Trends in Biotechnology

TIBTEC 1941 No. of Pages 6

Scientific Life

Creating BioethicsDistance LearningThrough VirtualRealityAntoine L. Harfouche1,* andFarid Nakhle1

Bioethics education is a central ele-ment in the biotechnology curricu-lum. Re-imagining distance learning,virtual reality (VR) is taking studentinvolvement to the next level of in-teraction, offering a real classroomexperience and a new way to gainethical reasoning skills. Here, weexplore a new paradigm for bio-ethics education that involves VR.

Elevating Bioethics inBiotechnology EducationScience and ethics have been inextricablyintertwined since the first expression of theHippocratic oath [1]. Biotechnology is apowerful enterprise that can be harnessedto improve people’s lives in fundamentalways and on a global scale. Despite themany ways in which biotechnology break-throughs have improved life, they cannotbe viewed as unequivocally beneficial oreven value neutral. As biotechnology gainsmomentum, so do issues concerning itsethical and social implications around theworld. These ethical considerations have

Box 1. How VR Can Make Biotechnologists ‘Ski

The coronavirus disease 2019 (COVID-19) crisis witnessnologies are currently at the frontier of development, an

Higher education institutions have always been at the cstudents are engaged, enthused, and challenged throuenvironment and delivered a university credit course in

The goals and objectives of the course were to developtechnology students. The Bioethics VR course groundstechnology. Lectures in VR classrooms provided studintersection of ethics and biotechnology with an eye towinvaluable new ways to experience learning by embraci

led to the design of frameworks withinwhich biotechnology can be developed insocially acceptable ways [2].

Therefore, it is imperative to teach bioethicsin higher education to help biotechnologystudents navigate ethical dilemmas earlyon in their career. Bioethics education is inhigh demand globally and has become acornerstone of 21st-century education.

The term ‘bioethics’, which addresses theethics relevant to biological knowledge andthe science of living systems, is popularlyattributed to Van Rensselaer Potter andfirst appeared institutionally in the USAin 1971, when Georgetown Universityestablished the Joseph and Rose KennedyInstitute for the Study of Human Reproduc-tion and Bioethics [3]. Principlism is animportant approach to ethics and, in bio-ethics, it includes the following core princi-ples: respect for autonomy, beneficence,nonmaleficence, and justice [4]. However,while principlism can be important in helpingstudents approach ethical dilemmas from astructured approach, it alone is not suffi-cient to address the many ethical dilemmasthat arise from biotechnology.

The purpose of bioethics education in abiotechnology curriculum is to adequatelyequip students to unpack the varioussignificant factors in an ethical dilemma, toweigh the ethically acceptable actions andtheir consequences, to balance benefitsand risks of decisions, and to chooseone that is most ethically and socially

lled Critical Thinkers’ and ‘Skilled Ethical Reasone

ed the beginning of a frenetic technological race to creatd the pace with which technologies are being produced

utting edge of new technologies, driving development anghout the online class is a key priority for bioethics distaAltspaceVR.

more refined skills in ethical analysis and enhance the crstudents in interdisciplinary approaches and models to aents with the background information necessary to undard practical approaches and ethical responsibilities (Figung critical thinking pedagogy with enthusiasm in the clas

responsible. Bioethics education provideslearners at all levels (biotechnologystudents, future scientists, and the newgeneration of aspiring innovators andbioentrepreneurs) a rich store of knowl-edge and a foundation for the developmentof creative critical thinking and ethicalreasoning skills to support bioethicaldecision-making. Bioethics education canallow students to delve into the intricaciessurrounding the ethical, legal, and socialimplications (ELSI) of biotechnologyresearch. ELSI aims to further the conver-sation among stakeholders in the inter-actions among science, technology, andsociety [5]. This learning can also help todevelop and reinforce bioethical valuesthat can guide actions toward sociallyappropriate outcomes and strengthen bio-technology research ethics systems atscale. For some students, bioethics willbecome a lifelong vocation.

Virtual Reality for Quality Teachingand LearningThe concept of VR technology can be tracedback to the 1960s, when Ivan Sutherlanddescribed VR as a window through whichparticipants perceive the virtual environmentas if looked, felt, sounded real, and in whichthey could act realistically [6]; currently, it isexperiencing a renaissance of developmentand consumer interest among educators indistance learning.

