family medical history provided a great opportunity to introduce
them to pedigree analysis. The students created a pedigree for Marcus’s family based on the information provided so far in the case
(Handout 6: Pedigree). The teacher used this opportunity to review
inheritance patterns of Mendelian diseases and to introduce inheritance of non-Mendelian diseases using Punnett squares to help students understand the probability of Marcus’s future children
inheriting any of the diseases. On Day 5, after a lesson describing pedigree construction and application, student expert groups were asked
to find example pedigrees or create pedigrees for individuals with
sickle cell trait, Marfan syndrome, and hypertrophic cardiomyopathy.
Student groups shared their created pedigrees with the entire class
and the teacher clarified the inheritance patterns and further explained
the content related to the different inheritance patterns.
On Day 6, a medical school student from the university’s ultrasound
institute accepted the teacher’s invitation to engage the students in
ultrasound scanning of a “standard patient” (Figure 1). The students
got a chance to ultrasound the patient’s heart. We recommend using
a “standard patient” and do not recommend engaging in ultrasound
on your own students, as the experience should be about seeing the
anatomy and understanding the ultrasound technology rather than a
diagnosis of student health issues. Because this interaction is not
possible for all teachers, we have included video footage of a
healthy heart and video footage that might represent Marcus’s diseased anatomy (see Figures 2 and 3; the videos are available from
the authors). However, the teacher should not show Marcus’s videos until the next day. Instead, the teacher can provide the autopsy
report from Marcus’s uncle, Robert Brown (a pseudonym; see
Handout 7: Robert Brown Autopsy Summary), and show a video
loop of his heart ultrasound (Figure 2) at the end of this class. This
ultrasound loop shows an enlarged diseased heart consistent with
This final Hospitalization Update was provided to students near the
end of the unit (before their final presentations) and the teacher
showed the students Marcus’s heart ultrasound:
Marcus continues to improve. He has been placed on
a beta blocker and has been moved out of the ICU. He is
eating well, talkative, and walking the halls. His cardiologist has been coming by every day to examine Marcus
and help him understand his disease.
Figure 1. High school biology students engaged in
ultrasound of a standard patient’s heart.
Figure 2. On the left is an ECHO of a normal heart and on the right is an ECHO of Robert Brown’s heart. Note the thickened walls
of the left ventricle of Brown’s heart and the small volume of blood in the ventricle (LV).