Problem-based Learning in

Biology
with 20 Case Examples
By PETER OMMUNDSEN
Problem-based learning (PBL) is an exciting way to learn biology and is readily incorporated into large
classes in a lecture hall environment. PBL engages students in solving authentic biological case
problems, stimulating discussion among students and reinforcing learning. A problem-based learning
environment emulates the workplace and develops self-directed learners. This is preferable to a mimetic
learning environment in which students only watch, memorize, and repeat what they have been told.
The examples given here are suitable for use in a first year college biology lecture theater, but the method
is applicable to any class size and educational level. [A more detailed explanation of PBL in Biology may
be found in Chapter Four of INSPIRING STUDENTS, published in 1999 by Kogan Page.]
METHOD FOR INSTRUCTORS
(1) Form Small Groups
You may decide to devote all or part of a class session to PBL, but students must form small work groups
during that time. Ask the students to form groups of 3-5 people, or assign the groups yourself or by lottery.
(2) Present the Problem
Present the students with a brief problem statement (preferably on a printed work sheet, an example of
which is shown below), e.g., "A 28-year-old man appears to have osteoporosis." In some cases a video
clip or specimen might be used as a trigger. Emphasize to the students that they are dealing with an
authentic case history. Bizarre problems work best [more examples follow]. Prior to class you should
review the case history and arm yourself with data that can be released incrementally (progressive
disclosure) as the case proceeds. There is a comprehensive data set for the osteoporosis problem in the
New England Journal of Medicine, 1994, 331:1056-61; 1088-9. Needless to say, the students should not
be given the reference, as the objective is to solve a problem, not read a solution.
(3) Activate the Groups
Ask the groups to brainstorm possible causes of the osteoporosis. Each group will have to discuss,
review, or investigate the biology of bone, including the role of osteoblasts, diet, vitamin D, parathyroid
hormone, growth hormone, calcitonin, kidney function, etc. This is when much learning occurs, as the
students help each other understand the basic biology. PBL students must reflect upon biological
mechanisms rather than just memorize facts (as might occur in some traditional lecture-only courses).
The instructor circulates among the groups, providing assistance but not solutions. The groups may well
explore avenues unanticipated by the instructor. This is highly desirable and should not be discouraged.
The instructor should avoid controlling the agenda of the groups. Each group ranks its hypotheses in

order of priority and prepares requests for more data. (E.g., for calcium deficiency hypothesis -- "What did
he usually eat?")
(4) Provide Feedback
Ask that a rep from each group place their top priority hypothesis or data request on the chalkboard (if
already entered by another group, place their second choice, etc.). If this is not practical, ask for oral
suggestions from the groups when the small group work is halted and the class is reconvened. Student
suggestions may include -

Low calcium diet

Immobility

Low density of vitamin D receptors

Calcitonin deficiency

Excessive PTH

Chronic acidosis buffered by salts mobilized from bone

The small group work can be stopped and the instructor can briefly discuss the ideas with the entire class.
It is important to value every contribution, to assist the students in analysis of the biology involved, and to
provide further information [he was not immobile, he had a normal diet, etc.]. The students can be
prompted for data requests: "If you could ask for just three test results from examination of this man, what
would they be?"
It is not likely that the students will solve a problem on the first pass, and the feedback from the instructor
motivates the next round of small group work. The students could now be told that the man's lumbar spine
density is 3.1 standard deviations below the average age-matched healthy female (osteoporosis = 2.5+
SD), his height is 204 cm, his left middle finger is 10 cm, and knee films show open epiphyses. (The
students should now be able to figure out that the man may still be growing at age 28). The cycle of small
group work and instructor feedback can be continued during the current class session or on future
occasions. The key to managing a PBL session is providing continual feedback to maintain
student enthusiasm while simultaneously prolonging the resolution of the problem to ensure that
adequate learning occurs.
(5) Ask for a Solution
At this point in our example the groups will likely focus on the hormones required for epiphyseal closure
and bone mineralization. They may ask you for serum estrogen levels (high) which will suggest estrogenresistance. Were estrogen receptors defective? (Yes.) When a reasonable number of groups have solved
the problem, you might request a brief written analysis from each group describing the biology involved in
the case. Students may be asked to include certain key words in their reports. If you wish to further
pursue this case at a later date you could tackle the genetics of the defect. (C to T transition in the
estrogen receptor gene in both alleles causing a premature stop codon; both parents heterozygous with
consanguinity in the pedigree.)
METHOD FOR STUDENTS

Effective problem-solving requires an orderly approach. Problem-solving skills do not magically appear in
students as a result of instructors simply throwing problems at them.
Our students use the following heuristic: "How to make a DENT in a problem: Define, Explore, Narrow,
Test."
(1) Define the Problem Carefully
What exactly are you trying to determine? Does the problem have several components? If several, state
them separately. Does everyone in the group agree with the way the problem has been framed? Ask
group members to "think out loud," as that slows down their reasoning and enables people to check for
errors of understanding.
(2) Explore Possible Solutions
Brainstorm ideas that may contribute to a solution. Justify your ideas to group members. Clarify for them
the biology involved. Have them paraphrase your ideas. Listen carefully to the ideas of other group
members and give positive feedback. Make a list of learning issues. What do we know? What don't we
know? Is this problem analagous to any past problem? What core biological concepts may apply to this
problem? Assign research tasks within the group.
(3) Narrow Your Choices
After developing a list of hypotheses, sort them, weed them, and rank them. List the type of data required
to test each hypothesis. Give priority to the simplest, least costly tests. It is easier to get information on
the diet of a subject than it is to do sophisticated biochemical tests.
(4) Test Your Solution
Seek from your instructor the data that you need to test your ideas. If all your possible solutions are
eliminated, begin the cycle again: define, explore, narrow, test. When you encounter data that confirm one
of your hypotheses you may be asked to write a biological explanation of your solution and justify it using
the available evidence.
MORE CASE PROBLEMS
Following are examples of typical case problems that have been culled from biological journals and that
have been successfully class-tested at the first-year college level.
A sample student work sheet may be seen by clicking here.

Case problem SOURCES for these examples are shown here for the benefit of instructors, but normally
sources are NOT given to students as that would defeat the purpose of PBL.

(1) A Case of a Confused Person

A 58-year-old woman experienced attacks of confusion: she would repeat the same question 30 times
even though it was answered for her each time. [New England Journal of Medicine 315:1209-19.]

This is a good introductory case, as the students are able to generate a wide range of ideas: Alzheimer's
Disease, trauma, alcohol abuse, atherosclerosis, arrhythmia, hypotension, cancer, epilepsy, diabetes,
hypocalcemia, emphysema, dehydration, hypoglcemia, stroke, etc. The students perceive that the class
as a whole is a credible learning resource, and the instructor can help the class reflect upon the biological
implications of each suggestion.
Eventually the students will ask the circumstances of the woman's attacks (e.g., "Following alcohol
consumption?") When the students learn that the attacks occurred in the late afternoon, they will likely
focus on diet and blood sugar. The instructor might at this point present a short talk on carbohydrate
function and blood sugar regulation. This can be done using a transparency, with copies available to the
students. It is important in a PBL environment to minimize the time required for note-taking.
The students will ask for information on the woman's blood glucose level (1.6 mmol/L) and urine glucose
level (zero). The student groups can now brainstorm and investigate possible causes of the low blood
glucose: glucagon deficiency, insulin poisoning, anorexia nervosa, extreme exercise, etc. They may ask
for an x-ray image of her abdomen, which the instructor can display as a transparency copied from the
article. The students can be assisted in identifying the anatomy, including an abnormal mass in the
pancreas (an insulin-secreting tumour). Additional discussion and learning opportunities can be generated
by displaying copies of the ultrasonogram, angiogram, histopathology, etc.
The students in each group may then collaborate in writing a brief report that explains the biology of the
case.
(2) A Case of Falling Cats
Sabrina the cat fell 32 stories from a New York skyscraper and easily survived, as do most cats that fall
from skyscrapers, especially those that fall more than several stories. Not so for humans. Why? [Natural
History Magazine, August 1989: 20-26.]
This intriguing case requires students to confront (or review) fundamental concepts that have wide
application in biology, including allometry, momentum, stress, compliance, friction, surface area,
acceleration, equilibrium, adaptation, and natural selection.
(3) A Case of Puzzling Parenthood
A woman with type AB blood gave birth to a child with blood type O. A second type-O child was born six
years later. [Nature 277:210-211.]
This case appears to contradict Mendelian inhertiance, which the students will be obliged to thorougly
review, but it also demands that they make a rigorous examination of meiosis, gametogenesis,
fertilization, and early development in order to propose some credible explanatory mechanisms.
(4) A Case of Wilting Plants
A farmer was alarmed to notice tomato plants that were stunted and withered.
This case initially requires the students to carefully reflect upon many basic concepts of plant anatomy,
histology, physiology, ecology, and pathophysiology. Students might discuss and explore possible effects
of soil quality, water relations, humidity, transpiration, hormones, and nutrition. Students should be
encouraged to explore examples of pathogenic mechanisms, perhaps involving TMS, wilt fungi, wilt
viruses, stunt viruses, and wilt bacteria.

