A Compulsory Bioethics Module for a Large Final Year Undergraduate Class

Abstract

The article describes a compulsory bioethics module delivered to ~120 biology students in their final year. The main intended learning outcome is that students should be able to analyse and reason about bioethical issues. Interactive lectures explain and illustrate bioethics. Underlying principles and example issues are used to foster thinking skills. Three assessed seminars, each contributing 10% to the final mark, give practice in analysis and reasoning. In the seminars students work in groups of six and productive discussion is fostered through set procedures and demonstrator help. Generic feedback, along with specific feedback, helps to foster thinking skills. This is assessed in an examination accounting for 70% of marks in which students answer questions that test analysis and reasoning, as well as knowledge. Feedback from students indicated positive approval for the opportunity to think. However, it also identified concerns that reflected the unfamiliar demands of the module compared to demands of other modules. The assessments were strong motivators for students to take the module seriously and to improve their thinking skills. The assessments differentiated students of different ability as successfully as did assessment in other modules. Results were consistent with the module fostering thinking and analysis rather than just ‘learning’.

Keywords:

• Bioethics
• critical thinking
• seminars
• large classes

Introduction

Bioethics is an essential component of undergraduate degree programmes in biology (QAA, 2007). This is largely due to public interest and concern over the potential effects of applying biological knowledge and biological technologies. Most students accept that bioethics is an appropriate component of their degree (Lysaght et al., 2006).

Teaching and learning in bioethics modules is not straightforward. The main focus is often on example issues of our times and includes opportunities for students to argue about how they should be resolved. However, it is also important to prepare students to deal with novel issues. The QAA Academic Standards: biosciences benchmark statement indicates bioethics, as well as science, as requiring intellectual skills (QAA, 2007). However, people often regard ethics as an imprecise subject. This attitude could affect the willingness of students to engage in critical thinking about ethics. Furthermore, fellow academic biologists may regard ethics as not sufficiently intellectually robust to be included in a science curriculum. However, ethics is no less intellectually robust than science itself. In science, the creation of new knowledge through hypothesising and experimentation is impossible without both imagination and reasoning. Similarly, good ethical judgements are only possible if there is careful analysis of the underlyng considerations and of the possible consequences of the options, and this too involves imagination and reasoning. Misunderstanding of ethics can be overcome by using examples of critical thinking contained in the analysis of the underlying principles of ethics, and this will also help prepare graduates to address whatever issues the future brings, however unfamiliar.

Therefore teaching and learning in bioethics requires teachers as well as learners to take unfamiliar ideas on board, and to put analysis and reasoning at the core of their approach (Pearce, 2004, 2006, 2008). Clearly, an approach that engages students intellectually may succeed in appealing to those that are confident in their own intellectual abilities. But other students with less confidence may worry because they realise that simply applying learnt facts will not be sufficient.

Ideally bioethical issues would be introduced in the first year and bioethical analysis practiced at progressively more demanding levels in later years of the degree, but other curriculum demands can make this difficult to implement (Downie and Clarkeburn, 2005). Most often bioethics is taught in the second year of undergraduate biology degrees but in approximately one-third of UK universities it is only, or mainly taught, in the final year (Willmott et al., 2004). However, teaching bioethics in the final year of a degree has some advantages. The knowledge and understanding of biology and the range of transferable skills that the students have acquired will be greater than earlier in their degree. Also, it allows bioethics itself to be taught at a level that makes it possible to tackle a range of issues at a deeper level.

The literature includes descriptions of several courses in bioethics but these are mostly ones that are delivered before the students’ final year (Downie and Clarkeburn, 2005; Bond et al., 2002; Bryant and Baggott la Velle, 2003; Willmott and Wellens, 2004). Some final year courses have been outlined at meetings on teaching ethics to biologists (Bowsher, 2005; Mordue, 2003) but there appear to be no complete descriptions in the refereed literature, though some aspects of the academic assessment in our module have been described (Pearce, 2008). The objective here is to describe our well-established final year module (‘module’ is the name at Newcastle University for component courses of degrees). The module, Social Impacts of Biology (BIO3015), preponderantly addresses bioethics but also includes advanced factual sessions on some key related areas of biology. This article outlines the module’s aims and intended learning outcomes and its structure and content, gives illustrative key details, discusses potential effects of teaching spaces on the success of the module, and uses student performance and feedback to understand more about the impact of the module on the students. The intentions are to provide illustrations that may be helpful to those who are trying to establish a similar module or who are taking on larger classes in bioethics, and to identify and discuss issues that arise in delivering a bioethics module.

Methods and Teaching Context

BIO3015 Social Impacts of Biology (referred to in following sections as the bioethics module) is a 10 credit module that is delivered by the School of Biology in the Faculty of Science, Agriculture and Engineering at Newcastle University. It is compulsory for the three degrees that are managed by the school, Applied Biology, Biology and Zoology.

The University’s undergraduate honours degrees are taught over three years and comprise 120 credits of study in each year. Ten credits are intended to equate to 100 h of study. Most modules in the School of Biology have a value of 10 credits and a few have a value of 20 credits. The 10 credit module Social Impacts of Biology comprises one-twelfth of the teaching and learning in the final year of the School’s degrees.

The Social Impacts of Biology module was devised in the early-mid 1990s as a final year compulsory module for the degree in Applied Biology. It was first delivered to classes of between 20 and 30 students; subsequently it was offered in other degrees and in the last two years it has been delivered to classes of over 100 students. In anticipation of these numbers, seminars replaced a major essay four years ago and have been progressively improved to act as a key vehicle for engaging students directly in ethical analysis and reasoning.