In amodernworld with diverse opportunitiesto innovate, technology is shaping the futureof education by continuously establishing

rs’

e online courses for virus-stranded students. VR tech-is extraordinary (Table I).

d creating the next generation of scientists. Ensuringnce education. Thus, we developed a virtual learning

itical thinking and ethical reasoning ability among bio-ddress the most pressing bioethical challenges in bio-erstand ethical dilemmas and explore issues at the

re I). VR helped unlock students’ potential, giving themsroom.

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Table I. Representative VR Technologies for Teaching and Learning

VR platforma,b Content sharingc Means ofcommunication

Worldbuildingsupportd

Accessibility Supportedoperatingsystems

Supported VR headsets Website

AltSpaceVRe Web content viabrowserf

Voice, textmessages,emojis

Yes Free MicrosoftWindows,Android

HTCg Vive, Oculus Rift,Oculus Go, Oculus Quest,Samsung Gear VR

Altvr.com

Engagee Whiteboard,images, videos,PDF, presentations

Voice No Free MicrosoftWindows,Android

All HTC, Oculus Rift,Oculus Rift S, OculusQuest, Valve Index, PicoG2, Pico Neo 2

Engagevr.io

Rumiie Screen sharing,whiteboard,images, videos,PDF, 3D models

Voice, textmessages

No Free MicrosoftWindows,macOS,Android

HTC Vive, HTC Vive Pro,all Oculus

Dogheadsimulations.com/rumii

Mozilla Hubse Screen sharing Voice, textmessages,emojis

Yes Free, opensourceh

Any OS withbrowsersupport

Any headset withbrowser support

Hubs.mozilla.com

Glue Images, videos,3D models

Voice Yes Paid MicrosoftWindows,macOS,Android, iOS

HTC Vive, HTC Vive Pro,Valve Index, Oculus Rift,Oculus Rift S, OculusQuest

Glue.work

Immersed Screen sharing,whiteboard

Voice No Free version,paid features

MicrosoftWindows,macOS,UbuntuLinux

Oculus Go, Oculus Quest Immersedvr.com

meetingRoom Whiteboard, PDF Voice No Free version,paid features

MicrosoftWindows,macOS,Android, iOS

HTC Vive, HTC ViveFocus, all Oculus, all Pico

Meetingroom.io

Spatial Web content viabrowser, screensharing, 3D models

Voice No Free version,paid features

MicrosoftWindows,Android

Oculus Quest, HoloLens Spatial.io

Wonda VR Screen sharing,images, videos,3D models

Voice, textmessages

Yes Free version,paid features

MicrosoftWindows,Android

HTC Headsets, OculusRift, Oculus Go, OculusQuest, all Pico

Wondavr.com

vTime Images Voice, textmessages

No Free MicrosoftWindows,Android, iOS

Oculus Rift, Oculus Go,Google Cardboard,Google Daydream,Samsung Gear VR

Vtime.net

MeetinVR Web content viabrowser,whiteboard, 3Dmodels

Voice No Free MicrosoftWindows,Android

HTC Vive, Oculus Rift,Oculus Rift S, OculusQuest

Meetinvr.net

aInside VR platforms, students are represented by customizable avatars. However, the Spatial platform automatically generates a custom avatar based on a photographof the student’s face. All listed platforms were developed within the past 5 years.bVR platforms make it possible to live stream and record classes to streaming platforms such as YouTube, Twitch, and Facebook.cContent sharing allows the ability to display multimedia content on a projection screen.dWorld building allows educators to easily build and customize their own personalized classrooms.eEducational communities, such as Educators in VR, make use of these platforms to host events for educators and learners to prepare them for the use of immersivetechnologies in education. Joining Educators in VR led the Bioethics class to adopt AltSpaceVR as its hosting platform. In conjunction with Educators in VR,the Immersive Learning Research Network (iLRN) is hosting its 2020 annual conference in VR to provide training support to educators enabling them toimplement VR in their courses.fSharing content via browser allows educators and students to share screen, whiteboards, presentations, documents, and videos.gHTC, high-tech computer corporation.hOpen source software is code that is designed to be publicly accessible: anyone can see, modify, and distribute the code as they see fit. It is developed in a collaborativeway, relying on peer review and community production.