Ultimately the cause may be attributed to ABA deficiency, and the instructor might suggest this by
introducing evidence of viviparity. Students can then focus on the roles of ABA and ethylene, and further
work might address the genetics of the defect. .
There is a comprehensive literature on ABA-deficient mutants, and many easily accessible web
resources, e.g., Plant Biology 2000 Abs 706, XVI International Botanical Congress Abs 6158, etc.
(5) A Case of an Unusual Pregnancy
A 94-year-old woman admitted to hospital for pneumonia had a swollen abdomen. A CT scan revealed a
fetus. The woman had dementia so was unable to explain what had happened. [New England Journal of
Medicine 321:1613-14.]
This case prompts exhaustive brainstorming of all aspects of reproductive physiology and will produce
many imaginative hypotheses.
(6) A Case of Declining Biodiversity
In a coyote-control experiment coyote population density was greatly reduced. The number of rodent
species then declined from ten to only two! Rodent species richness did not change on comparison areas
where coyote density remained high. [Journal of Wildlife Management 63:1066-81.]
This case opens many avenues of biology for exploration, including trophic levels, population regulation,
population limitation, competitive exclusion, niche breadth, keystone species, umbrella species, predator
control policy, biodiversity, and species richness.
(7) A Case of Aversion to Sugar
A 24-year-old man experienced abdominal pain, diarrhea, and distention whenever he consumed sugar.
This was a life-long problem. [New England Journal of Medicine 316:438-442.]
This case ensures that students master the taxonomy of carbohydrates, and the physiology of
carbohydrate digestion and absorption.
(8) A Case of a Tight Grip on the Toothpaste
A woman encountered her 30-year-old daughter squeezing the toothpaste and unable to let go. Later that
day the daughter was found holding the doorjamb and unable to move forward. [New England Journal of
Medicine 317:493-501.]
(9) A Case of Murder
Obtain a selection of DNA-typing profiles (RFLP autorads or STR electropherograms) from local police,
and construct a brief but equivocal fictional case history. Divide the class into to groups of five each
group with one judge, two prosecutors and two defense attorneys. Each student should have a copy of
the case and copies of raw DNA profiles. (The old autorads force the students to measure by hand.) Each
side must argue the evidence before the judge and submit to the instructor a brief written report along
with a written decision from the judge. This exercise demands that students help each other to thoroughly
understand the genetics, and the proceedings result in much hilarity. It is desirable to introduce some
complexity, for example we included an autorad from blood on a knife that contained specimens from
several people.
Another good source of DNA typing problems is wildlife census data from hair traps (e.g., grizzly bears).

(10) A Case of Epidemic Agitation

121 cases of illness were characterized by sleeplessness, headache, tachycardia, shortness of breath,
sweating, tremor, heat intolerance, and weight loss. [New England Journal of Medicine 316:993-998.]
(11) A Case of Deadly Exertion
A fitness test of applicants to a fire department resulted in 32 hospitalizations with back pain, muscle pain,
and reduced urine output. One person died. [MMWR 39:751-6.]
The students will at some point address muscle physiology. What happens when muscle cells break
during exertion? What are the consequences of hyperkalemia on the heart? Where does all the
potassium originate? What are the effects of myoglobin on the kidneys? What is the impact of oxygen free
radicals produced by damaged muscles?
(12) A Case of the Gritty Lungs
An 80-year-old woman suffered from confusion, falls, and fractures. Her lungs were gritty like hard
sponges. [New England Journal of Medicine 315:1209-19.]
(13) A Case of Many Illnesses
A one-year-old boy began to have recurrent bacterial infections including pneumonia, sinusitis, and
middle ear infections. This pattern continued, and at age 9 he developed Hodgkin's disease. He is HIVnegative. [New England Journal of Medicine 320:696-702.]
(14) A Case of a Short-Lived Male
In one mite species of the genus Adactylidium the male is born, does nothing, and dies within a few
hours. What evolutionary selection pressures might have shaped this life-style? [Stephen J. Gould, The
Panda's Thumb (book) pp 73-75.]
(15) A Case of 25 Eggs per Day
An 88-year-old man had eaten 25 eggs per day for many years, yet his serum cholesterol was only in the
range of 150-200 mg/dL. [New England Journal of Medicine 324:896-900.]
(16) A Case of Exercise Aversion
An 18-year-old man fatigued quickly during exercise. [New England Journal of Medicine 324:364-9.]
This is an excellent case for application of principles of cellular energy metabolism.
(17) A Case of Mass Fainting
Four hundred people at a rock concert collapsed or experienced faintness, with possibly as many as six
different proximal causes. [New England Journal of Medicine 332:1721.]
Students must reflect on the biology of a number of organ systems: fasting hypoglycemia, fasting
acidosis, orthostasis, hyperventilation-induced cerebral vasoconstriction, Valsalva pressure from
screaming and crowding, etc.
(18) A Case of Dead Trees

A forest patch was logged, then replanted, but within seven years the newly planted trees began to die.
[Local example -- acid precipitation, leaching of soil nutrients, inadequate woody debris left on ground as
a soil nutrient bank after logging.]
(19) A Case of a Rattlesnake Warning
A rattlesnake can flick its tail 90 times per second. (Compare that to the speed at which you can flick a
finger and address the possible differences in muscle biology.) [Science News 150:53 July 27 1996.]
(20) A Case of Lassitude
A 26-year-old woman complained of weakness and lassitude. Her blood pH was 7.56 and her arterial
pCO2 was 45.2 mMol. Blood pressure was 90/60.
This is a terrific case, well presented, with a wealth of data on blood gas and electrolyte values. The case
requires students to consider the functional interaction of several organ systems. [Nephrology Dialysis
Transplantation 16:1066-1068.] A printable pdf copy is available at Teaching Point.

Critical Thinking in Biology:

Case Problems
A Guide for Instructors
By PETER OMMUNDSEN
This page illustrates how CASE PROBLEMS can inspire students in an introductory college biology
course to develop scientific reasoning skills.
Critical thinking means seeking reliable knowledge. Many students fail to assess the reliability of
information to which they are exposed in everyday life, let alone pursue the dissection of scientific
literature. And many people are deceived and defrauded by pseudoscience. Practice in critical thinking
prompts thoughtful examination of the role of science in society. This is an important outcome of a biology
education, and brings us closer to addressing the Socratic dictum "The unexamined life is not worth
living."
CONTENTS:
SAMPLE SOLVED PROBLEMS:
Analysis of a Biology News Report
Weighing Conflicting Evidence
Judging Confidence
Judging Testability of a Claim
Science vs Religion
MORE PROBLEMS
REFERENCES

Currently featured Biology Critical Thinking links:

Science-based Medicine Articles and comments exploring

questionable medical claims.

Bad Science Weekly newspaper column.

