Email Address: jdt4n@virginia.edu

Unifying theme of educational research:

Practical experience drives my educational research. The four projects I have undertaken in the past eight years comprise current, authentic conundrums with prudent, purposeful solutions. 

PROJECT 1:  Student Engagement & Technology

BACKGROUND

      Vast increases in amount and types of information technology stream into the educational realm each month.  These advancements solicit use by teaching faculty hoping to validate classes, provide authentic exercises, enhance student involvement, and streamline assessment.  Their question remains, however, “Do the students learn better?”

      The University of Virginia School of Medicine has devoted the past 10 years to significant advances in educational technology for faculty.  We utilize web-based course management, online quizzes, discussion news-groups, electronic evaluation, and virtual exercises for microbiology teaching.  Recently, availability of audio-recorded lectures became a contentious issue among faculty believing student attendance and engagement would decrease.  Medical Microbiology (a Second Year course in the medical school curriculum) provided the perfect “laboratory” to answer apprehensive faculty based on attendance data for all classes (head-count of attendees).  These data fueled my first educational research project.

HYPOTHESES

Student attendance would decrease after availability of pod-casts of faculty lectures.  Decreased attendance would reflect poor engagement of students with the material, thus resulting in lower examination scores.

RESULTS

Surprisingly, despite a small decrease in attendance initially in the first year of pod-cast availabilities, average attendance was not statistically affected pre- and post-pod-casts.  Notably, attendance actually increased in the second year of pod-casts.  After significant student discussion, this phenomena appears to reflect to student understanding of the importance of class presentations for content mastery.  Interestingly, a related study was conducted where students’ exam performance was  correlated to self-reported lecture attendance.  While statistical significance varied among the comparative groups, we found a consistent, small, negative trend among students who admit low attendance.  Concomitantly, highest grades belonged to those students with highest lecture classes. 

EFFORTS

• Data accepted for presentation in collaboration with James Martindale, at the 12^th Workshop on Educational Strategies (Assoc. Medical School Microbiology and Immunology Chairs), Myrtle Beach (May, 2008).
• Manuscript in preparation

PROJECT 2: Faculty Recruitment Retention and Welfare

BACKGROUND

As an elected member of the Faculty Senate, I requested assignment to a newly created subcommittee, Faculty Recruitment, Retention and Welfare (2006).  This group of eight individuals undertook the enormous task to establish Faculty views of the future of the University, particularly focusing on those issues impeding academic achievement.  Active work on this subcommittee for 9 months generated a hand-crafted survey (in collaboration with the University’s Institutional Assessment & Studies) addressing Faculty perceptions of  collegiality as well as priorities for research, teaching, and benefits. This survey is the first of its type and scope at the University.

HYPOTHESIS

Faculty perceptions of the academic environment diverge from those held by the University Administration.

RESULTS

The survey was administered to approximately 3000 faculty at the University of Virginia (May-June, 2007), obtaining a 67% response rate (2100 respondents).  Remarkably, the high response rate and intense level of written responses generated extensive fuel for faculty-driven change in diverse arenas.  Data and reports are available through the Institutional Assessment & Studies:  http://www.web.virginia.edu/iaas/surveys/past/2006-07/fac07senate.htm

PROJECT 3:  Using Bloom’s Taxonomy to direct student learning

BACKGROUND

Faculty dialogue remains deficient when attempting to compare assessments across the School of Medicine curriculum at the University of Virginia.  Rather, faculty instructors contribute exam questions in isolation, lacking integration among course objectives or evaluation by other faculty (both clinical and basic science).  As a result, the student expectations for course assessments differ vastly from the resulting faculty assessment instruments.  A recent national study revealed the reality of this dichotomy at other institutions.¹  Because our School of Medicine is undergoing curricular renewal, we took advantage of the opportunity to initiate such a dialogue among faculty and students.  Numerous curricular and facility changes have created impetus to revise the current medical school basic science and clinical skills curriculum (Years 1-3).  A clear evaluation of our curricular assessments is required at the faculty, student,² and institutional levels.  Bloom’s taxonomy provides a valuable structure through which faculty can communicate expectations in clear manner for intensifying content application, analysis, and evaluation (Bloom’s levels 3-5).   

