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Patrick R. Field
Associate Professor
pfield@cougar.kean.edu
Department of Biological Sciences
Kean University
Brain vs. Spinal Cord: A Directed Case Study in CNS Injury

In this case study, students read about the injuries sustained by a young man hurt in a serious diving accident. To solve the case, they must determine the type of central nervous system injury described using their knowledge of the differences between symptoms and signs of brain and spinal cord injury. The case was developed for upper-level neuroscience courses and rehabilitation courses that cover the neuroanatomy of the central nervous system and the symptoms of different types of central nervous system injury.


Coffee and Cigarettes: Second-Hand Smoke and Smoke-Free Laws

This analysis case explores second-hand smoke and its impact on the decision to institute a smoking ban in the outdoor seating area of a popular coffee bar.  In working through the case, students discuss the medical, ethical, legal, and societal issues of smoking in public areas.  in addition, they devise experimental schemes for collecting data to determine how profitability is affected by a smoking ban. The case could be used in many science courses, including introductory biology and chemistry, in addition to liberal arts courses that deal with public policy, such as political science or civics.  It could also be used in a course in public health or adapted to a business/management class.


Diagnosis of a Congenital Disorder 

This progressive disclosure case study explores the medically-related issues of a female infant born with the congenital disorder Sirenomelia, more commonly known as "Mermaid Syndrome." The case starts with a high-risk mother participating in prenatal testing, which reveals a caudal vascular malformation in the fetus, but is not conclusive as to the extent of the deformity. Upon birth, the infant presents with a fusion of the lower extremities and compromised thoracic and abdomino-pelvic viscera. Students are confronted with various medical decisions in each part of the case that could determine the fate of the young girl as a fetus, an infant, and a pre-adolescent. The case can be used in undergraduate allied human health courses that include medical ethics such as introductory biology, human anatomy and physiology, and genetics. It would be suitable for undergraduate pre-professional biology majors, including, for example, pre-medicine, pre-physical therapy, pre-occupational therapy, and pre-physician assistant majors.


Indigenous Knowledge and the Search for Medicine: Controversy in Chiapas

This case study is based on a real scenario in which a high-profile ethnobotanical study in Chiapas, Mexico, ended when local and international organizations accused the managing researchers of biopiracy. Students will explore how the Maya International Cooperative Biodiversity Group (Maya ICBG) project shifted from one of promise to one of controversy. The case addresses a variety of topics including the ethics of prior informed consent, rights to indigenous knowledge, biopiracy, and the intersection of indigenous communities, national governments, researchers, companies, and funding agencies. The case is presented as a progressive disclosure in which students read information on the real-world situation and then address perspective-oriented questions that are distributed to students in stages following the chronological development of events. The case is appropriate for undergraduates majoring in anthropology, sustainability science, environmental science, or biology and is suitable for courses in ethnobotany, medicinal botany, anthropology, bioethics, ecology and conservational biology. It could also be adapted for an AP or IB biology course in secondary education.


The Game Changer: Keeping Your Head in Contact Sports

This interrupted case study traces the football career of Anthony "Tony Tonka Truck" Williams, and the types of brain  trauma that he suffers from youth league through high school, college and his draft into the pros. In order to be successful during this case, readers will have to be familiar with the signs, symptoms, epidemiology and ramifications of concussions, Second Impact Syndrome, and Chronic Traumatic Encephalopathy (CTE). Students will analyze and compare the differences between these three types of brain trauma and predict the outcome of Anthony's health based on symptoms and events given in each part. Although Anthony is fictional, the teaching notes include real examples of young men who have suffered or died as a result of these types of brain trauma and should be shared with the class. This case can be completed during one class session and is appropriate for upper level undergraduate and graduate courses in neuroscience, sports-related rehabilitation, and anatomy and physiology.


Under the Knife and Completely Aware: A Case of Intraoperative Awareness

This case study is based on a newspaper article about the suicide of Sherman Sizemore shortly after he underwent an exploratory laparotomy (abdominal surgery).  After his surgery, Sherman experienced symptoms similar to post-traumatic stress disorder (PTSD) including nightmares, paranoia, depression, insomnia, and dramatic mood swings. Sherman's family later discovered that he had been awake during the first part of the surgery; although given a muscle relaxer, he was never administered an anesthetic. Sherman was never told that he had been awake during surgery or that he had been given an amnesic to suppress memory of the traumatic event.  The condition that Sherman experienced is variously called intraoperative awareness (IOA) or anesthesia awareness. This case study explores the moral, ethical, and biological issues relevant to IOA by using role play and the device of a fictional mediation between three stakeholder groups: Sherman's family, the anesthesiologist group that administered the anesthetic, and the hospital and lead surgeon who conducted the surgery. The case is suitable for use in a wide variety of courses including medical ethics, psychology, abnormal psychology, introductory biology, anatomy, and physiology.