What's New by Bob Park Weekly critical comments on scientific

issues.

The Panda's Thumb "The virtual pub of the University of Ediacara.

The patrons gather to discuss evolutionary theory, critique the
claims of the antievolution movement, defend the integrity of both
science and science education, and share good conversation."

An Index to Creationist Claims [and critique] "This site attempts, as

much as possible, to make it easy to find rebuttals and references
from the scientific community to any and all of the various
creationist claims."

Quackwatch "Guide to Quackery, Health Fraud, and Intelligent

Decisions."

Why most published research findings are false

"Claimed research findings may often be simply accurate
measures of the prevailing bias."

The Telson Spur Compehensive compendium of science links

including latest science news.

Problem-based Learning in Biology with 20 Case Examples

Biology Case Studies in Multiple-choice Questions

PART I: SAMPLE SOLVED PROBLEMS:

A good starting point in development of critical thinking skills is use of authentic examples meaningful to
the student. The popular media are rich in such material -- sports physiology, reproductive health,
nutrition, fad diets, psychoactive drugs, alternative therapies, pollution, genetic engineering, and
evolution.
The following examples show how active learning can be incorporated into the lecture theater
environment to target critical thinking skills. Active learning requires that the students themselves
grapple with the case examples, such as in temporary small groups within the lecture hall. During small
group work, the instructor can circulate among the groups and suggest directions for student discussion.
Short lectures (15-20 minutes) are excellent for inspiring students and for demonstrating how to attack
problems, but active learning is superior to a mimetic learning environment in which students only listen,
take notes, and repeat what they have been told.

Note the brevity of these introductory cases. Brief quotations help students focus on the fundamental
scientific issues without distraction and provide ample substrate for group discussion. Students may of
course progress to the analysis of longer articles, scientific papers, advertisements, and web pages
assigned as homework or term papers.
In each case, the students must evaluate the reliability of the claim being promulgated. Reliable
knowledge is evidence-driven. The students musk ask, "What is the quality of evidence supporting
this claim?"

ANALYSIS OF A BIOLOGY NEWS REPORT

Case Example: Reproductive Health
This case provides skills and practice in evaluating a report of a scientific investigation, and
introduces students to the need for evidence-based medicine.
Exposure of students to a diversity of health care claims is an important component of a biology
education. Health care is a multi-billion dollar biology-based industry, but with many examples of
pseudoscience, deception and fraud. Scientific reasoning is an indispensable tool for the citizenry in
evaluating health care claims.
Alternative therapies such as homeopathy, reflexology, acupressure, and therapeutic touch are often of
interest to students and their families, and can be critically examined in a biology course on a topical
basis, e.g., iridology when studying the biology of the eye. Students can critique the evidence for
alternative medicine against a rigorous scientific protocol. Pathologist and consumer advocate Marcia
Angell has repeatedly stated that there are but two kinds of medicine: that which has been adequately
tested and that which has not (Angell and Kassirer 1998).
Example:
Ask the students to form groups of three to five within the lecture room or assign groups by lottery.
Provide the following brief news report to analyze. Tell the groups that you may call upon them when the
class reconvenes after 15 minutes of small group work. Ask the groups to decide whether or not the
claim in the report is justified by the evidence cited in the report.
The 11 November 1998 issue of the Journal of the American Medical Association reported that a Chinese
remedy used on pregnant women improves the position of the fetus for an easier birth. The treatment
reduces the risk of breech (rump-first) births.
The treatment involved heating an acupuncture point upon the smallest toe ("moxibustion"). Two hundred
and sixty women with poorly positioned fetuses were studied. Half of the women were randomly selected
to receive moxibustion. The other women ["controls"] received no treatment. The investigators found that
the untreated women had significantly more breech births. The authors stated that previously no
randomized controlled trial [like this one] had ever been conducted.
Ask the students to form their decision using the following five criteria:
1. Outcome measure: Was the promised treatment outcome actually
measured to determine if it occurred?
2. Control: Was the outcome of the treatment group compared to the
outcome of an otherwise similar untreated group?

3. Replication: Was the treatment replicated, that is tested on an adequate

number of subjects to rule out coincidence?
4. Randomization: Were subjects assigned to the treatment or control in
an unbiased manner?
5. Reproducibility: Has other research produced similar evidence?
6. Plausibility: Are the results consistent with established science?

Reconvene the class and solicit responses from the groups for an instructor-led discussion with the class
as a whole. Comments may be similar to the following.
1. Outcome measure: Was the claimed treatment outcome actually
measured?
In this case the answer is yes. The claimed outcome pertains to the risk
of breech births, and that is the outcome that was measured -- the
number of breech births. In some cases fraudulent claims are
pseudojustified by measuring irrelevant variables or by citing speculative
assertions by "authorities" (argumentum ad verecundiam).
2. Control: Was the treatment outcome compared to that of an otherwise
similar untreated group?
In this case the outcome of treated women was compared to that of a
control group of 130 untreated women that should have been otherwise
similar. However, this control group was not otherwise similar. Treated
women knew that they were being treated and untreated women knew
that they were different -- they were not being treated. Differing
expectations between the two groups may have affected the motility of
the fetuses. For example, the treated women may have been less
worried about birthing because they knew that they were being treated
and therefore had different levels of stress hormones. A better
investigative design would blind the women to their treatment status. The
control women would receive a sham treatment such as heating of a
non-acupuncture point.
3. Replication: Was the treatment replicated?
The answer is yes. One hundred and thirty pairs of women were
used in the investigation. If only one pair of women was studied
(no replication) there would be little confidence that a difference
in outcome between them was other than happenstance.
Adequate replication establishes a statistical benchmark against
which to judge the treatment, that is the likelihood of breech
births among untreated women.
4. Randomization: Was the treatment allocated randomly?

10

The answer is yes. The women were randomly assigned to

either the treatment group or the control group. This is important
because it guards against bias. For example, if all women of slim
physique were assigned to the treatment group, unique results in
that group might be credited to the treatment when in fact
perhaps physique was the cause.
5. Reproducibility: Has other research produced similar evidence?
The answer is no. The report stated that until now no
randomized controlled trial had been conducted. A claim tested
by only a single experiment, as in this case, is tenuous until the
results have been reproduced by a number of high quality trials
conducted by independent investigators. Results must be
reproducible.
6. Plausibility: Are the results consistent with established science?
The answer is no. There is no known biological mechanism
whereby heat applied to the smallest toe could affect the position
of a fetus. If a claim is not founded in basic science, or
contradicts established laws of nature, caution is required in
viewing the results. A common aphorism is that "extraordinary
claims require extraordinary evidence," or as stated by Thomas
Jefferson, evidence must be "proportional to the difficulty" of the
claim.
The claim that moxibustion is helpful in positioning of the fetus is not well justified. A major flaw in the
evidence is the lack of proper controls. A better test of this claim would involve double-blinding, that is
giving a sham treatment to the control group, thus isolating the independent variable.
Also, the claim is implausible as there is no known mechanism. It is especially desirable to determine if
other investigators can repeatedly reproduce the results using better quality methods. Johnson (1999)
states, "If results from a study cannot be reproduced, they have no credibility ... Individual studies rarely
contain sufficient information to support a final conclusion about the truth or value of a hypothesis." The
next example addresses this issue in more depth.

Analysis of a Biology News Report

Weighing Conflicting Evidence
Judging Confidence
Judging Testability of a Claim
Science vs Religion

Critical thinking skills may be tested in large classes using multiple-choice exams. [An example is
shown below.]