Box 1 shows the intended learning outcomes of the module and Box 2 shows an outline of the module’s structure and content and how different components relate to the intended learning outcomes. The module is taught through lectures (22 × 1 h) and seminars (3 × 2 h) totalling 28 contact hours, leaving 72 h available for private study. Hard-copies of projected information (in Microsoft Powerpoint) are provided in lectures and to support the seminars and are also available on a web site. The average number of contact hours in 10 credit final year modules in the School (excluding those where the contact hours are nearly all in the laboratory or field) is 23 h but the standard deviation is 11 h. Differences in contact hours between modules reflect differences in teaching and learning requirements. In the case of the Social Impacts of Biology module the above-average number of contact hours is justified by the need for seminars and in particular the requirement that the in-course test pieces are discussed and completed during the seminars. The different nature of the lectures is also a consideration because they include more than usual interaction between the lecturer and class and this slows the pace at which key points are covered.

Box 1 Intended Knowledge and Skills Outcomes

1. Students should know and accept the importance of ethics including

   1. applying ethical principles;

   2. a logical approach to analysing an issue;

   3. the impact which public perceptions of biology can have on the success of their application; and

   4. scientific investigations of the possible impacts of applied biology.

2. Students should be able to describe, explain, and analyse specific example issues in moderate depth. They should be able to develop a logical, structured approach to a specific problem or to a general type of problem.

The Social Impacts of Biology module is the only one that is compulsory in all three degrees delivered by the School. Assessment statistics for the Social Impacts of Biology module are compared with those from several other modules that are compulsory or optional in the different degrees managed by the school. The 20 credit module Cell Proliferation and Death (BIO3013, referred to in later sections as the cellular module) covers the cellular, biochemical, molecular, genetic and developmental aspects of abiotic stresses. The author is the module leader for this module as well as for the Social Impacts of Biology module. Three 10 credit modules are also included for comparison: Animal Ecophysiology (BIO3001, the ecophysiology module) covers physiological, biochemical and behavioural adaptations used by animals to allow survival in a range of environmental conditions; Animal Population Dynamics (BIO3002, the population dynamics module) covers animal population processes and the factors that affect them, and discusses models to describe those systems; Biotechnology 2 (BIO3018) is about how genes are constructed to function and how this understanding can be exploited. Both the Cell Proliferation and Death and the Biotechnology 2 modules are compulsory components of the Applied Biology degree and are optional components of the Biology degree but are not offered in the Zoology degree. The Animal Ecophysiology module is a compulsory component of the Zoology degree and an optional component of the Biology and Applied Biology degrees. The Animal Population Dynamics module is an optional component of the Biology and Zoology degrees but is not offered in the Applied Biology degree.

Box 2 Outline Structure and Content and Relation to Intended Outcomes

Lectures:

Introduction (1)^*

Ethics; argument and reasoning. (6) (Box 1: 1a, 1b, 2)^**

Animal ethics and welfare; research into whether animals feel pain. (2) (Box 1: 1a, 1d)

Tissue and organ transplantation — legal, ethical, practical issues. (2) (Box 1: 1a, 1b)

Food safety and GM foods. Food risk communication. (2) (Box 1: 1c)

Environmental ethics. (2) (Box 1: 1a, 1b, 2)

Environmental impacts of genetically modified plants. (3) (Box 1: 1d)

Seminars and associated sessions (Box 1: 1a, 1b, 2)

Seminar 1: Saviour sibling topic. (Searle, 2004; Chapter 10 of Bryant et al., 2006) (1 h session to explain preparation. 2 h for discussion plus writing. 1 h session to give generic feedback)

Seminar 2: Golden rice debate. (30 min session to explain preparation. 2 h for discussion, debate and writing. 1 h session to give generic feedback)

Seminar 3: In 2007/8, “Would the world be a better place without humans?” (No prior information. 2 h for introduction, discussion and writing. 1 h session to give generic feedback)

Assessment follows Newcastle University’s common marking scale and marking notes are provided for each seminar and examination question. However in the Social Impacts of Biology module general marking notes are also given, to emphasize the general requirement for reasoning. Seminar and examination scripts are thoroughly annotated, to give feedback in the case of the seminar scripts, and to allow moderators and external examiners to see the basis for the mark given. Results are moderated as specified by the University. Students can view past examination papers on the University’s web site and example questions are discussed in lectures. More details on marking, including examples of marking notes, are given by Pearce (2008).

Student attitudes to a particular module are monitored at its end using standard questionnaires provided by the University (form ID AES0104, recently replaced by an online system of feedback). This is required by the University as one of the means by which it monitors whether teaching and learning are functioning well. In response to 13 questions, students score aspects of a module from 1 (usually lowest score) through to 5 (usually highest score). Two additional questions invite students to write comments. The student responses help the module leader to identify aspects of the module that need improvement. Summaries of student responses are considered annually by the Board of Studies that oversees the content and development of the degrees, and the board can direct issues that emerge to the attention of module leaders or degree programme directors for appropriate action.

Marks, examination and degree results, and student feedback from the questionnaires were analyses using statistical packages in Microsoft Excel.

Structure and Content

Outline

The intended learning outcomes of the Social Impacts of Biology module emphasize analysis and reasoning (Box 1) and therefore these are assessed. Analysis and reasoning are also important transferable skills and are essential for good science, which further justifies fostering and assessing them (Pearce, 2004, 2008). Appropriate facts are necessary resources for reasoning, therefore knowledge is also a factor in the assessment. However, the emphasis on analysis and reasoning in delivering and in assessing the bioethics module makes it different to other modules and a challenge for the students. Another novel feature is that the intended learning outcomes indicate that students should accept the relevance of ethics to biology and the need to analyse and reason about ethics.

The lectures discuss and explain principles, facts and ideas and link these to details of major issues (Box 2). The seminars (Box 2) give students the opportunity to practice, develop and apply their knowledge and understanding and reasoning ability by discussing example issues and by practicing writing reasoned cases. The seminars are compulsory and the work done in the seminars is worth a total of 30% of the module mark (10% for each seminar piece). The remaining 70% of the module mark is from a 1.5 h examination. Some examination questions relate to particular topics covered in lectures and others relate to wider issues, but all demand, partly or predominantly, analysis and reasoning.

It is an essential feature of the module that the lectures are interactive. The lecturer’s aim is often to expose students to predetermined points but in a way that allows time for students to discover, understand, dispute, and clarify points. This is particularly useful in helping students to accept the most basic ideas. The increase in numbers of student taking the module, from 20–30 students to >100, has not inhibited the interactive nature of the lectures. In fact, in the author’s experience, the larger numbers make it quicker and easier to get a response and initiate discussion.

