I continue to be wowed by NeuroMOOC students so much so that I have changed both my teaching goals and the actions that I take to achieve those goals. This is not a new sentiment as I have written previously about several NeuroMOOCers in the past: Sabeen Mahmud, Anish Garikipati, Francisca Martínez Traub, Diana Keat, and Felipe Sales Nogueira Anorim Canedo. Yet, I perpetually fall short of adequately conveying the emotional impact that interacting with so many people from all over the world who share an interest in my beloved neurobiology has had on me. I am going to try again here. First I am going to describe two NeuroMOOCers, who by all rights should be strangers to me, who are not strangers to me. Not at all, not anymore. Then I will explain how my experiences with NeuroMOOCers such as Miguel Camarena and Apra Sharma, profiled here, have altered my approach to teaching and served as the motivation to offer a second online course on neurobiology, starting this fall.

Miguel Camarena: from analog engineer to neuroscientist

Miguel Camarena took Understanding the Brain: The Neurobiology of Everyday Life back in 2014. Shortly after completing the course, Miguel wrote me explaining how UtB had reinforced his interest in neuroscience. Miguel is an engineer and at the time was working for Intel. In his spare time, he wrote me that he intended to set up a worm (C. elegans) laboratory in his kitchen, hoping to contribute to neuroscience. Miguel was aiming to be a citizen scientist!! Just like Charles Darwin! This totally rocked my world. In just a few months, Miguel was indeed putting together a small setup, complete with a USB microscope (which I didn’t even know existed until Miguel told me), and sent me a picture reminiscent of the Day of the Dead holiday celebrated in Mexico, Miguel’s home country.

Miguel Camarena’s worm lab is pictured with a “Day of the Dead” scientist hard at work. Photograph kindly provided by Miguel Camarena.

Just this past month, Miguel left his job in engineering to accept a position at the National Autonomous University of Mexico’s Institute of Neurobiology, which is in the city of Queretaro. There, Miguel wrote that he will be using the “ideas from computer vision and machine learning to distinguish and quantify locomotive phenotypes” in worm mutants. This is really interesting work that aims to delineate behaviors in a bias-free, assumption-free manner. Many who are serious about behavior are thinking about this type of approach. Not only has Miguel successfully married his engineering skills and background to his growing neuroscience interests, but he’s doing so in a laboratory run by a student of the great Ricardo Miledi. Working with Bernard Katz, Miledi demonstrated that calcium ions are needed for synaptic transmission. It is now known that a high local concentration of calcium ions at the active zone is necessary for synaptic vesicle release through rearrangement of the SNARE complex. In Neurotree terms, Miguel will be the scientific grandchild of Miledi and great-grandchild of Nobel Laureate Katz.

Here is Miguel on his first day in a worm laboratory at ITESM. Clearly this is a happy engineer-neuroscientist!! Photograph kindly provided by Miguel Camarena.

Apra Sharma: the confusion of brain injury in a loved one

Apra Sharma wrote me, after having found UtB on Coursera, about her mother who had suffered from a subarachnoid hemorrhage. She sent me scans of her mother’s brain and asked for my opinion on several specific questions concerning prognosis, time frame for “a full recovery” and the possible utility of using zolpidem, a drug that has brought several people in minimally conscious state (MCS) back to a transient functional and responsive state. [It should be noted that prospective studies such as this one have yielded disappointing results, suggesting that a very small proportion of MCS patients can benefit from zolpidem.] I wrote back and after stating that I am not a physician, gave Apra general thoughts about vegetative and minimally conscious states, highlighting the difficulty in predicting the time course of recovery, if any recovery does in fact occur, from states of altered consciousness.

Apra’s sadness is palpable. Clear in her letter to me is Apra’s belief that her mother is still alive in there, showing signs of responsiveness, and that she could recover. Her mother is only 49 years old. One day, mom is okay and the next, not only is mom not okay but she is so far from okay that she cannot determine her own choices. Apra’s mother cannot choose between treatment options. Now consider Apra’s position. From not knowing anything about states of altered consciousness one day to having to make decisions about her mother’s life the next day. The life-and-death drama of brain injury – due to trauma, stroke, ischemia or tumor – is never anticipated. The family members of brain-injured patients are forced to deal with highly specialized medical concepts at a time when their emotions could not possibly be more jumbled. Understanding the medical landscape of brain injury would  challenge even the most calm person on their best day. No one can function optimally after suddenly learning of a loved one’s incapacitation.