WEIGHING CONFLICTING EVIDENCE

Case Example: Treatment of Stroke

11

This case introduces skills and practice in weighing conflicting evidence and detecting publication
bias. It is a surprise to many students that a multitude of apparently similar experiments may
produce somewhat differing results, but this is a crucial point to address in teaching critical
thinking skills.
Have the students participate in a two-stage analysis:
1. Ask the students to form groups of three to five in the lecture hall or
assign groups by lottery.
Provide the students with practice in analyzing funnel plots. Display or
issue copies of funnel plots such as Exhibits A and B, below. Each dot
shows the outcome of a published controlled trial. Exhibit A is a plot of
the outcomes of 34 trials that investigated the effect of hostility on the
risk of developing coronary heart disease (adapted from Petticrew et al.
1999). Exhibit B shows the results of 19 trials that studied the effects of
maternal smoking on risk of preterm delivery (adapted from Shah and
Bracken 2001).
Remind the students that reproducibility is an important criterion of
reliable knowledge. Ask the students to spend ten minutes or so
preparing an interpretation of the plots: Is there an effect of the
independent variable (hostility and smoking)? Why are the results within
each exhibit so variable? How might we account for the shape of the
plots?
When the class reconvenes, solicit suggestions from the student groups,
and assist the class in explaining the plots. The students might suggest:
(1) The shape of each plot is consistent with the Law of Large Numbers:
greater variability among estimates from small samples. (2) Results from
the larger sample sizes in each plot may be worthy of greater weighting
in drawing a conclusion. (3) The hypothesis that hostility increases the
risk of coronary heart disease is not well justified by the pattern in Exhibit
A. (4) The weight of evidence is consistent with the inference that that
maternal smoking may be a cause of preterm delivery.

12

13

2. Now the students can progress to the stroke case. Ask them to form
small groups again. Display or issue copies of Exhibit C, the effect of
acupuncture in the treatment of stroke (adapted from Tang et al. 1999).
Ask the students to spend ten minutes or so discussing the shape of the
plot and proposing explanations. Then reconvene the class, solicit
suggestions from the various groups, and assist the class in explaining
the shape of the plot.
The students may suggest: (1) The position of the outcomes of trials with
large sample sizes suggest little evidence of a treatment effect of
acupuncture on stroke. (2) The lack of symmetry is suspicious -- we
would expect additional points to the left of the plot (in this case negative
outcomes). (3) The lack of symmetry suggests the possibility of
publication bias, a tendency for negative outcomes to not be published.
(4) Other factors also could explain the shape, such as disproportionately
poor responses of control subjects in small trials. Recognition of the
possibility of publication bias is an important learning outcome.

Analysis of a Biology News Report

Weighing Conflicting Evidence
Judging Confidence
Judging Testability of a Claim
Science vs Religion

JUDGING CONFIDENCE
Case Example: Treatment of a Cold

14

This case introduces the concept of confidence. At first glace it appears to involve some heavy slogging,
but the numerical values used in this example are very easy to work with and the educational benefits are
immense.
Display or issue copies of the plot below and ask the students to form groups of three to five in the lecture
hall. The graph shows the last reported day of cold symptoms in (a) a group of 100 people treated with an
experimental purported cold remedy designed by a biotech company (dark bars) and (b) a group of 100
people treated with placebo (light bars).

1. Ask the student groups to discuss the graph for ten minutes. Ask them to
decide if the treatment "worked," and ask them to decide how much
confidence they have in their decision. The students will soon realize that
they must formulate an arbitrary criterion in order to make a decision,
and criteria may vary among the groups. Also they will notice that
experimental data do not necessarily segregate nicely: in this case many
subjects who consumed the placebo fared as well or better than those
who used the remedy.
2. Reconvene the class and tally the results of the decisions, solicit criteria
employed, and discuss these as appropriate.
Inform the students that they will be asked to further interpret the data,
but should use some specific tools. You may wish to suggest that they
weigh any or all of the following:
Difference in mean recovery time
The mean of the treated group is six days and the mean of the control
group is seven days.
Relative risk of still showing symptoms beyond six days can easily be
computed (= 0.6). The number of subjects showing symptoms beyond

15

six days in the treatment group was 37 and in the control group was 61.
[(37/100)/(61/100) = 0.6].
Comparison of standard deviations between the groups
These are 1.9 and 2.1, respectively, or for purposes of this exercise
could be rounded to 2.
Confidence intervals
By rounding, a ninety-five percent confidence interval around the mean
(plus or minus 0.4 days) can be calculated in the students' heads simply
as plus or minus two standard errors. This simplified process gives the
students an intuitive feel for a confidence interval. If the confidence
intervals do not overlap, the students would be justified in rejecting the
statistical hypothesis that the difference between the groups was random
variation.
P value
A simple explanation of a P value can be presented regarding the data. P
is the probability of observing the data (or more extreme data) if the
statistical null hypothesis is true, that is assuming samples were drawn
from the same population. In this case the likelihood of observing such a
difference between sample means (per unit of standard error) is
improbably small (P=<0.05).
Risk of error
Weighing risk of error requires considering whether to set the P value
rejection criterion high (P=0.05) or lower. The latter protects against a
type I error (false positive). Setting a high value protects against a type II
error (false negative).
Effect size
Effect size (difference between the means/mean standard deviation) is a
function of sample size. The results of fifteen pairs of random
subsamples of n = 5 and fifteen pairs of n = 60 are shown below:

3. Ask the students to return to their groups and spend fifteen minutes
reassessing the graph using their new tools. Ask the students (a) Do the
confidence intervals overlap? (b) What does a P value tell us about the
probability that the treatment works? (c) Does the data pattern justify the
inference that there is a biologically or clinically significant difference
between the groups in this trial? (d) How might a different relative risk

16

statistic be derived from this plot? (e) What factors could haved biased
the outcome of the trial? (f) What further research, if any, would they like
to view before inferring that the treatment is effective?
4. Reconvene the class, solicit opinions from the students, and discuss
these as appropriate.
Likely the students will point out that although there is a statistically
significant difference between the groups, the two confidence intervals
are very close, which raises questions about the biological significance.
Cold symptoms are subjective and to infer symptom clearance within a
time frame of a fraction of a day is likely fraught with problems. The P
value tells us nothing about the probability that the treatment works (the
biological hypothesis). The P value tells us only that the chances of
obtaining our sampled data are small given a statistical null hypothesis.
This may or may not justify inferring a clinical treatment effect. Many
other aspects of the trial require scrutiny.
Make a list of potential sources of bias and confounding variables
suggested by the students. It would be desirable to know what
operational definition of a "cold" was used by investigators. Were all
subjects infected with the smae cultured virus? "Colds" may be caused
by many viruses, which may show differences among them in response
to a particular drug. The students should note that the numerical value of
the relative risk statistic depends upon the end point that is chosen. In
this case the end point was six days. Is there a more meaningful end
point? Ultimately, the students may state that they would like to know if
the results could be consistently reproduced by other investigators.
Time permitting, you may wish to demonstrate how to derive a
confidence interval on relative risk (in this example the 95% interval is
0.46 - 0.78) and introduce the students to graphical methods of plotting
confidence intervals such as forest plots.
Finally, you may wish to introduce some discussion of Bayesian analysis,
in which the probability of the statistical hypothesis, given the data, is
calculated, P(H I D), rather than the probability of the data given the
hypothesis, P(D I H), as above. A Bayesian approach allows the
likelihood to be modified by a prior estimate of probability of the
hypothesis. The effect of assigning a low prior probability is to require the
accumulation of more data to reach the same conclusion as a less
skeptical researcher.
Major outcomes of the discussion should focus on (a) the difficulty of
hypothesis-testing as the treatment effect moves toward zero, (b) the
difference between rejecting a statistical null hypothesis and making an
inference about a biological treatment effect, two separate operations,
and (c) the reasons why the literature on many useless alternative
medicines may be plagued by false positives.