HYPOTHESIS and EXPECTED OUTCOME

Wide variability in the level to which different medical school basic science courses examine their students fuel the chasm between basic science and clinical practice.  After establishing an assessment base-line founded on Bloom’s taxonomy for all medical school courses, we will utilize these critical components as the foundation of to the curriculum renewal currently underway.

PRELIMINARY RESULTS

Initial funding provided a student-generated taxonomic analysis of Medical Microbiology examinations.  Data from paid student-reviewers laid the foundation for a second-tier analysis by faculty to confirm Bloom’s assignments to correlate student and faculty rankings of examination items.  Subsequent studies address a wider sampling of examinations from both first- and second-year courses, including Medical Biochemistry and Cell & Tissue Structure (currently underway).  This collaboration with Selina Noramly, PhD, is the subject of our recent, successful application to the Harvard Macy Program for Institutional Assessment.  Pilot data are extending our work in assessment and provide significant networking and collaboration opportunities.

PROJECT 4:  Educator Development to augment student autonomy

BACKGROUND

Throughout history, teachers have been held up as the conduit of knowledge. But what makes a “good teacher?”  I define “good teaching” broadly as that which enables students to learn well.  Therefore, the actions of the teacher are determined by the result of the student, consisting of complex, multi-step transfers of information, processing, and coordination.  The result is a difficult “product” to measure.  The gold-standard measuring true student learning would be “career success,” however such outcomes are extremely difficult to establish and follow. 

Another complexity of measuring teacher “effectiveness” is the changing landscape of educational learning theories.  Such shifts have been dramatic in the past thirty years, ranging from behavioral theories (1970’s) to cognitive theories (1980’s), and then social learning theory (1990’s).³  Each theory provides a strong foundation for “the way learners learn.”  While a “good teacher” will likely use multiple tools from each theory, it is often the “gut feeling” that drives organization, communication, and interaction with students.  Indeed a “good teacher” is prepared for the class by not only knowing the content, but also by presenting the information in a manner whereby students may become engaged in the dialog of knowledge.

Institutions of higher learning across the country fuel faculty development programs in order to develop teachers who appreciate their own teaching style, understand the needs of their learners, and integrate tools necessary to accomplish learning.  “Faculty Development” comprises a large and eclectic series of seminars, workshops, classes, coaching, and mentoring—all designed to elucidate, elaborate, and enhance teaching.  A critical finding of a recent study by Clark, et al., illustrated the importance and prevalence of faculty development in teaching.  “General teaching skills,” “small group teaching,” and “learner assessment” were among the most important requests by faculty when compared to twenty-seven total categories.⁴  Thus, teaching methods, evaluation, and communication are critical to the success of a teacher.

Faculty development is related to outstanding teaching in that it provides a forum for engaged faculty to reflect upon their own craft, realizing—often for the first time—improvements and evaluating changes over time.  Wilkerson defines faculty development as “a tool for improving the educational vitality of our institutions through attention to the competencies needed by individual teachers and to the institutional policies required to promote academic excellence.”³  My goal in facilitating teaching is to equip faculty for development to their highest potential through a powerful set of Faculty Development offerings, and this practical goal forms the structural basis for this research.

HYPOTHESIS

A well-defined Faculty Development program will cause measurable differences in quality of teaching and student learning, as well as openness of both parties to effective teaching methods and to transparent dialog about learning.

GOALS OF THE PROJECT

This dynamic faculty development program seeks to accomplish the following goals:

1.  Determine the teaching behaviors of faculty that preclude engaged and active learning;

2.  Identify and convey preparative elements needed by faculty to become better teachers (“Teach the Teacher”);

3.  Evaluate the impact of such in-depth faculty development upon student learning;

4.  Evaluate the growth of individual faculty due to participation in such a development program.

EFFORTS

• Ongoing faculty development sessions as preparation for Medical Microbiology Small group teaching sessions (supported by informal Departmental funding for six years)
• Grant written to identify measurable improvement accomplished via intensive faculty development for facilitation of small group discussions in Medical Microbiology (as a model for School-wide efforts) –

Summary of Microbiological Research

Unifying theme of scientific (bench) research:

My microbiological research focuses on the nexus of mycobacterial infection and the immune response.  To that end, my laboratory efforts utilize human cells to investigate the molecular signatures induced by the cell biology, immunology, and bacteriology of mycobacterial infection and/or coculture with human immuno-deficiency virus (HIV).  Using parallel approaches, I address these topics in two different model systems.