A pair of CT scans illuminated by sunlight, with a backdrop of an Indian landscape. Kindly provided by Apra Sharma.

I don’t know how many people Apra reached out to or why she felt that she needed to reach out to anyone beyond her mother’s physicians. But she did. And she found me through this world wide web of people interested in neurobiology. The unlikelihood of my connecting with Apra is beautifully illustrated in a picture that Apra sent me, showing a couple of scans, illuminated by sunlight, against the backdrop of an Indian city. For me, this juxtaposition of the familiar scan with the entirely foreign backdrop exemplifies the incredible power of connecting with people across the world with whom I share nothing and everything simultaneously.

Flipping the classroom

Now I want to take a slight detour and explain my decision to “flip” the classroom on the Medical Neurobiology course that I have taught in, in one way or another, for the last quarter century. Since my textbook was published in 2011, I have taught this course solo at Pritzker Medical School. The brutal medical school schedule gives me roughly 28 days (or 27, depending on how the Jewish holidays fall) to teach hundreds of pages of material. To address these demands,  I settled on a schedule that involves 2-hour lectures, five days a week. And I don’t take a break. So that is 110 minutes of straight lecture. Yeah, the students don’t love the no-break part…

Last year, my 6^th year teaching this course solo, I realized that I could do a better job by pre-recording lectures. By so-called flipping the classroom, we could use a shorter amount of class time to greater effect than we were to date. Having students come to class with the basics in hand would enable class time for more-fun-things-than-lecturing such as:

• Active exercises to illustrate the material. For example, when learning about gaze; the VOR, optokinetic nystagmus, post-rotatory nystagmus, and smooth pursuit movements are all easily demonstrated. These demonstrations are memorable and stick with the students. Illusions are great ways to understand the vision and hearing.
• Work through clinical scenarios. Given a case presentation, small groups can make their way through to a diagnosis and an understanding of the underlying basic neurobiology.
• Class-wide ethical discussions. Neurobiology and neurology are rife with ethical dilemmas: how to define death; whether the critical period should be re-opened; neuro-enhancements; the use of EEG, MRI, and polygraphs in the criminal justice system for lie detection; cochlear implants for congenitally deaf children; and the culpability of individuals with dementia are just a few of the topics that can be discussed. The most beautiful feature of these discussions is that no answer exists. The fun is in the discussion, the expansion of one’s perspective, and a deeper appreciation of the complexity of human choices.

There is nothing new about flipping the classroom, except the term itself. Law schools have used this approach for more than a century. Students read material beforehand so that class time can be spent in discussion. Substituting videos for book chapters does not change the essence of the flipped or inverted approach.

A new online course on Medical Neurobiology will feature several themes familiar to NeuroMOOCers including this bit where I malign the poor alligator’s cognitive abilities and telencephalic size. The course, opening in the fall of 2017, and intended for medical students will also feature topics and deep dives that were not covered in Understanding the Brain.

Where do NeuroMOOCers come in?

As we planned to put Medical Neurobiology into video form, one initial idea was to license the videos to other medical schools, freeing them to move beyond the primarily lecture format just as we were doing. But from the beginning I also wanted an avenue for individuals, regardless of background, position, geography or finances, to be able to access the course for an affordable price. Here I was thinking of NeuroMOOCers. As I am mostly untouched by the entrepreneurial spirit, I never had much verve for the licensing idea. And due to my experience teaching Understand the Brain: The Neurobiology of Everyday Life on Coursera, I had gads of enthusiasm for open access teaching. Happily, I have been given the go-ahead to make the course open access through iTunes U and perhaps through YouTube as well. This leads me to shout out from the tree-tops:

I am thrilled to announce that I will release an open access, on-line course, entitled Medical Neurobiology, this (2017) fall.

The online Medical Neurobiology course will be different from Understand the Brain: The Neurobiology of Everyday Life. It is intended for medical students and closely follows the second edition of my textbook in topic order and content. That said, judging from the NeuroMOOCers that I have gotten to know over the last three years, I think the course could be accessible to motivated and interested individuals willing to put in work. I hope that you all will let me know how it goes for you.