Analysis of a Biology News Report

Weighing Conflicting Evidence
Judging Confidence

17

Judging Testability of a Claim

Science vs Religion

JUDGING TESTABILITY OF A CLAIM

Case Example: Brain and Behavior
This case introduces the concept of testability.
A common impediment to scientific progress is failure to frame testable questions. Pseudoscience may
employ untestable metaphors as explanations for alleged healing powers and may invoke unmeasurable
variables. (Wilhelm Reich, the psychotherapist, championed "orgone rays," touch therapists cite "energy
fields," traditional Chinese medicine cites qi, and traditional Indian medicine (Ayurveda) cites the
tridosha.) Challenging students to dissect such claims provides important lessons in the need for
testability, parsimony, elegance, and rigor in scientific reasoning. An example follows:
Ask the students to form groups of three to five within the lecture room or assign groups by lottery.
Provide the following brief quotation to analyze. Tell the groups that you may call upon them when the
class reconvenes after 15 minutes of small group work. Ask the students how they would decide if the
claim were justified, and how they might investigate the claim. Encourage them to draw upon their
knowledge of biology to suggest tests of any alternate hypotheses that might occur to them.
Why do some people have little difficulty quitting smoking? The answer is Will Power. This is what
psychotherapists term "intrinsic motivation," an underlying need for competence and self determination.
To investigate why some people are successful nicotine abstainers, the students might suggest an
experiment that compares long-terms abstainers to to a control group of people who frequently resume
smoking. The dependent variable in this case is frequency (per unit time) of resuming smoking after
quitting. The independent variable, Will Power, is of course elusive. The only way to measure "Will Power"
and its trappings as portrayed in the quotation is to measure the dependent variable, success in quitting
smoking, leaving the experiment with no independent variable! The reasoning is circular, a common
problem of pseudoscience.
Once the students identify the circularity, they can proceed only if they frame a testable hypothesis, and
this will require application of biology. The students will have to brainstorm a list of measurable variables
that might impact on levels of nicotine addiction. They might hypothesize that easy-quitters have less
nicotinic receptors and/or nicotinic receptors that are less sensitive to nicotine. There are many
possibilities for creative investigative designs. In terms of critical analysis, however, a major outcome of
interest to the educator is that the students recognize the flaw in the original proposal regarding will
power.
This is a milestone case for many students, as it awakens them to literature that masquerades as
science, and makes them more critical readers. Much writing on natural history, healing, and human
behavior is entangled in untestable metaphors and therefore is divorced from the window of science. A
splendid analysis of the concept of "motivation" is provided by Chiesa (1994).
The eminent microbiologist Louis Pasteur revolutionized medical practice largely by demanding testability
and scientific rigor (Debre and Forster 1998). This was a hard-won lesson that needs constant
reinforcement in biology classes.

Analysis of a Biology News Report

Weighing Conflicting Evidence

18

Judging Confidence
Judging Testability of a Claim
Science vs Religion
SCIENCE VS RELIGION
Case Example: Evolutionary Biology
This case provides practice in discriminating scientific explanations from nonscientific explanations.
Most students are aware that some religious organizations lobby to have supernatural claims, particularly
intelligent design creationism, taught in science classes. Media attention given to this issue is fortuitous,
as it provides a dramatic substrate upon which to confront the question "What is science?"
Rather than lecturing students on science as though it were dogma, such as the "evidence for evolution"
as is presented in many textbooks, it is preferable to actively engage the students in examining and
comparing scientific and nonscientific theories. Ask the students to bring to class lists of criticims of
evolution that they find on the Internet. These can be analyzed in small groups and students can
themselves generate a list of criteria to discriminate science from religion.
Example -Ask the students how they would go about testing a phylogenetic hypothesis. This forces them to
confront a question that many have never before contemplated.
Have the students form groups of three to five in the lecture hall or assign groups by lottery. Ask them to
suggest an investigation to test the phylogeny hypotheses in the following quotation. ALSO ask them to
reflect on their methodology and brainstorm a list of characteristics of science.
Evolutionary biologists have proposed that new kinds of living organisms arise sequentially through time
via genetic modification. For example, it is hypothesized that amphibians evolved from fish and that birds
evolved from saurischian dinosaurs. By contrast, there are "scientific" creationists [members of the
Creation Research Society] who believe that all basic kinds of life (birds, amphibians, reptiles, etc.) arose
within a six day period.
The students will likely suggest that the evolutionary explanation predicts that the fossil record would
show a sequential emergence of fish, amphibians, reptiles, and birds over a span of time geologically
dated at significantly longer than six days, whereas the creation hypothesis predicts that all life forms
would appear together throughout the fossil record, inhabiting the earth from the beginning of the record
of life. The students may have other suggestions, such as seeking transitional fossils, quiescent ancestral
genes, and present-day mutants.
The creationist claim, by contrast, predicts that the fossil record would show the emergence of birds and
reptiles (and all other major life forms) simultaneously without transitional forms.
When the class reconvenes, the students' ideas can be elicited, and an instructor-led discussion can
include a review of the the fossil record, transitional forms ( Archaeopteryx, Tiktaalik, etc.), and genetics
(such as Hoxd13 pattern found in Australian lungfish, tooth genes in birds, the Talpid specimen, etc.)
Of most interest, however, is the list of characteristics of science contributed by the students. Any of the
following might emerge and are worthy of discussion.
1. Scientific ideas are provisional

19

The tentative language of biological science used in the quotation

("proposed", "hypothesized") contrasts with the dogmatic language
("believe") of the scientific creationist. Creationist Research Society
literature states that "members of the Society are ...committed to full
belief" in their explanation. By contrast, scientific hypotheses are
provisional and are abandoned if they fail rigorous testing. For example,
it was once thought that plant development was influenced by "mitogenic
rays," but this idea has not withstood extensive investigation (Langmuir
1989) and has been discarded. As such, it is important for the student to
recognize that science is simply a human behavior, not a mirror of Truth
or a mirror of Reality. The provisional nature of science illustrates that
truth and reality are human interpretations subject to revision. As David
Western has said, "Anyone who believes that science is dispassionate
and objective has never worked with scientists" (Western 1997).
2. Science deals only with the observable
Science constructs explanations based upon a language of human
perceptions of the natural environment. Scientific claims are tested by
observation and measurement. In the case of phylogeny this may involve
geometric dating, fossil records, DNA typing, genome sequencing, etc.
The value of scientific hypotheses is measured by their predictive power
-- whether or not patterns of physical evidence in nature conform to those
expected by the hypothesis. Nonscientific explanations may encompass
the non-observable (supernatural), may rely upon historic writings
(religious texts), or may invent untestable constructs (psychoanalysis). In
the phylogenetic problem, the creationists may rely on religious scripture
as one form of evidence.
3. Science relies upon persuasion rather than force
Competition among scientific theories is resolved through continual
research. For example, by the late 1800s most scientists accepted the
Germ Theory of Disease because it had been well tested. The popularity
of the theory was not dependent upon scientists being ordered to believe
it. This contrasts with religions in which research may be unwelcome
(e.g., Galileo's testing of Copernican Theory), and members are
expected to hold certain beliefs. Membership in the Creation Research
Society implies commitment "to full belief."
4. There is considerable consensus among scientists
Science relies on full disclosure of investigative methods and on
principles of testability and reproducibility. This promotes consensus. The
vast majority of scientists worldwide use the theory of evolution as an
explanatory tool. Nonscientific disciplines are often highly fragmented as
they lack a protocol for resolving differences. The number of religions is
testimony to this trait, as are their differing positions on evolution.
5. Science thrives on curiosity and eagerness for new information and
new discoveries
Science as a cultural enterprise encourages ongoing research. Science
is self-critical and evolutionary hypotheses are continually being

20

reshaped and fine-tuned. Nonscientific and pseudoscientific

organizations may be wary of research and new ideas. The alternative
health care movement "largely denies the need" for research (Angell and
Kassirer 1998), and organized religion has punished (Galileo) or killed
(Aikenhead) reflective thinkers.
A few students may view religious teachings as incontrovertible, and be impervious to scientific evidence,
and it may be helpful to point out that acquisition of new and more reliable knowledge through controlled
trials was in fact exemplified in ancient texts:
Daniel 1:12-15 -- "Test your servants for ten days; let us be given vegetables to eat and water to drink.
Then let our appearance and the appearance of the youths who eat the king's food be observed by you,
and deal with your servants according to what you see." So he listened to them in this matter, and tested
them for ten days. At the end of ten days it was seen that they were better in appearance and fatter in
flesh than all the youths who ate the king's food.
Although several of the examples discussed above were from popular literature, students should be made
well aware that articles in peer-reviewed journals are not necessarily scientifically credible. For example,
Skalski and Robson (1992) listed a large number of published peer-reviewed ecological experiments that
lacked randomization and/or adequate replication.
Analysis of a Biology News Report
Weighing Conflicting Evidence
Judging Confidence
Judging Testability of a Claim
Science vs Religion

