genomics & society

Tell Us What You Think!

Posted by Myra I. Roche on March 7, 2012

What do you think about students using their own DNA for classroom activities ?  Click to vote in the poll,

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7 Responses to “Tell Us What You Think!”

  1. Karey said

    I am on the fence with this one. I feel that students should be able to use their own DNA in classroom activities only if it will add to the learning experience. There are many other factors involved in deciding if this type of exercise is appropriate in the classroom setting such as issues of power, confidentiality of results, and cost of the tests to name a few. I guess I am still on the fence with this question.

  2. Rachel said

    I’m on the fence there with you Karey! I think there can be a good case made for the value of experiential learning – so much of what we do in classrooms relies very heavily on reading and listening to lectures, neither of which are the best way to make things stick in people’s heads. The benefit to med students or upper-level biology students might be substantial. Whether that benefit is enough to outweigh the risks is something that I think would need to be taken up on a case-by-case basis, considering the issues Karey noted around power dynamics (which can never entirely be removed, but dealt with more or less sensitively), equity in payment for the tests, and privacy.
    Beyond risks and benefits to the students themselves, though, I think it’s also important to consider exactly what lessons they are taking away. For example, the classroom context is probably one in which students are going to have at least some background knowledge themselves, plus substantial support from other students and professors and a recourse to multiple levels of appeal in the case of breaches of confidentiality or unanticipated concerns. This is the experience they are going to draw on when thinking about genetic tests in future, potentially when recommending them or discussing them with patients, and they may not think critically about the (probably much less adequate) resources their patients possess in dealing with and interpreting results.

  3. marthaeking said

    It would be really useful information to present this problem to a class of undergraduates, survey their willingness to participate, have them spend a few weeks reading about the potential risks/benefits of the testing including all of the issues Karey mentions, and then see who changes their minds about getting the DTC tests done. In other words, if these students were thoroughly educated and counseled on the social and ethical implications (even well beyond a level of informed consent) as part of their educational experience, what would the outcomes be? I’ve been tinkering with an outline for an “Anthropology of Genetics” course I’d like to teach someday, and it might be interesting to add something like this as a learning module– to go beyond what was offered in the biology classes to include ELSI issues in the education and discussion of their potential test results.

    • Kelly Hogan said

      Yes a great idea. Students and consumers in general tend to make decisions about this kind of testing without in-depth consideration. Often people turn to genetic counselors after the fact, but genetic counseling before-hand is what students don’t understand the need for. As I have told you in my presentation of this material to you as a group, I feel I have a lot of power as their professor to persuade undergraduates one way or another on their opinions on this topic. I attribute this power to the very short introduction I give them in my class. This past year, I did have my students read about the Berkeley controversy and we brainstormed a list of issues we would need to further ocnsider at UNC if we were to do this. It was a short exercise and not much time was devoted to it, but hopefully the discussion resonanted with some students. More careful surveying of students before and after is needed indeed.

  4. Marsha Michie said

    Karey and Rachel, make some room on that fence. The situations in which this kind of learning has been used are so very different. For medical students who likely will be prescribing or using the results of genetic tests for their patients, having testing themselves may be very valuable in a simple experiential sense. For students (particularly upper-level students), Rachel has mentioned that experiential learning may help some lessons “stick” more than reading or lectures, and I agree in a limited sense. I also think that the Berkeley case, in which anonymity was well-protected and testing was limited to a few fairly trivial genes, didn’t pose especially horrible risks to students.

    On the other hand, the downsides to this kind of learn-from-your-own-genes paradigm are ever present. I’m not talking about the risk to confidentiality, which was effectively dealt with at Berkeley and Stanford and could be handled with appropriate measures anywhere. I’m not even talking about the power/coercion issues, which are ever-present but can be minimized with careful consideration. The problem, as I see it, is this: either the students (1) receive scary, harmful, and/or unwanted information about their DNA; (2) they dodge the bullet, so to speak, and get only good news; or (3) they are protected from the risk of scary genetic information by having limits imposed upon in the information they receive. The problems with (1) are obvious; but what about (2) and (3)?

    If some aspect of this experiential-learning exercise is meant to give students a better idea of the implications of genetic testing as an increasing part of clinical care (and I think it should be), then students who get only ‘happy’ results may be getting a false sense of security, both about their own health and about the larger picture of genetic testing. Each of us has mutations that could prove harmful to us or our offspring, under the right circumstances – even if a particular test or battery of tests doesn’t turn any up. Further, the same sense of genetic determinism that may make a 20-year-old with negative results feel invincible may also make them less empathetic toward others who aren’t so lucky – it may also reinforce a sense that ‘good genes’ or ‘bad genes’ go to those who deserve them. Education about these issues can counter misconceptions in the classroom – but without carefully addressing these pitfalls, genetic testing as a learning tool may give students more than they bargained for, and their future patients less than they deserve.

  5. martha k said

    Well said, Marsha. Some of these things are unique to the student cases. We’ve discussed the imbalance of power inherent in the various case studies (including our own mini-case study here at UNC). There is also this issue of late-teens / early-twenties invincibility that adds a very interesting dimension to the social impacts of testing at this age (be those with “good” or “bad” results). I do think that it is significant that some of the other things putting us all on the crowded fence hold true for any person obtaining DTC results (and, of course, our UNC example was both DTC and in an educational setting).

  6. Kelly Hogan said

    Marsha,
    An excellent point about how what we teach can sometimes bring upon new misconceptions. Your example about the student leaving with a rosy picture is a real concern of mine– considering at this point and time with technology, I think this will be the outcome for the majority.

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