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Figure I. Bioethics Virtual Reality (VR) Classroom. The classroom serves as an interactive lecturing space. Teaching materials, such as presentations, documents,or videos, are projected onto the central screen. Students in VR are represented by customizable avatars that allow them to take on a virtual persona, which facilitatessocial interactions to boost their confidence, especially for those who may have difficulty with face-to-face communication. Teachers in VR have exclusive access to avariety of ‘host tools’ that assist them in class management. These include a ‘mute all’ button to limit distracting sounds, a ‘message all’ button to text all students inclass at once, a megaphone button to amplify the microphone, a stage-blocking toggle to allow students access to the stage, giving them the opportunity to play ateacher role, and an audience participation panel that gives teachers the ability to see students who have raised their hands, allowing them a turn to speak. As for thestudents, several engaging actions enable them to interact with teachers and with each other: the microphone toggle to mute or unmute their microphone, an emojispanel to express their understanding and to visually interact with the teachers and each other, a floating web browser that enables students to navigate to anycontent of interest to their learning class that can also be shared to display its content for everyone in the classroom, and a raise hand button that reflects studentsintent to ask a question.

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new tools and platforms in a student’s learn-ing experience. When it comes to human-computer interaction, VR is different fromother forms since students and educatorsparticipate in the virtual world rather thanuse it.

An expression attributed to BenjaminFranklin, a statesman and scientist whowas one of the leading figures of earlyAmerican history, encapsulates an influen-tial approach to education: ‘tell me and Iforget, teach me and I may remember,

involve me and I learn’. Franklin claimed in-volvement was the key to learning. There-fore, online learning environments mustallow students to interact with each otherand with teachers to help simulate animmersive experiential learning.

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Trends in Biotechnology

Emerging VR systems have applicationsthat span education, training, and com-munication, among others [7]. The areasof application of VR in education are vast(reviewed in [8]). VR is an exceptionallypromising immersive and interactivetechnology for the enhancement of the

Box 2. Bioethics Breakout Teams: Team-Based

The Bioethics of a COVID-19 Vaccine: A Case Stu

COVID-19 is an infectious disease caused by the severWuhan, China, in December 2019. The virus was decestablished coronavirus action plans comprising severaward generating unique solutions, including vaccines.

However, while biotechnological research is on the frontrize key ethical considerations drawing on the findings oincrease diversity, students were randomly assigned to

Team Balancing Risks and Benefits

Through VR teamwork, students critically reasoned the rnumbers of people first look for adverse effects and immunethical. Safety and whether individual volunteers fully

The team envisioned that the way in which risk-benefit aical trial volunteers should have a definitive say in decidenemies of safety and mitigation of risk; the team reasoonly involve participants who have a relatively low risk ofdiate access to intensive care and any available medici

Given the risks and uncertainties of these trials, the teamcircumstances and commands enormous societal valu

Team Prioritizing Stakeholders

In this scenario, the world’s science enterprise is challenis needed to develop COVID-19 vaccines. However, m

The breakout team in VR envisioned that rich governmeat what price. Instead, theymust be prepared to supportto ensure fair global access, especially to the poorest c

Developing an effective vaccine to prevent people gettingphilanthropies, industry, academia, foundations, and pholders involved should do everything feasible to recogworldwide if they are to bring the pandemic to an end.

