to help the students connect the “basic science” that they learn in the lectures to the “real-world” patients and problems they will soon face as clinical veterinarians. To accomplish this, I wanted to design virtual groupwork activities where students would use skills beyond those we teach directly in our course. I put in some extra work to understand where my students stood in terms of the skills that I would need them to use. I looked through syllabi from other courses, spoke with other instructors and conducted informal conversations with students after each activity session. As instructors, it’s important that we understand what our students learn elsewhere in the curriculum (although I admit I have a distinct advantage because I am a graduate of our VMD program).

Ultimately, I designed four activities, first used in spring 2021 and then again in spring 2022 with some adjustments. All activities were held via Zoom breakout rooms in randomly assigned groups of 5-6 students. At least two faculty were available for questions in the main room throughout. Groups submitted their work together via a Canvas group page upload and feedback was provided via comments on that page from the course organizer. Completion and active participation contributed to their final grade in the course. The four activities were:

Journal Club: We used this activity to introduce novel topics and help students see the relevance of research to clinical practice.  After some preparation presented by the faculty that explained topics students might not be familiar with, students read a short article on toll-like receptor expression during a clinical case of demodicosis (an overgrowth of skin mites). Then they worked in groups to evaluate the article’s scientific rigor, patient population and implications on clinical practice. 

Show-and-Tell: Each student in the group performed background research on a commonly used diagnostic immunoassay for infectious diseases of domestic animals. They specifically identified what the test detected (e.g. antibody or antigen), described the technology used (e.g. ELISA) and explained a particular factor that could affect interpretation of results (e.g. age of animal, vaccination status). The group then completed a table for submission following review of the background research by each student. 

Infographic: Following a lecture on vaccinology and vaccine hesitancy in pet owners, groups selected a platform (either Piktochart or Powerpoint) to design an infographic to answer the question “Are vaccines safe?” which were submitted for evaluation.  After students completed this project, we highlighted the importance of clear communication skills and indicated the importance of approachable language explanations.

Clinical Case Work-up: Following a lecture on inherited disorders of the immune system in dogs, students were asked to work through a “paper case” of a puppy with recurrent infections. Together, students developed a problem list that ranked the dog’s problems in degree of specificity, then linked the dog’s breed to an inherited disorder of Border Collies and crafted a message to describe the diagnosis and prognosis to the dog’s owners. 

I believe these activities have been successful, not only because they are engaging and make the material more applicable, but also because they help to provide context for our course within the entire professional veterinary program.  Throughout we emphasized that we chose small groups for these activities so that students can build rapport over the activities (we assign groups randomly, which stay fixed across the four activities). We also explained that the group approach is reflective of smaller, consistent teams which are the norm in a veterinary setting. 

After two years of completing these activities, feedback from students has been positive overall. Students have stated that “the [activities] were a great way to get us thinking about the material” and that “while they were not in person, they were some of the most engaging labs that I have had at Penn.” Occasionally we have heard that they “are what students make of them” and that some groups “mostly worked in silence in the online format.” Future directions for our class include making sure that all groups are getting something out of the activity with active check-ins or debriefs.

At Penn, across the faculty and schools, most of us teach within the context of a larger program. Many of our students may or may not have similar career goals or ideas, but active groupwork can be used to help contextualize our courses within that larger program and within a field or fields that students are likely to pursue. It shows our students that we care about their success beyond our own individual courses or classrooms when we can draw on their other experiences in a program and show them how they may ultimately use what they are learning. Within the Penn Vet immunology course, I suspect it points out to our students that our course has implications far beyond the final exam--that the skills and knowledge they gain in our course have implications on their entire career path. Groupwork allows students to practice key abilities and demonstrate foundational understanding, but most importantly, work with potential future colleagues while it is still “okay” to make mistakes. 

Stephen D. Cole is an assistant professor of clinical microbiology at Penn Vet.
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This essay continues the series that began in the fall of 1994 as the joint creation of the College of Arts and Sciences, the Center for Teaching and Learning and the Lindback Society for Distinguished Teaching. 

See https://almanac.upenn.edu/talk-about-teaching-and-learning-archive for previous essays.