PART II: MORE CASE PROBLEMS

Homeopathy is a form of treatment in which a remedy may be repeatedly

diluted until only the solvent remains in the container, a solvent thought
to have acquired a "memory" of the remedy once present. A recent study
of the effectiveness of homeopathy reported here involved interviewing
6544 patients to determine if their health improved after homeopathic
treatment. "70.7% reported positive health changes." Does this result
support the claim that homeopathy has a unique biological effect?
Explain.
[The students should point out that the claim is not justified because
there was no control group. It is unknown what percentage of people
would have reported positive health changes without treatment. And
most treatments have placebo effects -- that is why blood-letting was
popular for thousands of years. Recipients of biologically ineffective
treatments may claim that "it works" because of placebo effects, but this
is not evidence of a unique biological effect. The response of a treatment
group must be compared to the response of a sham-treated group (both
groups and clinicians being unaware of which group is recieving which
treatment). Also in this example, it would be important to have clear
outcome measures, not just reports of generally feeling better. A
discussion of this study is available here .]

21

A homeopathic therapist admits that most large well-designed trials of

homeopathy show no treatment effect, but he can point to quite a few
experiments that do show a treatment effect and he claims that these
demonstrate that homeopathy must have some value. Is he justified in
his claim?
[The students should respond that he is not justified. In fact we can
EXPECT false positives due to chance even when the weight of
evidence from many trials points toward NO treatment effect. And the
smaller the sample sizes used in the experiments, the greater the
likelihood that their estimated treatment effects are not representative of
what would be obtained with large sample sizes.]

A touch therapist claimed that therapeutic touch can reduce the

frequency of headaches and as evidence published testimonials from
clients claiming reduced headache frequency after one treatment.
Critique this evidence and suggest a better test of this claim.
[The students should respond that it must be determined if touch is better
than placebo at reducing headache frequency. An investigative design
must rule out coincidence. Testimonials are not useful as evidence
because a positive results may be coincidence or a placebo effect. A test
of the claim requires a large number of subjects (replication) who are
randomly assigned to either touch or a sham treatment (control group)
such as an inert pill. The outcome measure is frequency of headaches.]

An ad for an herbal product that has failed large clinical trials contained
the following testimonial as evidence of its effectiveness: "I was very
pleased with your product. It certainly works for me. My headaches now
disappear within a few hours of taking the pills." Critique the quality of
evidence in support of a treatment effect for this product in this customer,
and suggest a better source of evidence.
[This is an interesting claim, because it is quite possible that a drug may
show no significant effect on a test population yet benefit a unique subset
of people. This was seen with the drug bucindolol in treating heart failure.
Therefore the question in this case is whether the product is better than
placebo in this one person. The "target of inference" from any evidence
is this one single person, not a population. That rules out replication.
However, randomization is possible. An experiment could be designed in
which the subject was randomly given (blindly) either the herb or a
placebo each time he/she suffered a headache. The outcome measure is
headache duration.]

An experiment was reported in which the potential effects of a pollutant

were assayed by applying the pollutant to a large fish tank containing
100 fish, and comparing their survival to 100 otherwise similar fish in an
unpolluted control tank. The treatment tank was selected in a random
manner. Critique this experiment based on this brief description. What is
the greatest flaw in the investigative design? [Such questions are
adaptable to multiple-choice format:]
a. Lack of clear outcome measure.
b. Lack of appropriate controls.

22

c. Lack of randomization.
d. Lack of replication.
[The answer is (d), this is an example of pseudoreplication. It is the tanks
that must be replicated (Hurlbert 1984).]

A drug company is seeking licencing for a drug that reduces breast

cancer risk by 50 percent. However, this same drug increases the risk of
uterine cancer by 100 percent. How would you decide if the drug should
be approved?
[The students should realize that they require baseline data on the risks
of the two cancers. The incidence of breast cancer is about 80 per
100,000 population. The incidence of uterine cancer is about 15 per
100,000.]

Homeopathy is a form of treatment in which a remedy may be repeatedly

diluted until only water remains in the container, water which is thought to
have acquired a "memory" of the remedy once present. Arguments that
homeopathy is pseudoscience cite the fact that scientists have been
unable to demonstrate that water has a memory. They also cite the
failure of well-designed randomized controlled trials to show any value
beyond a placebo effect. An argument in favor of the effectiveness of
homeopathy is that there are three thousand practicing homeopaths in
Great Britain. Is this good evidence of the efficacy of homeopathy?
Explain.
[The students should respond that this is an example of argumentum ad
verecundiam -- argument from authority rather than from measurement
of effectiveness. The number of proponents has no relation to
determining whether or not something works.]

Some proponents of "intelligent design" demand that schools include a

supernatural explanation for the diversity of life in science classes. What
feature of science distinguishes it from the realm of religion and the
supernatural?
[Science is a method of explaining nature using hypotheses that can be
tested against human observations. It does not deal with supernatural
claims which are by definition untestable.]

An advertisment for ginseng, a herbal product, claims that it " promotes

endurance." How would you decide if this claim were fraudulent? What
type of evidence would you like to see prior to accepting this claim?
Provide details of an investigative design

Biologists hypothesize that whales evolved from land-dwelling animals

now extinct (mesonychids). How might this hypothesis be tested?

A web page promoting the health benefits of "touch therapy" claims that
"Healing Touch provides an energetic liver cleanse." What evidence
would you like to see in support of such a claim?

23

Natural history programs commonly attribute adaptive value to animal

colors. For example, the snake species Thamnophis elegans occurs in
two color phases: grey and brown. Grey snakes predominate on rocky
beaches, where they blend with the background color, while brown
snakes are most common in the uplands. What kind of experiment would
verify whether or not the colors were adaptive? How would you design a
rigorous experiment that would discriminate between the hypotheses of
selection and drift?

A documentary TV program on "reflexology" claimed that pressure

massage of a certain region of the foot would relieve congested sinuses.
What evidence would be necessary before you would accept such a
claim?

Iridologists claim that by examining the eye they can detect diseases in
other body organs because the iris is neurally connected to them.
Biologists say that there is no neural transmission between the iris and
the major organs. What evidence would be required to validate iridology,
for example, to diagnose kidney disease by viewing only the eye? See if
you can find if such evidence exists.

Sigmund Freud, in his book "The Interpretation of Dreams" claimed that

dream content may receive contributions from a special "psychic
[censorship] function" separate from dream thoughts. Freud said that
episodes of dream resistance and dream realization prior to wakening
was "incontestable proof" of this psychic function. Critique Freud's
evidence from a biological perspective.

The web site of The American College or Orgonomy states that this
branch of psychiatry is based upon the theory of Wilhelm Reich that "in
almost all individuals, the flow and release of orgone energy [which 'fills
the universe and pulsates in all living things'] is blocked by chronic
muscle contraction in various areas of the body." Orgone therapy [of
emotional illness] is thus aimed at relief of spastic muscles. Critique this
theory. What type of investigation would be necessary to test this theory?
What type of evidence would you like to see prior to accepting this
proposition and spending money on orgone therapy?

REFERENCES
Angell, M and Kassirer, JP (1998) Alternative medicine: The risks of untested and unregulated remedies.
The New England Journal of Medicine, 339:839-41.
Chiesa, M (1994) Radical behaviorism: The philosophy and the science. Author's Cooperative, Inc.
Debre P and Forster E (1998) Louis Pasteur. Johns Hopkins University Press.
Giere RN (1998) Understanding scientific reasoning. Holt, Rinehart, and Winston.
Hurlbert, SH (1984) Pseudoreplication and the design of ecological experiments. Ecological Monographs,
54:187-211.