While the interactive nature of the lectures has always been a feature of the module, the seminars were created in anticipation of recent increases in class size. The seminars were designed to cope with the whole class in three 2 h sessions. In these sessions the students discuss in groups amongst themselves but according to a plan and with help from demonstrators who move between groups. All groups tackle the same bioethical question. After the discussion (and in one case after a debate) students write a short case and hand it in at the end of the session for marking and later return.

Coverage of principles in ethics

The intended learning outcomes (Box 1) mention ethical principles. This does not refer to absolute standards of behaviour, but to principles that either characterise ethics, or are widely useful, though not infallible, in considering ethical questions.

Two logically unavoidable principles

One is the claim that there are right answers to try to find. Ethical reasoning would be pointless without this. However, extreme relativism asserts the opposite, that opposing claims as to what is right and wrong are equally valid or ‘right’. This is a logically self-defeating claim (section 2.9 in Mepham, 2008; “relativism, ethical” in Honderich, 2005). Nevertheless, people often tend towards relativism, or superficially appear to. Perhaps this is because the knowledge and understanding that is the fuel for reasoning, may not be certain, or because questions may be stated unclearly. In any case, there is a clear difference between claiming true answers are impossible, and asserting that a true answer is hard to find without clarity of statement and sufficient appropriate and reliable information.

The other essential and logically unavoidable principle is that facts alone are insufficient to decide an ethical issue; value judgements are essential. The frequency of unexpressed assumptions sometimes makes this point hard for students to see. To illustrate this, figure 1 shows Powerpoint slides that in an interactive lecture help to introduce and illustrate the idea that value judgements are essential.

Figure 1 Powerpoint slides showing how the idea of value judgements is introduced.

The upper slide includes questions to discuss with the class. The first (“Is this a reasonable conclusion?”) is deliberately open. Revealing and discussing the second question (“What if it were a disease-causing microbe?”) helps show that the preceding sentences were insufficient alone to form a complete argument. The final point (“…can’t get an ought from an is…”) is philosophers’ encapsulation of why the argument does not work without a value judgement (section 2.3 in Mepham, 2008).

The lower slide then illustrates how adding a value judgement overcomes this problem. Discussing the three suggested value judgements in the second slide also shows that the value judgements themselves have to be thought about and justified, and can help students see that value judgements are often hidden assumptions in arguments, and to see the potential importance of making them explicit (as the examples show, there may be factual assumptions too).

Useful principles (not incontrovertible)

There are three common and important value judgements: wellbeing, autonomy and fairness and these three should be considered when making ethical judgements. The different value judgements may lead to the same conclusion on some issues but to conflicting conclusions on others. Therefore reasoning often has to be deployed to balance their rival indications. Although these principles cannot be put forward as absolute, they are very useful for helping to focus ethical analysis. A purpose of the few lectures on ethical theories is to discuss how such principles might be justified.

The same value judgements are used in Mepham’s Ethical Matrix (Mepham, 2008). The matrix allows each value judgement to be considered for each ‘interested party’, i.e., for those likely to benefit or be disadvantaged by the outcome. The idea of interested parties is particularly useful for biologists because it does not confine interested parties to humans — if the issue concerns chicken welfare, then chickens are one of the interested parties. The ethical matrix provides students with a useful structure to help organise analysis and reasoning, for example in seminars and in writing examination answers.

Nature of arguments

The principle features of reasoning are a brief but essential part of the module. The important points can be made simply: a piece of reasoning contains two elements, foundational assumptions, and the reasoning that can be drawn from them. These also define how an argument can be opposed or overturned, by either undermining the assumptions (that is, not merely objecting to them, but giving a reason to object) or finding a flaw in the reasoning.

Confusing and confounding factors

These are important because they are varied, common, and easily overlooked. They often occur as hidden or unconscious assumptions. Examples include when different people in an argument use the same word with a difference in meaning (e.g. ‘nature’ meaning everything scientists are trying to explain, versus ‘nature’ meaning only the things that are not influenced by people), or when people have different world-views (e.g. religious belief, Gaia hypothesis, science: Pearce, 2004b).

Students are asked to pay attention to these considerations when working in the seminars and when answering examination questions. However, we also make more general points, that any reasoning, ethical or otherwise, requires careful thinking: paying attention to the meaning of words, understanding and exploiting the structures of the arguments that are made, organising the material to achieve clarity. Students who try to do this will be advancing their general reasoning skills as well as being more likely to come to sound ethical judgements.

Seminars

The purpose of the seminars is to give practice in thinking about bioethical issues and in writing answers to bioethical questions, and thereby help prepare students for the examination. The marks and feedback are intended to directly help the development of skills. The sequence of topics also fosters development of skills, with the intellectually most demanding topic in the last seminar, and arguably the least in the first (Box 2). On the other hand, all demand imagination — often lateral thinking — to look at the issues from different perspectives.

In the first part of each seminar session students discuss the topic in groups and at the end they write an individual argued case (whatever case they think best, not a consensus from their discussion). A team of markers help to mark the work (for more details on marking, including marking notes, see Pearce, 2008). Generic feedback is given in the following week and students get their work back with individual feedback at the start of the following seminar.

The sequence of seminars comprises topics of narrow through to broad scope (Box 2). More details of the first two seminars and alternative topics for the third are outlined in Pearce (2006). Students are asked to write about one side of A4 in 25–30 min but they are allowed to write up to two sides (we tell the students that we do not read beyond two sides). This limitation in size is essential for turning the marking round in two weeks, but it is also justified because it can help students in several ways. Periods of preparation and discussion precede the writing and therefore students will often already know what they want to write before starting. However, because students do not have to write a lot, they can afford to take some time to refine their thinking during the writing period. Also, we can put emphasis on the benefits of conciseness and clarity. Nevertheless, because of the time constraint, we do not expect polished answers.

