You had me at bone marrow bingo

by | 27 Mar, 2018 | 0 comments

The study of blood doesn’t tend to conjure up images of classroom banter, bingo calls or The Biebs. Until Associate Lecturer Rebecca Keppel and her team of scientists decided to change all that.

This story was originally published on UTS: Newsroom and is reposted here with permission. 

Together they’ve reimagined the way their students learn about haematology at UTS, designing a series of games and authentic assessments that help students learn what they need in a way that’s interesting to them.

With a warm impish smile and a laugh that makes her shoulders bob, it’s easy to see that Rebecca Keppel’s a bit of fun. And as she talks through the activities she’s introduced to her classes – like ‘bone marrow bingo’ and ‘diagnose a celebrity’ – you can’t help but get caught up in her enthusiasm. Which is funny, says Rebecca, because “I never thought I’d be a teacher. My mum was a teacher and I was set on a career in microbiology.”

Today, the Associate Lecturer in the School of Life Sciences (and a UTS biomedical science graduate) splits her time between both roles, teaching at the university and working at Liverpool Hospital. Officially, says Rebecca, her title is Hospital Scientist. “I spend my day at the microscope looking at over 100 blood films and making diagnoses on these patients. A lot of us teaching Haematology 1 and 2 work part-time in the industry, meaning we still work in labs day-to-day. What we wanted was for our students to actually learn what we were doing in the lab outside of university, so they can build the skills required in the workplace. Most importantly though, we wanted to make these experiences fun! We wanted to create hands-on activities that would engage our students.”

So, what did they do?

Well, says Rebecca, “We developed a project to design activities that would change the way our students learned. We termed it ‘small things that make a big difference’. One example was the ‘case study project’. In the case study project, groups of students are assigned a set of case studies, progressing from basic to advanced. At each stage, the groups are assigned a celebrity exhibiting symptoms of varying degrees – we’ve Miley Cyrus, Bieber, you know the usual tabloid headliners. The students must look at the symptoms their celebrity is presenting and then proceed to order tests for the patient so as to find out what’s wrong with them.”

To help the students, Rebecca and her team (Susan Green, Toni Flanagan, Karieshma Kabani, Daniel Mediati, Samira Aili, Reece Ajaka, Hiba Bahidh and Tamara Carrodus) designed a PowerPoint slide deck with embedded macros. As students work through the slide deck, they are prompted to ask, ‘which test do I order next?’. Choosing from four possible tests at each stage of the diagnosis, the macros work in the background to calculate the total costs of their selected tests, and for each test the group selects, presents the relevant results.

“What we wanted was for our students to actually learn what we were doing in the lab outside of university, so they can build the skills required in the workplace.” Hopefully, says Rebecca, at the end of the simulation the groups have enough information to make their diagnosis for their celebrity, all while keeping to their assigned budget.

“The activity focuses on the skills students need in the workplace – students need to interrogate a range of symptoms, to be realistic about the total test expenditure, to be able to interpret certain results, and importantly make a progressive link to a diagnosis,” she explains. “In some cases, someone might try to order a bone marrow biopsy for a patient that has come in with a fever. In a real situation, that’s not a logical step. By assigning them real people, albeit famous celebrities, with ‘real’ symptoms, we hope the students will get a sense of what it’s like to order tests for a patient. It’s about teaching them to make sense of what they are seeing results-wise and the next steps to take. It’s all a process and they need to learn that process.”

It’s just the same when looking at cell changes under a microscope. That’s where ‘bone marrow bingo’ comes in. “We introduced ‘bone marrow bingo’,” says Rebecca, “because looking at a bone marrow slide is just hideous. As a scientist, I don’t even do it in the industry!” Previously, tutors would dedicate an entire three-hour practical class to students examining bone marrow slides under a microscope. “To give you an idea that’s asking them to identity a single cell in 10 billion,” Rebecca says.’

“The students were just overwhelmed by this and didn’t have any idea what they were meant to be looking at. And we, the facilitators, would need to get around to 40 students one-by-one to try to show them the cells they needed to know. It was boring for our students and many felt like they weren’t making any progress. I would say to the students, ‘look, at the end of the class, all I need is if I give you a picture of the cell you know what cell it is’. So, I thought, well why don’t I just do that.”

Bingo!

“So, we developed an activity where one-by-one we would flash up the 16 cells the students needed to be able to recognise. Like bingo, when they recognised it, they marked their bingo card. And, like bingo, the first to recognise all tests would get a prize.”

Students agree the change has been positive. “I studied haematology in block-mode over Summer. There’s a lot to learn in two weeks; some days we could have up to six hours of class,” explains Bachelor of Medical Science student Luke Milham. “The games were a fun way to break up the day and helped us see where we sat in comparison to the rest of the class,” he adds. “For our last game before the test, Rebecca had read through all the cells and no one had yelled ‘bingo’. She eventually figured out that the megakaryocyte card had been skipped. When she found the cell card and flashed it up – 35 out of 40 of us yelled ‘bingo’.”

It was this work, and more, that saw Rebecca and her team take out the Team Teaching Award in the 2017 UTS Learning and Teaching Awards. And, while the recognition is nice, Rebecca’s motivation is much simpler: “I just like getting students to have as much love for science as I do. Getting them to the moment where they understand something they once couldn’t, that’s just really rewarding.”

You can find out more about Rebecca’s work at the Vice Chancellor’s Learning and Teaching Awards Showcase – Wednesday 6 June, 3.30pm UTS Great Hall.0
Rebecca and the team – that’s Susan Green, Toni Flanagan, Karieshma Kabani, Daniel Mediati, Samira Aili, Reece Ajaka, Hiba Bahidh and Tamara Carrodus – will take home the aptly named ‘Team Teaching Award’. Congratulations all. 

You can also take a look at Rebecca’s presentation from the 2017 Teaching and Learning Forum.

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