24

Johnson, D (1999) The insignificance of statistical significance testing. Journal of Wildlife Management,
63:763-772.
Langmuir, I (1989) Pathological Science. Physics today, October:36-48.
Nussbaum, MC (1997) Cultivating humanity. Harvard University Press.
Peters RH (1991) A Critique for Ecology. Cambridge University Press.
Petticrew, M et al. 1999. Relation between hostility and coronary heart disease. British Medical Journal
1999;319:917 ( 2 October ).
Rorty, R (1991) Objectivity, relativism, and truth. Cambridge University Press.
Shah, N and MB Bracken. 2001. A systematic review and meta-analysis of prospective studies on the
association between maternal cigarette smoking and preterm delivery. Journal of Nutrition.
2001;131:1032S-1040S.
Skalski JR and Robson DS (1992) Techniques for wildlife investigations. Academic Press.
Tang J-L, Zhan S-Y, Ernst E. 1999. Review of randomised controlled trials of traditional Chinese medicine.
British Medical Journal 319:160-161.
Western D (1997) In the dust of Kilimanjaro. Island Press.

Copyright 1999, 2005 Peter Ommundsen

Ill-Defined Encounters Are the Right Kind!

(guiding problem-based learning in science
classrooms)
The best way for students to learn science is to experience
problems that challenge science, and the thought, habits of mind
and actions associated with trying to solve them. This implies
opportunities for authentic, inquiry-based learning. Problem-based
learning (PBL) is a powerful vehicle for this, in which a real-world
problem becomes a context for students to investigate, in depth,
25

what they need to know and want to know (Checkly, 1997). It is a

robust, constructivist process, shaped and directed primarily by the
student, with the instructor as metacognitive coach.
PBL is not just another iteration of what many science educators
already use in their classrooms. To be truly "problem-based",
Gallagher (1995) emphasizes, all three of these key features must
be present: initiating learning with a problem, exclusive use of illdefined problems and teacher as metacognitive coach.

The nature of ill-defined problems

At the heart of true PBL is an ill-defined problem, an unresolved
"murky" situation. This is presented to small groups of students
who have been given a stakeholder role which is the "hook", says
Gallagher (1995), that propels and invest students in the ill-defined
situation.
To better understand what is meant by an ill-defined problem it is
helpful to examine what is meant by a problem. Although problems
can differ in many ways, they all can be considered as having three
characteristics. First, there is an initial or present state in which we
begin. Second, there is a goal state we wish to achieve. Finally,
there is some set of actions or operations needed to get from the
initial state to the goal state.
While all problems have these components, they often differ in how
well-defined they are. Problems can vary on a continuum from
relatively well-defined to ill-defined along each of these
components. In PBL, the problem is ill-defined with respect to all
three characteristics, which is typically how problems present in
science (and life!). The "problem" is unclear and raises questions
about what is known, needs to be known and how to find out. This
opens the way for finding many problem possibilities, the nature of
which are influenced by one's vantage point and experience.
In typical classroom problem solving approaches, students
encounter problems after all information is taught, giving the
misleading impression that problems only arise in circumstances
26

where all information needed for solution building is available. In

PBL, Gallagher (1995) emphasizes, the order of learning is inverted
to reflect real life learning and problem solving. Learning begins
after students are confronted with an ill-defined problem.

Science, learning, and problem-based learning

The theme of science education reform is to understand science as
ways of thinking and doing as well as bodies of knowledge.
Emphases are thinking and problem solving and habits of mind that
promote exploration and discovery such as curiosity, questioning,
openness to ideas, learning from errors and persistence. Learning
needs to occur in the context of real investigation through inquiry
and reasoning, which means teaching for understanding not
memorization of facts (AAAS, 1989; NSTA, 1992).
Learning specialists concur. Wiggins and McTighe (1998) advise
that learning is best, much more takes place, when the learner is
the one who looks deeper to create meaning and develop
understanding. Understanding, Perkins and Blythe (1994) explain,
is deep learning that goes well beyond simply "knowing", such as
being able to do thought-demanding things with a topic like finding
evidence and interpreting information in new ways. Wiggins and
McTighe (1998) stress that students need to "uncover" content for
meaning, to question and verify ideas if they are to be understood,
and Caine and Caine (1997) emphasize that the mind needs to be
understood as purposive, self-reflective, creative, and requiring
freedom to create meaning. For these reasons, advise Wiggins and
McTighe (1998), a priority in teaching for understanding is shaping
content in ways that engage students in making sense out of it
through inquiry and application.
In PBL there is a shift in roles for students and teachers. The
student, not the teacher, takes primary responsibility for what is
learned and how. The teacher is "guide on the side" or
metacognitive coach in contrast to "sage on the stage", raising
questions that challenge students' thinking and help shape selfdirected learning so that the search for meaning becomes a
personal construction of the learner. Understanding occurs through
27

collaborative self-directed, authentic learning, characterized by

problem-finding, problem solving, reiteration and self-evaluation.
This, says Barrows (1997), is what distinguishes true PBL from
"same-name" methods that use a problem of any sort somewhere in
the teaching/learning sequence.
In PBL, Gallagher (1995) explains, students encounter a problem as
it occurs in the real world, outside the classroom. There is
insufficient information to develop a solution, no single right
answer or strategy, and a need to redefine the problem as new
information is gathered. Ultimately, students can't be sure of their
solutions because information will still be missing. This also
characterizes science, which one scientist I interviewed describes
as "a process of thinking about problems then designing means of
approaching them... not necessarily to solve the problem you
outlined, but to make an inroad or a start, asking what further
approaches can I use to get a handle on this problem?"

Connecting students with scientists

An exciting way to launch students into the process of science is to
link them with practicing scientists and their work. This led to my
interviewing six prominent biomedical scientists, during which
each was asked to describe a difficult, especially challenging
research problem. They were also asked to discuss their concept of
science and important thinking behaviors for scientists. Students
need to learn, first hand, about this "private side" of science, the
essential habits of mind and thought processes that promote
exploration and discovery.
These conversations by four men and two women, physicians and
Ph.D.s, are intended as catalysts for students to conduct their own
interest-based inquiries through a model I developed for problembased learning. Each scientist discusses perplexing aspects of their
particular research which may be on cancer, organ transplantation,
heart disease, AIDS, the treatment of wounds and burns, substance
abuse, or human response to environmental toxins. Embedded in
these talks are many possible problems students can unearth, then
choose from to investigate using the "Steps in PBL" model. The
28

model follows, with examples of thinking by a group of high school

biology students who applied it to one of the conversations.

Guiding students in PBL

This ten-step approach (Figure 1) is based on the original medical
school model (Barrows, 1986). It involves students in constructing
understanding through critical and creative thinking and promotes
collaboration and autonomy in learning:
1. Encounter an ill-defined problem: Students can encounter
real-life, ill-defined problems in many compelling contexts. As
stakeholders in a situation they might be environmentalists
investigating a pollution problem or scientists confronting a
puzzling research finding. In the following scenario, biology
students are a special interest group attending the
presentation, "Programmed to Die" (text from one of the
scientist interviews):
Picture ID's identify you as invited guests to a cancer
research presentation in the hospital conference room.
Your organization, Science in the Public Interest , does
more than report medical research findings to the
public. It questions them and actively explores further
meaning for public consideration. You listen carefully as
"Programmed to Die" begins...
Metastasis... cells dividing out of control. That's what
kills us. Finding a cure for cancer is a difficult problem
because all cancers aren't alike. I'll make the analogy to
infectious diseases like HIV and influenza. Their treatment
and how they cause disease differs. Colon cancer behaves
different than melanoma, which behaves different than
prostate cancer. While some things are similar, like cells
dividing out of control, they behave differently. Melanoma
likes to go from the skin to the brain and liver, not to bone or
lung. Colon cancer goes to the liver, breast cancer to lung,
bone and brain. It's like these cancers have zip codes. There's
selectivity as to where they go and set up shop. So it's been a
29