This system focuses on the components, analysis and reasoning, that most need practice. It makes clear to students that they will need to be able to analyse and reason to meet the intended learning outcomes of the module as tested in the examination and, potentially, as exercised in their careers.

Organisation of Discussion

It is particularly desirable that every person in a group contributes. Also, there must be sufficient opportunity to identify and consider the most helpful points. Furthermore, while constructive argument is always helpful, unmanaged arguments even about key points can be time-consuming and thus prevent consideration of other key points. The discussion will be most helpful to most students if it is organised and managed in a way that addresses these points. Our system is as follows.

Obviously, for groups to be most effective in fostering helpful and productive discussion, they should be neither too large nor too small. We use a size of six because it is approximately optimal (Ziller, 1957; Schellenberg, 1959). Each group chooses a chair person.

The groups are given a procedure to follow (Pearce, 2006). This is based loosely on de Bono’s “Six Thinking Hats” (1999). There is a series of rounds in which each person contributes in turn. The first four rounds bring forward different kinds of consideration that may be useful in the final round, which aims to draw a conclusion. During the first four rounds nobody should object to any contribution; they can do so in the final round.

The rounds are as follows.

• People often have emotional reactions to ethical issues, or at least an initial gut feeling. As they may well influence the discussion, it is better to know about these than to ignore them. In the first round students state their initial reaction to the issue, but must not at this point give any justification. This establishes the range of starting positions and gets people’s emotional reactions into the open.

• In the second round students are asked to identify those likely to benefit or be disadvantaged by the outcome (interested parties). Apart from its innate importance, this is necessary later for using Mepham’s ethical matrix (Mepham, 2008).

• In the third round students contribute facts that they think are relevant. This includes identifying important gaps in the available facts. The round can be repeated until students are satisfied that they have enough facts. (Importantly, de Bono, 1999, explains that ‘facts’ should not include — at this stage — the opinion of the individual contributor, though it can include stating that a particular opinion is widely held.)

Figure 2 Powerpoint slides showing examples of generic feedback about the golden rice work. In the seminar, students argue for or against the use of golden rice to help reduce vitamin A deficiency. The generic feedback session is held soon after the seminar while it is fresh in students’ minds, but before they have seen their individual feedback.

The upper slide addresses common problems and aims to help students become more critically aware. The slide reminds them that they should try to justify claims, which many forget to do. It also reminds them that they have more relevant ideas and knowledge, even if not detailed, than they realise. For example, they could imagine that circumstances in different countries might differ, which could affect the chances of success of golden rice or of introducing more leafy vegetables. Being final year students, they could think about the chances of gene escape and of selective advantage in the wild.

The lower slide illustrates a point that students may not have thought of. The slide itself does not deal with the potential objections but these were already discussed in earlier contexts in the session. Here the focus is on the relative simplicity and strength of the point. Discussion of this example focuses attention on the importance of thinking broadly and indicates the potential revolutionary effect of expressing ideas simply and clearly.

• In the fourth round students contribute a point from lateral thinking. This can, in the final round, be helpful for understanding opposing views, and if an attempt to reason gets stuck, lateral thinking can indicate alternative approaches.

• In the final round, having gathered facts and ideas in the previous rounds, students can argue (but initially making points in turn) about which view is right and why. By debarring argument in the preceding rounds, the procedure tries to ensure efficient collection of ammunition for analysis. It also helps to ensure that all students have an equal chance to fully take part in the process. Also it is more likely to be obvious by the end of the first four rounds as to which considerations students should focus on in trying to draw a conclusion. Had immediate objection been allowed in the preceding rounds the discussion could have become stuck at an early stage and important considerations likely to emerge later might have been overlooked.

In practice, this procedure is followed more closely by some student groups than by others. Also, some rounds are more helpful with some issues than with others, so sensible adaptation is allowed. However it is always a useful structure to use because demonstrators can prompt ideas by asking questions in relation to different rounds, and can use the need to progress through this procedure as a lever to move a group on if they have got stuck, (for example through prematurely objecting to points).

Students keep notes to help them write their argued case but in practice, with 90 minutes of analysis and argument fresh in their minds, they can often plan their piece and write it straight from their heads.

Generic feedback

Generic feedback has two functions: important common problems can be identified and discussed, and it exposes students to alternative ways to analyse a problem. Figure 2 shows two Powerpoint slides that illustrate these functions, from the generic feedback session on the golden rice seminar.

Students commonly argue by making a claim that something is the case but forgetting that others may not agree (upper slide in Fig 1). So students need to show they understand this by trying to support their claim. To carry this off requires some insight — especially into why the claim may not be universally accepted — and an attempt to respond. The slide illustrates three common examples and indicates the weaknesses. It prompts discussion and shows that general knowledge can be useful. It also indicates connections to other parts of the curriculum, here to the scientific understanding of likelihood and potential effects of transgene escape.

In seminars students argue the case they wish to make. They are required to draw a clear conclusion, but it does not have to be a particular conclusion that the marker would agree with. Consequently, feedback written on the answer of each student will mostly relate to the way they made their case. Clearly, it would be useful to also tell students about the strength and weakness of other cases that could be made. The lower slide in figure 2 illustrates the potential effectiveness of broad and lateral thinking.

Overall, the generic feedback sessions can help foster development of skills and a deeper understanding of issues by re-examining in a class discussion the original issue, and by connecting with related issues that contribute new or important considerations.

The Examination

The examination has two sections: Section A questions are linked to particular topics covered in the module whereas Section B asks broader questions including topics not covered in the lectures or seminars. Section B questions can focus the student’s attention on the most general features of ideas. This is important since, while ethical issues often relate to particular situations, very commonly there are broader underlying principles that are influencing people in making their judgement, and it can be enlightening to analyse these independently of the particular case.

Broad issues as well as narrower ones are explained and their analysis practiced in lectures and seminars. This is in line with the intended knowledge and skills outcomes of the module (Box 1) which indicates that students should be able to develop a logical, structured approach to a specific problem or to a general type of problem. The examination gives them the opportunity to show they can do both.

