At a time when U.S. health officials are calling opioid misuse and addiction a serious national crisis, Harvard Medical School’s MEDscience program is using its unique method of experiential teaching to educate high school students about addiction risks through a new simulated neurobiology course.
“We’re using this moment of time and expanding our reach to address a public health issue and doing it in a story that makes sense to students,” said MEDscience co-founder Nancy Oriol, the faculty associate dean for community engagement in medical education at HMS. “It’s no longer hypothetical; it’s real, and it’s someone like them.”
The MEDscience program, begun in 2005, is a hands-on science, technology, engineering and math (STEM) curriculum taught in 30 schools in the greater Boston area, including 20 Boston public schools. The program educates more than 1,400 local high school students annually on the HMS campus.
Massachusetts First Lady Lauren Baker visited the program on April 24 to learn about the opioid simulation case and participate in a ribbon cutting for an additional simulation lab for the program.
“MEDscience is dramatically scaling up its capacity and impact. What we have here is a national model in experiential STEM education,” said MEDscience executive director Julie Joyal.
The new simulation room will help accommodate the MEDscience program’s growth by allowing more schools to participate in the program at one time.
Program staff will now be able to teach 3,000 students a year, Joyal said.
Baker called the course a way to “teach really incredible science and create really wonderful thinkers.”
Students as doctors
Program designers say they believe “the recipe for STEM retention and success is exposing students to real-life simulated experiences that are connected to their classroom learning, their own bodies and their personal lives.”
In the HMS MEDscience simulation laboratory, students assume the role of doctors and are tested on their scientific knowledge, teamwork skills and critical thinking skills as they work to diagnose and treat a “patient” represented by a mannequin voiced from a nearby control room by a MEDscience staff member.
The idea for the new opioid addiction case module, which helps students understand opioid addiction by showing them how drugs affect the body, was introduced two summers ago by MEDscience student intern Sam Adams, who was 16 at the time.
Now a high school junior, Adams has been involved with the MEDscience program for several summers. He said he noticed that while there was a MEDscience cocaine case, it focused more on treating the immediate medical emergency, not on addiction.
Because of the opioid epidemic in the country, he thought a case dealing with opioid addiction might make a relevant addition to the curriculum.
Adams suggested the opioid course to the MEDscience team, offering to research and write the case himself.
“A lot of kids know people who struggle with addiction,” Adams said. “I’m really glad I can help educate a lot of people.”
He said he aimed to make the case relatable to high school students by including in it a teen patient with whom the students might be able to identify. The fictional patient in the opioid addiction case is a 16-year-old high school student, who Adams pointed out “had a lot going for her.” She’s an athlete, with a full athletic scholarship to an Ivy League college, until having an ACL surgery.
“When a lot of people think about addiction, they just think about poor neighborhoods, but it can affect anyone,” Adams said.
He added that prescription pain killers are the most commonly abused drugs. The program allows students to work together as a team to understand how these drugs affect anatomy and physiology and permanently change brain chemistry.
Joyal said the opioid epidemic has affected people across all demographics in the United States. With that in mind, she said, “the more kids who can be exposed to this case, the better, because once someone is addicted, it’s a long road to recovery.”
MEDscience teacher Livia Rizzo echoed this sentiment, saying that one of the program goals is to help students understand the science of addiction before it’s too late.
“We can repeatedly tell students ‘don’t do drugs,’” reads the MEDscience training manual for the case, “but how will they understand the magnitude and severity of addiction until they care for a friend dying from this grossly widespread epidemic?”
During simulations, students ask the “patient” about symptoms, family history, past surgeries and lifestyle. Taking these factors and the patient’s vitals into consideration, they take notes and discuss theories with one another.
In the opioid case, the “patient” complains of stomach pain, which students eventually discover was caused by opioid-related constipation. The patient also reveals that she is dealing with a number of stressful experiences, including the death of her father, and that she was prescribed pills after her ACL and wisdom teeth surgeries.
One recent group of students initially thought the patient’s symptoms were caused by stress, but also considered parasites, pregnancy and other conditions. Eventually, after the patient became increasingly demanding for pills, the students called for a blood test and realized that she had opiates in her system.
At that point, the patient’s heart rate suddenly dropped and she stopped breathing. With time of the essence, the students had to identify and administer Narcan, a medication used to reverse and block the effects of opioids, saving the patient’s life.
The students said it was an intense, stressful situation and they had to trust one another and think quickly.
Julia Oliveira, a junior at Boston Latin School, said the experience was interesting and different from what she is used to learning, because it focused not just on the physical but also the mental aspects of a condition.
For her, the MEDscience program achieved one of its goals of promoting an interest in STEM courses.
“Towards the beginning of the course I knew I wanted to do something in biology, but as we got the patient interaction, I know that I definitely want to be a nurse now, so that was really helpful,” Oliveira said.
Some of the greater Boston-area schools where the course is offered include Kennedy Health Care Academy, English High School, Charlestown High School, Boston Latin School, the Boston Day and Evening School, Rivers and BC High School.
MEDscience’s mission, on its website, is to “combat the inspiration gap in high school STEM education by exposing students to the 21st-century skills that are necessary for success in academic and future careers. Our vision is that all students, regardless of background, education or zip code, have equal access to high-quality education in the sciences.”