Sequence 2: Stem cell inquiry

This sequence of activities focuses on Outcome 3 of VCE Biology Unit 2. It provides a series of activities and links to resources for teachers to use in facilitating students’ inquiry into the many issues related to medical therapies based on stem cells. Special acknowledgement to Dr. Jo Raphael for bringing Drama pedagogy into this inquiry process allowing the unpacking and engagement in scientific controversial issues.

VCE key knowledge (VCAA 2015)

Investigation of an issue (Unit 2, Area of study 3, Outcome 3, VCE Biology Study Design)

  • the characteristics of effective science communication: accuracy of biological information; clarity of explanation of biological concepts, ideas and models; contextual clarity with reference to importance and implications of findings; conciseness and coherence; and appropriateness for purpose and audience
  • the biological concepts specific to the investigation: definitions of key terms; use of appropriate biological terminology, conventions and representations
  • the use of data representations, models and theories in organising and explaining observed phenomena and biological concepts, and their limitations
  • the nature of evidence and information: distinction between opinion, anecdote and evidence, weak and strong evidence, and scientific and non-scientific ideas; and validity, reliability and authority of data including sources of possible errors or bias
  • the influence of social, economic, legal and ethical factors relevant to the selected biological issue.

Duration

1 - 3 weeks

Student learning outcomes

On completion of this module, students will:

  • fluently use scientific language related to stem cell science.
  • have a fundamental understanding of the complexities of stem cell science; its applications and implications of its use.
  • identify the stakeholders in the current stem cell debate and understand their arguments.

Teacher background information

See Sequence 1, Module 1: What are stem cells? for background information.

This inquiry module is to be completed after the scientific understanding modules.

Setting the scene

SBS Insight Program Episode 22 2014 is used as the basis for a scientific drama inquiry module stepping students through 6 phases focused on effective communication of the scientific, moral and ethical issues associated with stem cells.

Other background material and potential activities are highlighted in yellow.

Video

SBS Insight Program Episode 22 2014 (52:08 min)

In September 2014 the SBS Insight Program aired Episode 22: Stem Cells. In this program the views of frustrated patients are presented. Tired waiting for clinical breakthroughs to be supported by clinical data, some have turned to unproven stem cell therapies locally or overseas. In addition, the voices of other key stakeholders present their points of view.

Open
Article (Media)

Australian Stem Cell Loophole

A media article from The Sydney Morning Herald (April 5, 2015) describing the loophole uncovered in the Australian legislation relating to autologous stem cell treatment.

Presents a question for students to consider “is a loophole in stem cell law helping new therapy to thrive, or allowing dubious science?”

Open
Video (Media)

Stem cell therapy dilemma and ethical debate (7:42 min)

This Video with transcript positions the stem cell debate within Australia amongst stakeholders. Positive and negative outcomes of stem cell therapy, clinical trials, and what risks are people willing to take when considering unproven therapy. Discusses the Australian loophole in regard to autologous stem cell therapy. Dr Melanie Thompson, academic diagnosed with MS addresses the social media issues and Dr Julien Freitag provides one perspective from research scientist’s point of view.

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Video (Media)

Stem Cells – Insight Program

Program titled “Stem Cells” examines the impact of unproven stem cell technology on patients in Australia. (Episode 22, 15th July 2014).

Transcript is included along with an introduction to some of the participants that could be used as a guide when establishing stakeholder profiles.

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Video (Media)

Stem cell therapy dilemma and ethical debate

ABC News (13th Oct 2015) looks forward asking the community to consider the moral and ethical issues that would arise once stem cell technology can theoretically produce embryos from iPS cells. This video allows students to consider regulatory boundaries and how far is too far or if such research might be justified?

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Website

Stem Cells in the Media

This page provides links to current news and media releases regarding stem cell issues

The link to the Public forum - Selling Stem Cells: the need to reconcile hope, hype and evidence (10th Sep 2105) is no longer active but it can be viewed here.

Highlighted are the use of celebrities to promote or endorse stem cell therapies regardless of clinical studies and the role celebrity, social media and the internet in gaining acceptance of stem cell therapy. This is an important issue for students to consider and discuss with scientific investigation and data being marginalised in favour of popular opinion.

Open
News

Clinical trials … Hope is 5 years away.

Stem cell research is often in the news. However, for those who look to stem cells to alleviate their suffering it can sometimes be difficult to know if the latest ‘breakthrough’ means the chance of a treatment now or many, many years into the future.

Often lacking from media coverage is clarity about whether the new stem cell discovery is part of preclinical research (where a new approach is first explored in the laboratory and in animal studies); a clinical trial (where it is being evaluated in humans) or an approved evidence-based treatment.

The following SBS articles are examples students may investigate:

By performing a Google search, the latest news articles should be located. Some recent examples include:

  • Scientists correct defective gene in stem cells in fight against rare and deadly ataxia telangiectasia or AT (published online by The Courier Mail, 28th Feb 2016)
  • Australian stem cell bid to cure Parkinson’s disease (published online by The Australian, 15th Dec 2015)
  • In the news are positive stories of sick patients whose condition has improved through the use of stem cells.
  • The use of stem cells in knee injuries is one example published by the Herald Sun on Feb 28th 2016 and titled “World first Australian stem cell marvel that re-grows damaged cartilage could make joint surgery unnecessary”.