Three complementary guides are used in marking student scripts: the University’s common marking scale, marking notes relating to individual questions, and general marking notes asserting the importance of an analysed, reasoned case and of using appropriate facts appropriately (see more details in Pearce, 2008). An important feature is that the question-specific marking notes are illustrative, not prescriptive; it is the general marking notes that identify the absolute requirements, for analysis and reasoning.

The focus here is on example points from question-specific marking notes illustrated by section B questions (Pearce, 2008, gives examples of section A questions). Section B questions commonly address basic ideas and broad assumptions. The situation is often oversimplified in these questions but this helps to highlight the crucial effect of otherwise less-obvious assumptions. The following are examples that relate to environmental ethics.

1. “Consider arguments for and against the idea that the earth would be a better place without humans and draw a clear conclusion one way or the other.”

2. “Imaginary philosopher A says any species, if facing extinction, should, if possible, be saved. Philosopher B says that they should only be saved if it is human activity that has threatened their survival. Philosopher C says no species, except the human, should be protected from extinction. Philosopher D says not even the human species should be protected from extinction. Discuss who is right.”

A student attempting question 1 may realise that they have to take a position on what ‘better’ means, and justify it. If they have imagination, they may argue that non-human organisms operate consistent with the concept of betterness (any organism that is selective about what it consumes). Many may see an important question in whether something could be fairly judged better or not, when we are absent. Some organisms will be gainers, other losers, so there is also an issue about whether we could ever judge the aggregate as overall better. When set as an examination question, in 2006/7, plenty of students tackled it and, on average, did as well or better than students who tackled other questions (mean and standard error of 64.0 ± 1.4, compared with 62.3 ± 3.0 and 59.0 ± 1.0 in the other two section B questions; n = 46, 19, 59). When set as a seminar topic in 2007/8 students did as well as in other seminars (mean and standard error of 61.6 ± 0.7, compared with 61.6 ± 0.7 and 60.2 ± 0.8 in the first and second seminars; n = 103, 106, 102).

The second question is written in a way that helps the student to structure their argument. Amongst other things, the question is a test of whether students remember that to sustain a case they must show why the alternatives are not as good. People tend to assume that it is a sound principle that if something is the fault of humans, then humans have a duty to try to reverse the effect. However it would be impossible to amend every effect of humans (e.g. would every mouthful of any food have to be replaced?). It might be possible to argue that a narrower interpretation should be used, such as that it should apply only when the adverse effects are avoidable (though one could still ask why.) It may be that none of the alternatives can stand up as generalisations.

These questions address the hidden assumptions in peoples’ attitudes to nature. The student’s answer does not have to cover all the points mentioned above or in the question-specific marking notes; a student that gives an answer that recognises and tries to deal with any of the points, ideally recognising and trying to address the relevant counter-points too, is on the way to developing an ability to think critically about difficult issues inside and outside biology. This is equally so if a student uses an approach that is effective but mentions none of the points in the marking notes.

Teaching Space Issues

The success of the module partly depends on using suitable spaces for the teaching. These affect how well the lecturer can interact with students and the feasibility of holding seminar sessions for the whole class. The following outlines some important considerations.

Because our lectures are interactive yet classes are large, the lecture room needs to allow the lecturer to be able to get amongst the students so that there are opportunities to engage students in all parts of the lecture room. For example a lecture room with a central aisle facilitates this. By going amongst the students, the lecturer can also become part of the class, looking and commenting with students on some question projected on the screen. On the other hand, a long bench or similar barrier in front of the lecturer creates an impression of separation between the lecturer and students. A moderately-steeply tiered lecture theatre is also helpful when student numbers are large as the back rows of students feel nearer than in flat spaces or with shallow tiers. These seem small points, but they may be vital in turning a lecture session where students may feel they are passive absorbers of knowledge into a joint consideration of possibilities.

In the seminars, students discuss a topic in groups of six. In a class of over 100 this creates 17 or more discussion groups. The circles of chairs for the groups need to be spaced so that the class leader and demonstrators can go from group to group. Large spaces that can accommodate the class organised in this way, may be rare and may include spaces designed for other purposes and which therefore could lack normal teaching facilities. In the author’s experience, some of these problems can be overcome by using a prior session in a normal lecture room to explain about the session, so that a minimum of general instruction is necessary in the session itself. Ideally these large spaces should have surfaces for students to lean on to write their argued case. When this is not possible, the author has found that students are willing to bring something to lean on.

Could this seminar system be used with yet larger classes, for example classes of several hundred? There are large flat spaces in many universities that might accommodate 30 or more discussion groups (>180 students), but classes in some universities are already much larger than that. As our module shows, seminars can play a central role in bioethics modules with large numbers of students, a role that would not be easily replicated by a less space-demanding method. It could be worth holding each seminar twice to cope with very large numbers.

Student Performance

The students achieved the central intended learning outcome, which was a structured and logical approach to bioethics employing facts appropriately (Box 1). The examination tests analysis and reasoning about bioethics. Evidence of doing this (or, in the first seminar, of at least an attempt to do this) is required to gain a pass mark in the seminar work and examination questions. It is rare for students to fail the module. This is not to say that they are all good at analysis and reasoning; as Downie and Clarkeburn (2005) pointed out, one should not expect miracles. Nevertheless once students gain some experience of analysing and reasoning about bioethics there is a much better chance that after graduation they will try to apply and progressively improve these skills.

Another important intended learning outcome is to accept the importance of bioethics (Box 1). Since this is a matter of attitude rather than knowledge and skills, it is not tested in the examinations. The standard Newcastle University questionnaire used in the Student Feedback section below gives insights into this.

Overall, students did as well in this module as in traditional biological modules. The means of module marks were mostly similar in the bioethics and other modules module and the maximum and minimum marks awarded were also similar (Table 1). However, the standard deviations for the bioethics module in 2006/7 and 2007/8 were below those for the other modules (Table 1).