PROJECT A:  Dissection of the synergy in HIV/MTB coinfection

BACKGROUND

Unfortunately, one-third of the world population is latently infected with Mycobacterium tuberculosis (MTB).  After a 30-year downward trend in incidence of tuberculosis, the number of active MTB infections has increased dramatically over the past 20 years mirroring the swelling human immunodeficiency virus (HIV) epidemic.^5-6  Furthermore, a recent estimate suggests as many as 70% of MTB cases are undiagnosed.  Accelerated course of HIV progression and exacerbation of tuberculosis are hallmarks of disease among coinfected patients, but the mechanisms by which this synergy occurs remain unclear. ⁷

HYPOTHESIS

The production of HIV from cellular sub-compartments is enhanced by coinfection with MTB due to specific molecular antigens (lipid- and mannose-rich) elaborated during progressive coinfection.

RESULTS

Our findings have characterized the activation status of cellular contributors to MTB-HIV synergy.  Specifically, cell surface markers of activation, cytokine/chemokine profiles, and non-traditional antigen presentation molecules have been analyzed.  (publication submission pending)  Most recently, the focus has shifted to the role of lipid-presentation by the CD1 family of proteins.  The interaction of mycobacterial antigens with this small subpopulation of CD1-restricted T lymphocytes is under investigation.

PROJECT B:  Characterization of the effects of mycobacteria (strain BCG) on bladder cancer

BACKGROUND

Mycobacterium bovis  (strain BCG) is a live attenuated vaccine used to prevent tuberculosis for over 80 years, and was first used as a cancer therapy in the 1930’s after tuberculosis patients were shown to have a lower incidence of cancer.  In the 1970’s, a protocol was developed where intravesical BCG prevented recurrence of superficial bladder tumors, however the mechanism of this successful treatment—which remains in wide use currently—awaits elucidation. Specifically, high-risk, superficial bladder cancer patients are treated with urothelial instillations of recurrent doses of Mycobacterium bovis (strain BCG, FDA-approved vaccine strain).  In greater than 50% of cases predisposed for enhanced disease, BCG treatment reduces both progression and metastasis.^8,9  Using well-defined methods, we propose to dissect the response involved in BCG treatment of bladder cancer. 

HYPOTHESIS

Treatment of recurrent bladder cancer with intravesical Mycobacteria bovis (strain BCG) protects against invasive disease by promoting protection, both directly on the metastatic cells and indirectly through local immune responses.

RESULTS

Initially, we established assays to enumerate the effects of BCG treatment on staged bladder cancer cell lines.  Addressing our first major goal, we acquired relevant cell lines for our studies, extending our original target cells to include papilloma-transformed “normal” bladder cell lines, as well as graded bladder carcinoma cell lines.  Employing this diverse panel of bladder cells, we assayed viability, cell cycling, phosphorylation intermediates, and cytokine elaboration in the presence and absence of BCG.  We accumulated data to enumerate bladder cell viability during BCG coculture.  While these studies progressed, we began analysis of the cell biological effects of BCG coculture via surface expression of major histocompatibility complex (MHC) class I and class II.  Initial studies confirmed published reports that bladder cancer cell lines did not stimulate MHC class II in response to BCG coculture; MHC class I surface levels are high in the absence of any treatment.  Additional studies analyzed phosphorylation targets by Western Blot, however no BCG-regulated messengers were identified. 

Our second major goal was to begin to define the immune response during BCG coculture.  In order to elucidate cytokines elaborated during exposure to BCG, we use Luminex™ bead arrays to simplify our cytokine detection from stored coculture supernatants.  While this study is early in development, the foundation is laid to generate significant preliminary data.

We established strong impetus for studying bladder cancer at the University of Virginia, notably direct interaction with the University of Virginia Cancer Center and the Department of Urology (particularly Dan Theodorescu, MD).  Our objective remains that our studies on mycobacteria inform the clinical practice and treatment of  superficial bladder cancer and provide foundation for incredible collaboration in this cancer field.