When does life begin and how should that affect the regulation of genetic diagnosis of embryos? Should CRISPR gene editing ever be used on human germline DNA?? How can we use scarce medical resources to help more people? How can we keep humans alive and healthy in space? Should we try?
CBS students tackle these tough questions and more in two discussion-based classes that push them to consider not just what is possible with cutting-edge (and beyond) medical technology, but how it could and should be used.
Recent graduate Hanna Saveraid took one of the classes – Frontiers in Cellular Medicine taught by Genetics, Cell Biology and Development Professor Jeffrey Simon – as a senior. She recalls one pivotal conversation in which she and her classmates were discussing the cutting-edge technology behind life-saving stem cell transplants. As a long-time volunteer on a pediatric bone marrow transplant unit, Saveraid had seen the radiation and chemotherapy conditioning process that patients undergo up close. “It takes weeks or months,” she explained. “There are side effects and it can be dangerous for the patient.”
Saveraid shared those experiences with her classmates, taking what was already a rich conversation even deeper. “I still think it's a really exciting treatment,” she said, “but having seen that human face behind the technology has definitely shaped how I think about and discuss advancements in medicine. They really can have pros and cons.”
A student-centered approach
Simon designed Frontiers in Cellular Medicine specifically to foster the kinds of discussion that Saveraid experienced: student-driven and based on leading-edge research. The students explore not just the science, but policy and regulatory issues, ethics, social context, and the broader implications of implementing the science in the real world. The class is small, limited to 12 students, and the discussions each semester (he has now taught it three times) are always lively.
“The main course objective is to provide students with an opportunity for roundtable discussion, where they get practice honing their skills in critical thinking, debate, oral communication and persuasion,” Simon says, “skills that we envision are going to be useful in their professional careers going forward.”
These skills are especially important for students heading toward medical careers, as many of the students are, said Simon. Not only are they likely to work directly with these fast-moving new technologies, medical professionals also need to work in teams, have hard conversations, listen to each other, and make persuasive arguments for their own proposed solutions.
Bringing space back down to earth
This connection between big scientific questions and real-world implications is also what inspired Aaron Engelhart and Kate Adamala, both associate professors in the Department of Genetics, Cell Biology and Development, to create Astrobiology and Space Medicine: Life in the Universe, which they are teaching for the first time this spring. While it covers topics that catch the imagination of any outer space enthusiast, like exploration beyond Earth, living in space and the practical realities of medicine off planet, Engelhart and Adamala always bring those ideas back down to Earth.
“We’re going from this fantastical idea of ‘Let’s explore space’ to actual practical applications in human health,” says Adamala. “One of the biggest problems in biomedical sciences is that we have this amazing progress, but it is not evenly distributed,” she explained. “If we can develop cutting-edge biomedical technologies that do not need as many resources, then the access problem will become much less severe.”
Space, Adamala explained, is the ultimate low-resource environment. “You are literally cut off from the supply chain for very long periods of time. You have a very constrained energy budget, a very constrained mass budget, and limited access to refrigeration. So all of those problems that limit access to medical resources on Earth are also problems in space exploration.”
Students explore how vaccines and biologicals can be produced in that low-resource environment, as well as how biomining and biosensing can work in space, where miniaturization is important. But at the same time, Engelhart says, they are also learning how science, in general, gets done.
“We spend a lot of time reading primary research articles,” he explained. “So in the course of discussing those papers, it naturally comes up more than it might in a typical survey class, a bit more about the nuts and bolts of how research gets done, what it looks like to go into a Ph.D. program, what the structure of the lab might look like, who the people involved were.”
This can help students picture themselves working in those labs, doing basic science research, and helping advance science in the ways they are learning about in class.
An experience that sticks with students
Saveraid said she’s still in touch with people from her Frontiers in Cellular Medicine course and is now swapping tips with them about medical school applications. “It was very collaborative, and people got to know each other well,” she says. “We — the students — were the ones driving the discussion. In many ways, when you’re in college, you’re focused on learning what the professor is sharing. But it is good to have those moments when you take more ownership of your own learning. And this class was a great example of how that could be done.” — Tricia Cornell