Table 1 Statistics for overall marks for the bioethics and other modules in 2006/7 and 2007/8

	mean	SD	Min^a (%)	Max^a (%)	n^b
Bioethics (2006/7)	59.5	6.5	37	79	124
Bioethics (2007/8)	60.3	6.0	34	80	108
Cellular (2006/7)	61.6	6.8	50	79	25
Cellular (2007/8)	60.7	7.7	25	83	36
Biotechnology module (2006/7)	61.2	6.8	52	77	17
Biotechnology module (2007/8)	60.5	8.5	40	81	31
Animal ecophysiology (2006/7)	58	8.7	29	75	76
Animal ecophysiology (2007/8)	54.4	10.6	27	85	67
Animal population dynamics (2006/7)	60.2	9.0	39	90	86
Animal population dynamics (2007/8)	62.8	7.3	47	83	62

^a Minimum and maximum marks.

^b The bioethics module is the only final year module that is compulsory in all three degrees (Applied Biology, Biology and Zoology) and therefore class sizes were smaller in the modules that it is compared with.

Consistent with this, there was a trend in the bioethics module towards a higher proportion of marks in the combined second class, particularly when compared to the ecophysiology and population dynamics modules (Table 2). Correspondingly, there was also a trend towards fewer first class marks in the bioethics module compared to the average of the others: 6% (n = 2) compared to nearly 11% (n = 8). The low percentage of first class marks in the bioethics module was evident in earlier years too, cumulatively 4.3% in the three years 2004 to 2006 (n= 141). Possibly, because it was compulsory, students were less motivated towards bioethics than to the optional module.

On the other hand, the percentage of students with a third class or fail mark in the bioethics module was no worse than in other modules: 7.5 % (n = 2) compared to an average of 9.3% (n = 8) in the other modules. Again, there was a low cumulative value in the bioethics module over the three preceding years (4.3% third classes; no fails; n = 141). This indicates an important point, that the unfamiliar nature and compulsory status of the bioethics module was not associated with a higher than average frequency of poor or fail performances.

Table 2 Percentage class distributions in 2006/7 and 2007/8 of final marks for the bioethics and other modules, and for the whole degrees

	F or P^a	3	2ii	2i	1
Whole module marks^b
Bioethics (2006/7)	0.8	4.0	52.4	35.5	7.3
Bioethics (2007/8)	0.9	9.3	34.3	55.6	4.6
Cellular (2006/7)	0.0	0.0	36.0	52.0	12.0
Cellular (2007/8)	2.8	11.1	36.1	41.7	8.3
Biotechnology (2006/7)	0.0	0.0	47.1	41.2	11.8
Biotechnology (2007/8)	0.0	6.5	51.6	29.0	12.9
Ecophysiology (2006/7)	2.6	9.2	42.1	40.8	5.3
Ecophysiology (2007/8)	9.0	22.4	41.8	19.4	7.5
Population dynamics (2006/7)	2.3	7.0	37.2	40.1	12.8
Population dynamics (2007/8)	0.0	1.7	33.3	44.0	15.2
Whole degree marks^c
2006/7 (n = 121)	0.0	5.8	40.5	46.3	7.4
2007/8 (n = 106)	2.8	1.9	32.1	50.9	12.3

^a F or P: respectively fail the module or gain a pass degree.

^b Numbers of students as in Table 1.

^c Distribution of the marks presented to the board of examiners, 25 % from second year and 75% from final year results

In any case, this trend towards more marks in the combined second class in the bioethics module compared to some other modules, reflected only a small difference compared to year-to-year differences in distributions between classes, particularly 2i, within most modules (Table 2). Bearing this in mind, one can conclude that assessments in the bioethics module discriminated between students of different ability approximately as effectively as did assessments in other modules.

Table 3 Percentage class distributions in 2007/8 for individual pieces of work in the bioethics module

	Fail	3	2ii	2i	1	Min^a (%)	Max^a (%)	n
Seminar work	0.0	6.4	32.9	47.3	13.4	40	85	313^b
Exam Section A	0.9	9.3	31.5	49.1	9.3	30	85	108^c
Exam Section B	2.3	9.3	27.8	46.3	13.9	29	90	108^c

^a Minimum and maximum marks.

^b Marks pooled from three seminars.

^c Marks pooled from answers to different questions.

Table 3 shows that the bioethics module gave a consistent distribution of marks between classes for individual pieces of work, and that this was similar for the different components of assessment in the module. Clearly, all the assessments in the bioethics module, in the seminars and in sections A and B of the examination, successfully differentiated between the performances of different students.

The emphasis of the assessment in the bioethics module was different to in other modules therefore, despite the similarity in the assessment statistics between the bioethics module and other modules, we could not assume that individual students would generally do similarly in the bioethics module compared to in others. On the contrary, one might expect a difference. There was no correlation between the final marks for individual students in the bioethics and the cellular modules in 2005/6 and 2006/7 (P = 0.19, n = 19; P = 0.30, n = 25) but in 2007/8 there was (P = 0.011, n = 35 after excluding an outlier) and pooling the data for the three years gave overall support for a correlation (r = 0.31, P = 0.005, n = 78 after excluding outlier marks for two students who failed the cellular module). However in the comparison of the bioethics with the cellular module the scatter was much wider than when the cellular module was compared with the biotechnology module (r = 0.69, P = 1.7 × 10⁻⁹, n = 58, after excluding an outlier mark for one students who failed the cellular module) (Fig 3). To check if this was a general trend, 2007/8 results for the Biology degree were analysed and confirmed that individual marks in most biological modules correlated more closely with each other than with the marks for the bioethics module, though as one might expect, marks in another distinctive module, comprising a field course, also tended not to correlate closely with other modules (details not shown). Presumably, these differences are indicators of differences in the ability of different students to tackle the different skills needed in these more distinctive modules, and is an independent indicator consistent with the claim that the bioethics module fosters skills that are different to those acquired else where.

