The SSRA provides students with the unique opportunity to experience lab-based, clinical, patient advocate or educational research during the summer, aiming to promote a greater appreciation of the critical role which research plays in modern medicine, and encouraging students to develop a life-long passion for discovery. Three students discuss their experience of the SSRA.

1. Cathal Ahern

STAGE 4 UNDERGRADUATE MEDICINE AND SSRA FINALIST 2014

Project Title
A novel mind-map-slideshow hybrid for the standardised, interactive and graphical presentation of pathology topics.

Supervisors
Dr Peter Holloway, Mr Adam Tattersall

Location
Teaching and Learning Education Group, School of Medicine and Medical Science, UCD

The summer of 2014 brought with it the pleasure of working with Dr Peter Holloway, Special Lecturer and Educationalist at UCD SMMS, on an SSRA project. Our work concerned the development and evaluation of a new presentation platform, inspired by perceived problems with the use of presentation software (e.g. PowerPoint) in education.

PowerPoint is widely criticised in educational and psychological literature [1, 2, 3] for having little grounding in the theories and science of learning. Edward Tufte, a pioneer in the field of information design, leads the charge against PowerPoint. His book ‘The Cognitive Style of PowerPoint’ [1], argues that PowerPoint’s linearity and rigid structure - the way it progresses as a series of equal-sized boxes - forces simplification of complex content.

PowerPoint also suffers, says Tufte, from a narrow visual bandwidth - the way in which the majority of content is concealed at all times (i.e. only one slide is shown at a time). This can make it difficult to present information that exists as multiple stages or steps, or is inter-related in nature. Consider how to present in, PowerPoint, the muscles and movements of the lower limb, the coagulation cascade, or the life cycle of malaria. You might be able to cram these topics into 80 slides, but, viewers are likely to forget the slide that went before as you advance to the next, focusing on snippets of information without being able to appreciate the information’s relationship to what has gone before.

Enter Dr. Holloway, who whipped up a new presentation format: a ‘web-based hybrid mind-map-slideshow’, designed with pathology topics in mind. That phrase wasn't really rolling off our tongues, so we later called it 'OverPath'.

OverPath couples a left-sided mind-map to a right-sided presentation slide area in a web browser. The JavaScript-based mind-map gives a visual, interactive overview of a topic. Exploring the interactive mind-map calls up HTML-based slides, which explore the topic in more detail.

Graphical representations like mind-maps are justified in learning theory as providing overviews of concepts, offloading some processing burden to the visual brain and relating new learning to previous knowledge [4]. The brain organises knowledge into hierarchical frameworks. Tools that emulate or facilitate this process can enhance learning [4]. Learning is also enhanced when continuous and large topics are broken down into small, learner-controlled sections [5], as in the mind-map.

Why not try it out yourself at the link below?

http://www.url.ie/velo

The methods and results for this project have been published elsewhere, so I won’t go into detail here, but – after developing OverPath further, we conducted a survey, to which 40 medical students responded, which found a statistically significant (p=<0.001) preference for OverPath over a static PDF analogue in terms of perceived usefulness. This was a great vindication of our work.

As a student, it is a great feeling to be able to contribute to the future of medical education. This is part of what the SSRA programme offers you. Medical education projects, specifically, benefit from the counsel of their peers and faculty advisors and at weekly meetings. This real-time feedback helped substantially with staying on top of an evolving project and with solving problems as they arose. This was something that other SSRA students, working mostly alone, ran into issues with.

The next step for our team is to investigate whether or not OverPath objectively enhances learning. We hope to conduct such a case-control-like study looking at OverPath’s effect on exam performance soon.

2. Peter Fryc

STAGE 4 UNDERGRADUATE MEDICINE

As part of the 2014 UCD Student Summer Research I got to spend eight weeks working alongside an inspiring group of scientists in the UCD Centre for Research in Infectious Diseases, located by the National Virus Reference Laboratory, in a building that, as weeks went by, started to resemble a T4 bacteriophage due to its unusual architecture. The research project focused on a relatively obscure part of the oncogenic Human T Cell Leukemia Virus (HTLV), the HBZ protein, and its interactions with host immune system proteins. The crux of my activities involved preparing plasmids, transfecting HEK 293T cells with said plasmids and measuring the corresponding transcriptional and translational activity of the innate immunity Interferon pathway, via Luciferase assays and Western Blotting respectively. The noble, if not deluded goal was to add to scientific knowledge, seeing further by standing on the proverbial shoulders of giants, and to find out whether HBZ is a viable therapeutic target in HTLV-1 infections.

Getting immersed in a scientific environment was a serene and enjoyable experience. The hours were quite flexible but generally the project involved a nine-to-five schedule in the laboratory with out-of-hours’ time spent reading papers and filling out the infamous laboratory notebook. I also devoured weekly instalments of ‘This Week in Virology’ (TWiV) a podcast for virology aficionados. At times, reading the scientific literature on molecular biology felt like deciphering Sumerian cuneiform, a completely foreign, esoteric language full of hard to grasp acronyms and diagrams. But with persistence experienced amazing moments of clarity in which I made leaps in understanding the topic. The acquisition of in-depth knowledge on one given topic was very rewarding and put into perspective the complexity of biological processes and the potential for improvements in medicine when such processes are fully understood. The literature review made me realise how much modern medicine still suffers from scant understanding of the molecular mechanisms and still relies on clinical outcomes as was the case with the initial use of aminopterin in leukemia.