The latest news can be uncovered performing a Google search such as:

  • “latest breakthrough in Stem Cell therapy Australia”
  • “stem cell trials in Australia”
  • “stem cell treatment in Australia”

In assessing the findings students will need to determine whether the source is credible and the data accurate as per the intended outcomes. It is important to ascertain whether the information is, for example, published but only preclinical; published data from a clinical trial; speculative data based on anecdote.

Are the claims substantiated by a peer-reviewed publication? Are they an announcement from a national regulatory body ie the announcement of a new clinical trial (so still yet to be proven) or a company stating that the TGA have approved a new stem cell-based treatment?

Handbooks

Providing authoritative information about stem cell therapies for patients

The Australian Stem Cell Handbook

What you need to know about stem cell therapies? The University of Alberta Patient booklet Section 3 is titled “what you need to know about unproven stem cell interventions” and covers information such as advertising, patient testimonials, treatment types, costs and risks.

EuroStemCell Fact sheets

Activities

Phase 1 Exploration of issues and Stakeholders (whole class activity)

Activity

Activity 1.1 - Identifying issues associated with stem cells

Using the resources provided or via latest news searches uncover the issues related to stem cell therapy and treatment concerning Australians.

For example, should Australian doctors be allowed to sell unproven stem cell treatments using the patient’s own cells (so called autologous ‘stem cell’ therapies) or should regulations be tightened to protect patients from physical and financial harm? If we tighten Australian regulations would that mean that more patients will be forced to travel overseas? Do patients have a right to try whatever they want or should they have to wait for evidence? Should stem cell technology be used to generate sperm cells or embryos from stem cells?

Activity

Activity 1.2 - Identifying the Stakeholders

In January 2015 the Australian Therapeutic Goods Association released the “Regulation of autologous stem cell therapies Discussion paper for consultation” to allow community input into the current loophole in Australian Stem Cell legislation that allows clinics to offer autologous stem cells as therapy.

There are many different groups – so called stakeholders - in the community who have a direct and indirect interest in stem cell research.

Task 1: Students are to identify broad stakeholder groups and then provide examples of individuals in each group developing a comprehensive list of stakeholders.

Task 2: Create a mind map of each stakeholder

Example of Issue and Stakeholders to be considered:

  • Should Australian legislation be changed to make it more difficult to market and sell unproven stem cell treatments?
  • What impact would tightening Australian regulation have for patients trying to access treatment or for scientists from universities and biotechnology companies seeking to develop their research?
  • If there is no change to curb the sale of unproven treatment, could this impact on development of the Australian stem cell industry?
  • Are patients who pursue these treatments at risk and if so what risks?
Activity

Alternative activity - PlayDecide Stem cells

Alternative activity to explore the ethics and moral scenarios associated with embryonic stem cell research and possible treatments.

Students research and debate a European scenario that could be transferred into an Australian setting. Story and Stakeholder cards are available but additional stakeholders can be developed by students to explore moral issues. Using the knowledge acquired in Module 1: Stem Cell Understanding students are able to expand the debate to include iPS cells.

Other useful links can be obtained from the EuroStemCell site.

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Phase 2 Stakeholder research (small group activity)

Activity

Activity 2.1 - Individual Stakeholder Research

From the MindMap linking stakeholders created in Activity 1.2, students in groups of 1 to 3 focus on a specific stakeholder and begin to develop a background understanding of their key stakeholders view and how they can best represent them by investigating a series of research questions.

Working in their groups students are to create a 1-minute video of their stakeholder to introduce them and their viewpoint to the other stakeholders.

Download stakeholder descriptions
(.pdf 86kb)

Students may gain insight into stakeholders via the Internet or utilising the news articles and videos in the teacher background section above.

Key Stakeholder Questions (to be answered from your chosen stakeholder’s perspective):

  • What does stem cell research and therapy mean to you and what value do you place on it?
  • What controversy do you have to deal with in relation to stem cell research and therapy focusing on ethical or moral issues?
  • Explain how these issues impact you professionally and/or personally?
  • What alternative options could you consider?
  • What role should the Australian government have in funding or regulating stem cell research and its clinical application?
  • When is it ethical to start testing stem cell treatments in patients?

Note: Questions will be explored in the simulated Insight program (Phase 4)

Phase 3 Consider the viewpoints of other stakeholders (small groups)

Activity

Activity 3.1 - Compare stakeholder views

Student groups are to watch other stakeholder videos and consider how their stakeholder view compares.

Students groups are to present their responses to the key questions in some form of written format (i.e./ poster, report etc).

Key Stakeholder Questions (to be answered from your chosen stakeholders perspective):

  • What does stem cell research and therapy mean to you and what value do you place on it?
  • What controversy do you have to deal with in relation to stem cell research and therapy focusing on ethical or moral issues?
  • Explain how these issues impact you professionally and/or personally?
  • What alternative options could you consider?
  • What role should the Australian government have in funding or regulating stem cell research and its clinical application?
  • When is it ethical to start testing stem cell treatments in patients?

