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Andrea Nicholas
Teaching Professor
Department of Neurobiology and Behavior
University of California, Irvine
Antibiotic Resistance in a Russian Prison: Playing with the Spread of Tuberculosis

In this case study, students will have the opportunity to model the spread of tuberculosis and development of antibiotic resistance in a hypothetical prison environment. After reading a brief handout and viewing a short video, students play a simulation game by first identifying a group of prison inmates represented by index cards. The placement of the cards will influence how drug resistance spreads from one inmate to another. Using a dice roll to mimic random probability of infection and antibiotic misuse, students then track the development of resistance to four specific antibiotics, determined by selection of playing card suit. Opportunity for release or transfer on inmates from one facility to another introduces a further level of complexity, allowing students to study resistance spread. This activity was originally designed for a section of an upper-division biology course about antibiotic resistance, but it would also be appropriate for lower-division undergraduate and high school biology courses discussing antibiotic use.

Disease Along the River: A Case Study and Cholera Outbreak Game 

This case study centers on an active teaching game that simulates a cholera outbreak among five villages along a river, similar to the Haitian outbreak of 2010. By enacting the behaviors of fictional villagers, students learn how trade, travel, sanitation practices and geographic location contribute to the spread of diarrheal disease. Documenting various contamination events of village water supplies allows students to trace the progression of the disease and illustrates how adequate sanitation facilities provide protection against the bacteria Vibrio cholera. Originally designed for an undergraduate upper-division biology course focusing on the epidemiology of diseases, the simulation is also appropriate for microbiology and public health courses, as well as lower division undergraduate biology courses and high school. Biology or epidemiology components of the case study can be highlighted depending on the emphasis of the course being taught. The game can be completed within a 45- to 60-minute class period. Playing cards are available from the Supplemental Materials tab; detailed instructions are found in the teaching notes.