Team Bioethical Decision-Making Model

The team in the VR breakout room read accounts of thetions. Using a bioethical decision-making model, the teastakeholders, considered values, and brainstormed po

There is much hope and excitement surrounding the devresponsible use of COVID-19 vaccine and how to carve

This team proposed, in close collaboration with the otheparent and share knowledge with parallel COVID-19 vawho is developing COVID-19 vaccines can gather andvaccines are affordable and accessible to the people anpath toward a shared global goal of COVID-19 prevent

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distance-learning process. It can confermany learning benefits in complex topics,such as bioethics, which demands agreat level of understanding, due to itsability to help students reach their full po-tential. VR may hold great advantages foradvancing bioethics distance education

Learning in VR

dy

e acute respiratory syndrome coronavirus 2 (SARS-CoV-lared a pandemic by the World Health Organization (Wl stages that embrace, among others, research and innov

lines of beating back COVID-19, success will depend onf in-depth inquiries conducted by the bioethics breakoutthree groups of six using an in-house developed algorith

ight balance between benefits and risks of developing vacune responses only. Speeding COVID-19 vaccine testinunderstand the risks are paramount ethical concerns.

ssessments are conducted should be globally standardizing benefits and risks. When it comes to testing an expened that there should be a limit to acceptable risk, but thdeath or of severe complications from the disease. Volunnes if they were to become infected.

concluded that fast-track regulatory approval of an effice.

ged by a global pandemic. Public and philanthropic healthaking vaccines available is not only a scientific challenge.

nts around the globe should not let the private market sorthe necessary technology transfer arrangements that inclountries.

COVID-19 and curb human-to-human transmission requublic–private partnerships for building large-scale manufnize the importance of treating society responsibly by d

race to develop a vaccine to protect against COVID-19 am identified the ethical questions, listed the most relevantssible solutions to dilemmas that arose from vaccine dev

elopment of COVID-19 vaccine. There are also importanta path toward a global social acceptance?

r teams, a model demanding that researchers, innovatorccine efforts worldwide. The bioethical decision-making mpresent their development plans and findings. It is cruciald health systems that need them, and not in the form ofion through ethically and socially responsible vaccination

because participants can be immersed ina variety of situations that can aid under-standing and promote practice and learn-ing in ways that were not previouslypossible with traditional technologies(Boxes 1 and 2). VR also offers the poten-tial to achieve an authentic experience and

2), which was unknown before the outbreak began inHO) in March 2020. Governments around the globeation, which are essential ingredients for progress to-

its ability to reinforce ethical values. Here, we summa-teams in VR (Figure I). To vary group composition andm.

cines at pandemic speed. Clinical trials involving smallg by deliberately infecting volunteers may seem highly

ed and fully transparent. They also proposed that clin-rimental vaccine, urgency and speed are consideredis remains challenging. Volunteer clinical trials shouldteers need to be assured that they would have imme-

acious vaccine could be ethically acceptable in some

funds are the backbone of the underlying science that

t out the details of who gets access to the vaccine andude humanitarian clauses in their licensing agreements

ires urgent global collective action from governments,acturing capacity. The team proposed that all stake-eveloping a COVID-19 vaccine available to everyone

nd considered the relevant ethical and social implica-facts, examined bioethical issues from the viewpoint ofelopment.

questions to consider, such as how to ensure ethically

s, stakeholders, funders, and policymakers are trans-odel team envisioned a public forum where everyonefor governments to enact safeguards that ensure thehigh profits for private companies. This would carve a.

TrendsTrends inin BiotechnologyBiotechnology

Figure I. Bioethics Virtual Reality (VR) Breakout Rooms. These classrooms are student-centered learning environments where the teacher plays the role of afacilitator and students are fully immersed and empowered to learn from challenges and accomplish important and shared goals. Ideally, students sit in groups ofsix. The digital-inking whiteboard allows teams to iterate on ideas in real-time and to sketch with teammates, whether they are drawing, importing a presentation ora document, or typing text. It also helps introverted students participate in class. Consequently, students become more open to personal growth while engaging inrelationships that they have with one another. Within the VR classroom, there is one projection screen and two desktop computers. The setup creates a digitaltriangle within the room. The computers can be used to access any content of interest to the case study. On the projection screen, materials and instructionsrelated to the group task at hand can be displayed. The brainstorming roundtable prompts students to spark new ideas and empathize with each other. Studentsare also able to communicate by sending text messages to each other or to the teachers during a VR active learning session. The bulletin board provides a way todisplay relevant post-it notes and illustrations. Within the room, a coffee table serves as a hangout area where students can have virtual coffee breaks and helps toget them into a creative flow.

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evoke realistic responses in students. Itis fundamentally a reality simulator whereparticipants can be immersed in ascenario that depicts potentially realevents, enabling them to act and respondrealistically [9].