Additional Stakeholder Questions (to be answered from your chosen stakeholders perspective):

  • Having heard from other stakeholders have you changed your responses to any of the key questions? If so what and why?
  • Do you support all types of stem cell research (embryonic, adult and iPS; autologous or from a donor)? Why?
  • Who should the Government fund stem cell research in Australia?
  • How and when should patients have access to stem cell treatment?
  • What role do celebrity and social media have in communicating information about stem cell treatment?

Phase 4 Insight program (whole class dramatic role-play)

Activity

Activity 4.1 - Overview

Setting the scene: This drama role-play draws upon stem cell therapy, a contemporary controversial issue in science with global implications. Through both students and teacher taking on roles in the drama we can more closely consider the perspectives of the stakeholders in this issue, and explore language and ideas in relation to stem cell research and therapies.

Context: A TV studio for recording of an SBS Insight style TV program.

Roles: students as various stakeholders (see previous preparations and stakeholder cards - pdf 39kb). Teacher is in role as the TV program host who facilitates the discussion on the topic.

Teacher-in-role: The strategy of teacher-in-role requires the teacher (in this case playing the role of the host/facilitator) to help build belief in the drama context (a TV discussion program on stem cells) without losing sense of the important learning that needs to take place. It is important that the teacher does not get carried away with the performance because in this teaching strategy they are both the teacher and the role. As host they guide the discussion amongst the people in the studio but as teacher, they are ensuring that all students have a chance to contribute, and the important points of learning are made.

Debrief: A debriefing of the role-play (everyone out of role) is an important final stage of the process.

Activity

Activity 4.1 - Steps

  1. Prepare roles
  2. Set up the studio space for the role-play
  3. The teacher sets the scene and begins by taking on the role of the TV program host and students as representatives of stakeholder groups (an item of costume or a prop such as a microphone can help signify role). The host could begin by building some atmosphere with an introduction to the TV program such as this piece to camera:

    Welcome to tonight’s program.

    Stem cell therapy is a burgeoning and relatively new area of scientific research, and one that offers hope to many people who suffer from chronic and/or degenerative illnesses. Funded scientific research and formal regulation of the field is struggling to keep up with the global demand for these therapies that are desperately sought after by some as a cure for currently incurable diseases. People desperate for medical treatment can become easy targets for rogue operators selling little more than hope.

    Now you are a researcher in this area [gesturing towards a student in role] do you believe stem cell tourism is a threat to legitimate stem cell research?

    [Continue facilitating a productive discussion with interesting juxtaposition of views to make it interesting TV.]

  4. The host/facilitator is guided by the key and additional questions and provides opportunity for each stakeholder group to share their perspective and for other stakeholders to challenge them or add to their arguments.
  5. If required, build in an ‘ad break’ in order to review progress of the whole class role-play and where necessary provide information and encouragement before resuming the program.
  6. Bring the program to a conclusion. Teacher and students de-role.
  7. Finally, hold a debriefing discussion with the students out of role. This allows the students to ask questions and express some of their own ideas as themselves.
Activity

Activity 4.1 - Teacher Resources

Download facilitator questions
(.doc 62kb)
Download stakeholder cards
(.pdf 39kb)

Phase 5 Debrief (whole class)

Activity

Activity 5.1 - Student debrief

Students groups are to reflect on the insight program and the experience of the role-play in contributing to their understanding of the topic.

Phase 6 Write up (Individual)

Activity

Activity 6.1 - Student reflection

Individually students are to reflect on the insight program and consider what they learnt from other stakeholder perspectives and changes in their own opinions.

They are to submit their work in the form of a written response.

Suggested formats:

  • A journalist writing a newspaper report on the program representing various perspectives on the issue
  • Write a letter to the editor about a concern from your stakeholders perspective, acknowledging two other stake holder perspectives

Assessment Assessment Rubrics

Three Assessment Rubrics are provided:

  • Teacher assessment rubric
  • Peer assessment rubric
  • Self assessment rubric
Download rubrics (.doc 151kb)
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Contributors

Thanks to the following for contributing to the development of these sequences:

  • Dr. Elise Roper MTeach student at Deakin University (Pre-Service Teacher Contributor and Collator)
  • Dr. Julie Cooper MTeach student at Deakin University (Pre-Service Teacher Contributor and Collator)
  • Prof. Megan Munsie Policy and Outreach Manager and Head of Education, Ethics, Law & Community Awareness Unit, The University of Melbourne (Stem Cell Scientist)
  • Dr. Jo RaphaelDr. Jo Raphael Lecturer in Arts and Drama Education at Deakin University (Education Academic and Project Coordinator)
  • Dr. Peta WhiteDr. Peta White Lecturer in Science and Environmental Education at Deakin University (Education Academic and Project Coordinator)

Special thanks to Olivia Tan MTeach student at Deakin University (Pre-Service Teacher Contributor)