Author ORCID Identifier

Date Available


Year of Publication


Degree Name

Doctor of Philosophy (PhD)

Document Type

Doctoral Dissertation




Education Sciences

First Advisor

Dr. Rebecca McNall Krall


A common belief among pre-medical and medical students is that biochemistry is not relevant to practicing medicine. Among topics commonly taught in biochemistry, courses include the Central Dogma of Molecular Biology, which is among the most critical science topics taught to medical students by biochemistry educators. Perceived irrelevance among students may be due to common curricular trends in biochemistry education. Many biochemistry courses are found at Research I (R1) universities that teach biochemistry using traditional lectures with little evidence of supporting learning with real-world applications. Instructors commonly assume that students can make realworld connections independently during lecture courses, but it is difficult for students to establish such connections unless explicit examples are available. The objective of this dissertation is to find how the timing of a medical case study presentation can support learning the Central Dogma of Molecular Biology among undergraduate learners. Specifically, the dissertation seeks to identify how real-world learning situations can support students’ reasoning skills while constructing scientific arguments. This dissertation utilized a mixed-methods approach to analyze learning outcomes and reasoning during argument construction in an advanced genetics course at an R1 university that utilizes case studies. A published medical case reported on the diagnosis of Huntington Disease in a child was provided to students (n=19). Students were able to select if they wanted to review the case study before or during class.

The CBL+ group reviewed the case study before class, and the CBL- group was presented the case study during class. Overall, there was no significant difference in preand posttest scores using the Central Dogma Concept Inventory and self-efficacy between CBL+ and CBL- groups. However, learning gains were present in additional open-response tasks added to the pre- and post- tests. Students demonstrated foundational knowledge about the Central Dogma of Molecular Biology, and it appears that foundational knowledge remained consistent, but the CBL+ group began to develop a deeper understanding. The case study appeared to support both groups in applying the Central Dogma to real-world scenarios, but similar to trends in establishing foundational knowledge, the CBL+ group began to demonstrate deeper learning.

Students’ small group discussion and written pre- and post- test responses were analyzed to observe argumentation. The CBL+ group tended to construct complete arguments on their posttest responses, with a noticeable increase of argument warrants compared to the CBL- group, in addition to more detailed supporting arguments. While argumentation was less frequently observed during small group discussion, no instances of argumentation were observed in the CBL- small group discussion.

When students were asked to apply the Central Dogma of Molecular Biology to Huntington Disease, many students demonstrated increased understanding. Students in the CBL+ group demonstrated increased instances on argument construction and reasoning. In contrast, the CBL- group experienced minimal student interaction. Case studies appear to support student learning, but the timing of case study presentation influences argument construction and learning interactions among peers.

Digital Object Identifier (DOI)