Analysis of Student Feedback Questionnaires

‘Overall’ rating

One question in the student feedback questionnaire asks students to give their overall rating of the module. Students score this from 1 (lowest rating) through to 5 (highest rating). Four is the commonest modal score for all stage 3 biology modules, indicating a broadly favourable response to our teaching across the curriculum. The mean modal score for the bioethics module across three representative years 2003/4, 2005/6 and 2007/8 was 3.50 ± 0.29 (n = 3), and the mean modal score across a sample from the same years of other modules covering a range of biological topics was higher, but not significantly so, at 3.81 ± 0.23 (n = 8). (The cellular module used in comparisons of student performance, above, was typical, with a mean modal value of 3.83 ± 0.16, n = 3).

Nevertheless other details did differ. Although students discuss example questions in seminars and in lectures, this falls short of experience in the examination itself. Students will, by their final year, have previously tackled many examinations of their knowledge and understanding but they will have tackled few or none that primarily addressed their ability to write a clearly argued case. Consequently, students that were not confident in their ability to think independently or to express their thinking clearly might well have different opinions about the bioethics modules from those that were confident.

A larger proportion of students gave the bioethics module low scores in their overall rating, than gave non-bioethics modules low scores: the percentages of students giving the lowest scores of 1 or 2 for the bioethics module were 7.3 ± 3.0 and 19.3 ± 1.9 (averaging feedback from the same three years indicated above) whereas for the non-bioethics modules the percentages were 1.5 ± 0.8 and 6.3 ± 2.8 (n = 8; averaging several modules from the same three years). This indicates that about a quarter of all students, a higher proportion compared to other modules, were not happy with the bioethics module. This proportion has been stable over many years (details not shown), and continues in recent years despite changes in the module (the introduction of the seminars) that students generally welcomed (Box 3).

Box 3 Example student comments in 2007/8 in response to questionnaire Q14 “What do you consider to be the best feature of this module”

1. Responses from students giving the module an overall score of 4 or 5.

   • I really enjoyed debating ethical issues and finding out the different views…

   • …interactiveness of lectures.

   • Lectures from lots of different areas and relaxed mood in lectures.

   • Seminars very good… made you think.

   • Seminars allowed us to put what was learnt into practice…

   • Free thinking, not just regurgitated facts.

   • Very necessary and interesting topics.

   • Plenty of feedback…

2. Responses from students giving the module an overall score of 1 or 2.

   • Interesting concepts and a different approach to subjects from other modules.

   • Seminars were interesting to hear other view points.

   • Outside speakers…

   • Some good discussions.

Scores for appropriateness of the module for the degree

To understand this further we looked at the acceptability to the students of the module subject area as indicated by their scoring for appropriateness of the module. Again, students scored this from 1 (lowest rating) through to 5 (highest rating). The results had a similar pattern to the overall rating, with a substantial minority of the class giving low scores of 1 or 2 (e.g. 16% in 2007/8 compared to 0% in the cellular module mentioned above; similarly in other years). Consequently, the average modal rating over three years for appropriateness of the bioethics module, 3.67 ± 0.33 (n = 3), was significantly below that for the non-bioethics modules, 4.43 ± 0.20 (n = 7).

Analysis of individual student responses in 2007/8 showed that scores for ‘overall’ were correlated with scores for appropriateness (P = 5.8 × 10⁻⁷, n = 85). However, the intercept was significantly different from zero (P = 0.0003) therefore probably other factors besides student opinions on appropriateness were involved in explaining the score for overall satisfaction. While 40 of the 85 students who completed the questionnaire (out of 113 registered for the module) gave the same score to both criteria, of the remaining 45 (the majority of the group) 35 gave a higher score for appropriateness than for ‘overall’ and 10 gave a lower score.

From the students’ point of view bioethics may seem less attractive than their other modules because the latter were either optional modules or were compulsory but only for the particular degree that they chose, Applied Biology, Biology or Zoology. Without a comparator module that is compulsory for all three degrees, it is difficult to know how important the compulsory nature of the bioethics module was in explaining students’ attitudes towards it. However, analysis of student comments (following subsection) gives clues to factors that may help explain this difference in their judgement of the over-all acceptability of the module and in student judgement of its appropriateness for their degree.

Figure 3 Comparison of individual student marks in a cellular module with the bioethics module (A) or the biotechnology module (B).

Outlier marks that were excluded from the statistical analysis mentioned in the text, are included here (fails in the cellular module, two in A and one in B).

Student comments

The questionnaire also invites students to write comments. These indicated that the seminars and lectures successfully engaged them, but that some students worried about whether they would cope with the assessments. This is understandable since the module is the only one where their ability to analyse and reason is central. As indicated above, the average marks tended to be in line with those for non-bioethics modules. However, presumably individual students feared that they would be the exception to this generalisation, and the scatter of points in figure 3 indicates that indeed some students will do less well in this module than in others, though others will do better.

Separate questions asked students to identify respectively the best features in the module and what needed improvement. Some students answered both of these questions and some, having filled in the rest of the questionnaire, answered neither; less than a handful answered one but not the other. Thus nearly all students who wrote comments met the intentions of the designers of the questionnaire, that they would both identify a point to approve and make a suggestion for improvement.

Box 3 shows illustrative favourable comments. Of the 83 students who completed questionnaires in 2007/8, 43 wrote comments; 16 (40%) commented favourably on the seminars, 10 (23%) on the range of topics and on the expertise of the contributors, and 9 (21%) on the opportunity to think, to argue, and to understand others views (Box 3). This was consistent with comments in earlier years with smaller student numbers: for example, in 2005/6, the second year in which we included seminars in the module, similar components were mentioned: 9 (33%) wrote favourably of the seminar, 5 (19%) wrote favourably of the topics and contributors, and 8 (31%) wrote favourably of the greater knowledge and understanding they acquired (48 students registered that year, 31 completed questionnaires, 27 wrote comments).

Box 4 Example student comments in 2007/8 in response to questionnaire Q15 “Suggest one thing that could be done to improve this module”

1. Responses from students giving the module an overall score of 4 or 5. Feedback on seminars could have been briefer.

   Return work quicker.

   Feel ethics could be given at all three years.

   More explanation of the best way to answer questions.

2. Responses from students giving the module an overall score of 1 or 2.

   More engaging lectures.