The SSRA experience allows medical students a nice start on the path to becoming proficient translational practitioners. The projects allow students to improve critical thinking skills, and the scientific literacy involved with conducting research, presentation and publishing of it. Even application writing, I learned while submitting for the Wellcome scholarship, is an art form in itself and a highly touted skill when it comes to grants for the laboratory. Participants gain valuable laboratory experience in key techniques used commonly in medical investigations and research. Understanding the processes and minutiae of laboratory tests allows students to appreciate the results, as in the case of Western Blotting and its use in anti-HIV antibody testing in the clinical setting.

Feelings of ineptitude crept up every now and then, as it felt almost absurd trying to get proficient and confident in laboratory work in a short eight week period. When it came to the experiments, I sometimes wondered whether a small mistake or omission on my part could skew the results. I lacked confidence when providing conclusions. However after some rumination, doubts turned into moderate assertiveness. I realised that I did the work to the best of my abilities. This realisation allowed me to take pride in the results and conclusions that I presented at the 2014 SSRA adjudications and in the abstract for publication in the Irish Journal of Medical Sciences.

3. Caroline Moran

STAGE 3 BIOMEDICAL, HEALTH AND LIFE SCIENCES AND SSRA GOLD MEDALIST 2014

The enticing possibility of spending the summer abroad prompted me to take a different approach to the normal SSRA process in which students apply for advertised projects. I began searching for a research project abroad by contacting various groups and came across the UK Cystic Fibrosis Gene Therapy Consortium based at Imperial College London. The main focus of the Consortium at the moment is to develop a viral vector carrying the CFTR gene administered by inhalation. While this viral vector is anticipated to treat Cystic Fibrosis, it may also be exploited for the treatment of other lung diseases such as chronic obstructive pulmonary disease. Captivated and intrigued, I began to realise the true impact of this innovative approach. Could this finally be the cure that so many have hoped for? Following a short trip to London in March to meet the coordinator of the Consortium, preparations were put in place and the idea of spending two months in London during the summer soon became a reality.

Gene therapy, as with many things in research, is a much more complex process than it appears and many significant challenges currently impede its clinical utility. Prior to progression to clinical trials, the Consortium must establish the safety of CFTR viral administration. While results obtained thus far appear promising, the possibility of this virus inducing antibody development and therefore stimulating a potentially fatal cytokine storm is an important aspect of safety which must be addressed. As part of ongoing pre-clinical toxicology studies, I had the task of analysing mice serum to determine whether mice developed antibodies in response to repeated viral administration and, if so, whether antibody development depended on the viral dose.

Upon arrival in London, I was equipped with the necessary background knowledge and essential skills required to carry out the project. In addition to regularly passaging cells, the project primarily involved transduction inhibition assays whereby cells were seeded, mixed with mice serum, transduced with the virus and then whisked away to the flow cytometry lab in Hammersmith. Although I had no previous exposure to tissue culture or virology laboratory procedures, I soon became quite comfortable with the techniques as I performed them on a daily basis. While acquiring indispensable laboratory skills has been immensely beneficial, the research process itself also allowed me to further develop my analytical skills and to consider alternative approaches to answering the research question. Literature reviews, journal club presentations and public engagement events afforded me the opportunity to gain further insight into the challenges facing the field of gene therapy. To complement the lab research, I regularly visited the nearby Royal Brompton Hospital where I witnessed various tests being carried out as part of clinical studies. I also had the opportunity to spend time at the cystic fibrosis outpatient clinic in order to understand the burden which this devastating disease imposes and how gene therapy may contribute to relieving the affliction.

In addition to gaining invaluable skills and a positive insight into the field of inquiry, the promising results obtained from the project itself have played a pivotal role in confirming my desire for research. The simple finding that prior treatment with a low dose of the virus may induce immune tolerance in mice to prevent antibody development has since prompted further investigation. This discovery may play a role in the dosing strategy used in clinical trials in the future as subsequent administration of higher doses of the virus may provide a means to increase efficacy without increasing toxicity. Knowing that this research may help contribute towards the clinical application of viral gene therapy for cystic fibrosis someday has added great value to an extremely rewarding experience [6].

1. Tufte ER. The Cognitive Style of PowerPoint. 2nd ed. Cheshire: Graphics Press; 2006.
2. Gopal K, Morapakkam K. Incorporating Concept Maps in a Slide Presentation Tool for the Classroom Environment. In Proc. ED-MEDIA 2002. AACE, 2002.
3. House R, Watt A, Williams J. What is PowerPoint? Educating Engineering Students in its Use and Abuse. In 35th ASEE/IEEE Frontiers in Education Conference. IEEE, 2005.
4. Novak JD, Cañas AJ. The Theory Underlying Concept Maps and How to Construct and Use Them. Pensacola: Florida Institute for Human and Machine Cognition; 2006. http://goo.gl/URIiN3.
5. Mayer RE. Applying the science of learning to medical education. Med Educ. 2010; 44(6): 543‐549. doi:10.1111/j.1365‐2923.2010.03624.x
6. Bibliography: The UK Cystic Fibrosis Gene Therapy Consortium, (2015). United Kingdom Cystic Fibrosis Gene Therapy Consortium. [online] Available at: http://www.cfgenetherapy.org.uk/ [Accessed 23 Jan. 2015].