cure versus cures. There's a 95% cure rate for testicular

cancers. Hodgkins disease once had a bad prognosis, now
90% survive. But this doesn't apply to breast cancer or other
important diseases.
We've been studying metastasis by looking at genes that are
expressed in a tumor cell versus its metastatic components to understand the molecular differences between the original
tumor and one that went to the liver. En route, we discovered
a new gene that keeps a melanocyte in its normal state and
tends to prevent its progression to melanoma. As melanoma
develops, this gene is no longer "expressed". In science, you
often pursue directions that are different from your primary
focus and wind up discovering things that might be related,
like a gene that's important in the fruit fly or worm that's also
found in humans. In the worm, we discovered something we
call "programmed cell death", which is an exploding area of
cancer research.
In the development of the worm there are certain cells. When
cells divide in twos, one gets discarded and dies. It's meant to
die. If not, it's a problem. If a cell's DNA is damaged and isn't
repaired it's supposed to die. If not, it leads to cancer. Not all
cells produced are meant to continue to be produced.
Normally, you divide the two. Each one should have a function.
We did experiments to interfere with that and the animal's
whole system became abnormal. If cell death is important in a
worm, what about in humans when cells that should die don't?
Normally, when a cell is damaged, there's a mechanism for
repairing it. or getting rid of it. A cell dying by this mechanism
looks different from one dying from other causes.
A connection between AIDS and cancer is the immune system,
"the national guard that protects our shores". Cancer cells are
probably being produced all the time, but there's a lot to
suggest that the appropriate immune cells get rid of them.
When the immune system is suppressed and the national
guard troops have gone from thousands to ten, invaders come
ashore and set up shop. There aren't the natural killer cells
and macrophages that get rid of cancer cells, resulting in
malignant tumors that metastasize. The immune system is
30

important but not the whole story in understanding

metastasis.
In the future, we'll be better able to determine the behavior of
tumors through molecular testing. A cancer cell grows out of
control. Through gene therapy, which is being tried now, we'll
try to put those controls back in by reintroducing genes that
either were lost or non-functional to regain behavior.
Meanwhile we're searching for other solutions.
2. Ask IPF questions: As stakeholders, biology students begin
to examine this information by asking, "What's Interesting
here?" "What's Puzzling, curious, problematic?" "What's
important to Find out?" (Figure 2)
3. Pursue problem-finding: Embedded in "Programmed to
Die" are many problem possibilities students can unearth by
probing the information more deeply for meaning, which IPF
questioning initiates. To promote this, teachers can suggest
varied problem finding strategies, for example:
o draw a problem; even crude drawings can convey a lot of
information
o ask a series of "why" questions to reveal possible causes
of something
o create a flow map to sequentially link aspects of a
situation
o uncover possible false assumptions about information
o minify or magnify a situation to understand its essence
or scope
4. Map problem finding; prioritize a problem: Next, students
organize problem finding results to show patterns and
relationships among ideas. Again, teachers guide but do not
make decisions for students. This process needs to be a
construct of the learner as illustrated by the cluster map
(Figure 3) created by the biology group. Their map helps them
31

identify "lifestyle factors and cancer" as a problem to

investigate.
5. Investigate the problem: To help the group strategize,
teachers might ask: "How will you organize your overall
plan?" "What responsibilities will each group member have?"
Inquiry guiding questions might be, "Since you have decided
to interview people, who will you interview?" "How will you
find them?" "What information is needed?" "How will you
record this?"
6. Analyze results: Responsibility for analyzing information
again lies with students. Guiding questions for the biology
group might include: "Would it be useful to compare people
you interview for similarities or differences?" "How would you
show this?" "What's more important to find out: how people
are similar or how they differ?" In the process, teachers might
also introduce students to basic data analysis methods.
7. Reiterate learning: Reiteration is a distinguishing feature of
PBL in which students present what they have learned to each
other (Barrows, 1997). They actively apply learning back to
the problem to gain new understanding by re-entering it from
the beginning, critiquing and refining their original problem
statement, thinking strategies, sources and goals. They relate
what they learned to understanding other problems and try to
extract concepts that have broad applicability. Metacognitive
guiding questions might be, "How do your results help you
understand the problem you investigated? "Should you
investigate this again, what would you do differently and
why?"
8. Generate solutions and recommendations: Students need
to revisit outcomes of the previous two steps to determine
what direction they take. For example, biology students' data
might point to prevention/intervention. Teachers can suggest
idea-generating strategies such as:
o ask "how?" each time a solution is proposed to clarify
possible strategies and implementation steps

32

o propose improvements by substituting, combining,

adapting or modifying ideas (Eberle, 1971)
o use a metaphor to highlight aspects of something that
might not ordinarily be perceived
9. Communicate the Results: As stakeholders in a real-world
situation, students need to communicate what they have
learned. For example, biology students consider creating a
public information message emphasizing the relationship
between certain lifestyle factors and cancer. Guiding
questions might be: "What general themes were discovered in
your research?" "What conclusions can be reached?" "Who
gains from this and how?
10.
Conduct self-assessment: Assessing one's performance
progress is an important life skill that PBL develops. Students
assess their own problem finding, problem solving, knowledge
acquisition, self-directed and collaborative learning skills and
share this with their group. Authentic assessment methods
include journal writing, lab notebooks, self-rating scales, peer
interviews, and conferences with teachers for which students
develop discussion criteria. Teachers also provide their own
assessments based on students' application of the 10 step
model.

Encounters of the right kind

In science, questions answered lead to more questions.
Understanding occurs in fits and starts, characterized by
derailments, blind alleys and shifts in focus. Problems change as
they are being solved, resulting in constant changing relationships
between problems and solutions.
From the outset, PBL engages students in these important learning
experiences. As illustrated, scientists' conversations about the
challenges of their research is grist for launching students into
pursuits of their own that replicate the process of science. Within
the larger curriculum, this can be the basis for structuring a major
33

piece of learning agenda over an extended period of time, or for

special study to enhance a part of curriculum.
PBL gives students opportunities to be self-directed while
maintaining cohesion in the classroom. It is effective with students
of varying abilities because students are the ones who choose the
problems and methods of study based on development level and
interests. Above all, Gallagher (1995) emphasizes, PBL is a
curricular and instructional approach which successfully resolves
the seemingly contradictory demands of science education reform
in a way that is true to the discipline of science, its process, and the
larger goals of educating an independent reasoning citizenry.

Nina Greenwald, August 2001

Greenwald, N. (2000) Learning from problems. The Science
Teacher. 67 (4): 28-32
Reprinted with permission from NSTA Publications, April 2000,
from The Science Teacher: NSTA, 1840 Wilson Blvd. Arlington,
Virginia 22201

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AAAS. (1989). Project 2061: Science for All Americans and
Benchmarks for Science Literacy, N.Y: Oxford University Press.
Barrows, H.S. (1997). Problem-based learning is more than just
learning based around problems. The Problem Log, (2)2, 4-5.
Barrows, H.S. (1986. A taxonomy of problem-based learning
methods. Medical Education 20, 481-486.
Caine, R.M. & Caine, G. (1997). Education on the edge of
possibility. Alexandria, VA: Association for Supervision and
Curriculum Development.

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Checkly, K. (1997). Problem-based learning. ASCD Curriculum

Update, summer, 3.
Eberle, B. (1971). Scamper. Buffalo, N.Y: DOK.
Gallagher, S. Stephien, W.J., Sher, B.T., & Workman, D. (1995).
Implementing problem-based learning in science classrooms.
School Science and Mathematics, 95(3), 136-146.
National Science Teachers Association. (1992). Scope, sequence
and coordination of secondary school science. Volume 1, The
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Perkins, D. & Blythe, T. (1994). Putting understanding up front.
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Wiggins, G. & and McTighe, J. (1998). Understanding by design.
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