   Desks in the seminars would have been helpful.

   This module shouldn’t be in the final semester of the final year as so much hangs on these exams.

   More opportunity to actively work on writing style and “clarify” arguments.

While students had praised the seminars, they also suggested improvements (Box 4). In 2007/8, 16 (40%) identified points in the seminar to improve, particularly whether seminars should be shorter or longer, fewer or more, but there was no consensus. Such comments were made every year since the seminars were introduced and in two years I asked for a show of hands to see if there was a consensus, but so far there has been none.

Some students asked that individual feedback on seminar work should be given earlier. It is given in two weeks, at the beginning of the next seminar; this is in less time than the University demands. Nevertheless, the students have a point as they would like to digest the comments before, not at, the next seminar. On the other hand, with a team of markers needed to complete the marking in the time available, it would be hard to deliver the comments in under two weeks. The generic feedback (Pearce, 2006) helps address this problem but only partly.

Other issues attracted much less comment. The following were commented on by a few students in 2007/8 but also by students in previous years, so represent smaller but consistent concerns. Some asked for proper tutorials, or for the introduction of bioethics at an earlier stage, more time to write in the seminars, something to lean on when writing in the seminars, and much else that the author agrees with but which would be hard to deliver because of other constraints. However, there was usually no obvious connection between comments and whether the student gave the module a high or low overall approval score (Boxes 3 and 4). The tone of positive comments from those who gave strong approval scores tended to be more enthusiastic but the substance of the points tended to cover a similar range to those from students who gave low scores for overall approval.

While the majority of students took a constructive approach to suggesting what needed improving a few students were robustly critical. However, there was no consensus in their points. In 2007/8 only one student suggested the module should be optional and none suggested that it should not be offered. A few students in most previous years, back to when we began teaching bioethics in the mid 1990s, thought that bioethics was irrelevant. However the trend with time has been for a lower proportion of students to hold this view. But while there is a wide acceptance by students of bioethics in the curriculum, some of the comments they make (Box 4) indicate, unsurprisingly, that many consider it a less important component in their degree.

The above analysis indicates that strong negative attitudes to bioethics only partly contribute to the tail in the distribution of scores for the students’ assessment of the module overall. The students’ main concern seems to be with the competition between developing their ability to manage the unfamiliar demands of the bioethics module, and the demands of the other modules, but this was only sometimes linked with a low score for overall approval.

Discussion

The module exposed students not only to current ethical issues but also to underlying principles. Students developed and practised skills of analysis and reasoning about ethical issues and overall students did as well in bioethics as in other subjects. Perhaps the most demanding pressure on students was that in the examination they would have to think for themselves.

Many students were enthusiastic about the opportunity the module gave them to exercise their thinking abilities. This approval of thinking highlights the question of why there are not more opportunities for developing and practicing critical thinking in biology curricula.

Large classes create particular assessment problems and there are a number of strategies that can be used to help overcome these (Rust, 2001) including doing as much as possible in-class. In the seminars used in the bioethics module, the size of what had to be marked was limited by providing only the last 25–30 minutes of the seminar for writing no more than two sides of A4. Other aspects of the seminar system were inspired by other considerations. Partly, it was inspired by how undergraduate laboratory classes are organised. Our bioethics seminars show that large numbers of students can be managed in productive thinking exercises just as in the laboratory they can be managed to help develop practical skills. The seminar system used in bioethics would be equally suitable for developing and practising thinking in general.

Some students were concerned that the module could damage their overall performance in the degree. One concern was that spending time on the bioethics module reduced students’ time to deal with more familiar biological material which would, later, generate most of their marks. In answer, one could say that while a sound knowledge of current biology is important, its value may be much greater for someone who can think constructively about it and about its wider context. Reading between the lines, another student concern was that they might get lower marks in this module than they expected in others, possibly because the preparation for the examination required a different approach to how they prepared for examinations in other modules. The average performance was not disadvantageous but this hid a beneficial effect for some students balanced by a negative effect for others, more than would generally be the case with other modules. Since QAA (2007) specifies bioethics and “critical assessment and intellectual argument”, these effects are fair.

Mostly, students think that ethics should be included in the biological curriculum (Lysaght et al., 2006). Nevertheless, a number of final year undergraduate students in the School of Biology at Newcastle University thought that the bioethics module had a low appropriateness for their degree. Though the module addresses issues that arise out of biological discoveries and inventions, it emphasizes the process by which an ethical judgement may be reached, more than the biological considerations. Students, keen to understand organisms, may accept that they must understand bioethics but may not find it as interesting as other modules. This is not inevitable, as the comments from some student indicate they liked the intellectual challenge that the bioethics module provided. However, other factors may also be important. In a second year bioethics module at the University of Exeter very few students thought that the bioethics module was inappropriate for their degree (Bryant and Baggott La Velle, 2003). A possible explanation for this difference from the attitude of some final year students at Newcastle University could be that in a second year module students might be less concerned that performance in the module would affect their overall degree mark.

Assessment has an important role in fostering learning (Brown and Glasner, 1999). The form of assessment and its appropriateness for the stage of development reached by students, could be crucial. A number of bioethics courses that run in the second year of biology degrees in other UK universities use in-course assessment as the main form of assessment (Bryant and Baggott la Velle, 2003; Willmott and Wellens, 2004, Downie and Clarkeburn, 2005). The choice to use an examination as the main form of assessment in the bioethics module at Newcastle University reflected the fact that the module ran in the final year and it was thought, and proved to be the case, that third year students would find this a challenge that they would cope with. Had the module been assessed in-course then because of students’ commitments to other final year course work, particularly their project, this could equally have caused them concern. This does not amount to a case for moving the module to an earlier year in the degree. The pressure to meet the demands of the module as part of their final year studies should increase the chance that it will impact positively on the students’ careers.

Acknowledgements

I am grateful to Dr Ian Girling for help with searching the literature and to the Faculty of Science, Agriculture and Engineering, Newcastle University, for support through the award of a Teaching Fellowship.

Notes

^* Number of 1 h lectures.

^** Main corresponding outcomes