VR platforms (examples in Box 1) canbridge the gap between educators andlearners and transform the way we teachand learn because it brings complex sub-ject matter to life by creating 3D environ-ments called ‘virtual worlds’. Comparedwith traditional 2D environments, virtualworlds add a spatial dimension in which

students and educators are visually repre-sented as avatars [10], while promotingthe notion of collaborative learning wherethey learn together and often from eachother [11]. Moving beyond the traditionalclassroom environment, the pedagogicalbenefits of VR offer effective learning tostudents through new ways of interactionin student-centered and teacher–studentdouble-centered fashions.

Considering the impact VR can have onlearning, and looking to add an extradimension to bioethics course, we adoptedAltspaceVR to educate the next generation

of biotechnologists to think critically andcreatively in exploring ethical situationsin topical issues in biotechnology, andmaking informed decisions about thosesituations (see Figure I in Boxes 1 and2). Integrating VR technology into bioeth-ics education can improve the quality andoutcomes of education programs by pro-viding students with both an experientiallearning component and educators tobring bioethics into the classroom in acost-efficient way. VR technology isrevolutionizing the digital learning experi-ence, and we are only at the tip of theiceberg.

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Fostering Creative Critical Thinkingand Ethical Reasoning SkillsThrough Bioethics Education inVR ClassroomsAs biotechnology advances, there is anincreasing need for leaders who are ableto think critically about the pressing ethi-cal issues around it. The bioethics in VRcourse was designed to rigorouslycombine both foundational and practice-based learning experiences, including in-depth discussions of hypothetical and ac-tual examples. The course demonstratedthat students in VR have acquired exten-sive knowledge of current thinking inbioethics; have collected, synthesized,and critically reflected on ethical issues ofbiotechnology; and have developed ethicalreasoning about the societal value of bio-technology. Lectures in VR additionallydiscussed ethical issues related to thesafety implications of genetic engineering,genome editing, and gene therapy (seeFigure I in Box 1).

Through the case-study method, wewere able to teach ethical reasoningrather than just ethical principles. It isconceivable that the experience in bio-ethics in VR course also emboldenedstudents by increasing their comfortlevels in learning through doing, allowingthem to feel at the center of the teacher’sattention (see Figure I in Box 2).

By using VR, we developed new bioethicsimmersive teaching and learning commu-nities, and empowered them to applytheir theoretical knowledge to practical en-deavors in a multitude of settings insideand outside the VR space.

Promoting Ethical Decision-Makingin VR ClassroomsEthical issues are a growing concern forbioscience research development and en-terprise. Using the bioethics of a coronavi-rus 2019 (COVID-19) vaccine case study(Box 2), students practiced how todevelop an ethical decision-making

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model using a six-step approach. Thecase study was coded on three themes:balancing risks and benefits, prioritizingstakeholders, and the bioethical decision-makingmodel. In VR breakout rooms, stu-dents listed the relevant facts, identifiedstakeholders, clarified the underlyingvalues, weighed the risks against the ben-efits, developed a list of potential re-sponses, and considered the best action(Box 2).

VR encouraged a deeper level of interac-tion, exploration, and curiosity-driven ac-tion among students, which are essentialingredients to learn ethical decision-making. The case-study component ofthe VR course provided the students withan opportunity to practice the develop-ment of bioethical decision-makingmodels. What was fascinating about thisvirtual space was that all digital engage-ment happened in real-time, with theteacher explaining, guiding, asking, illus-trating, and answering students’ ques-tions. Our experience suggests that VRwill have a sustained impact on the wayteaching ethical decision-making is done,prompt new education advances, and im-prove educational outcomes.

Concluding RemarksVR is more than just a tool for driving bio-ethics distance-learning innovations; it isalso useful for motivating students, en-couraging interactive learning, and devel-oping ethical critical thinking and ethicaldecision-making skills. While VR can helpboost the learning process, combining vir-tual and augmented reality will create sig-nificantly better returns on innovation.

AcknowledgmentsPartial support for this work was provided by

the European Commission Erasmus Multilateral

Knowledge Alliances programme (BIOINNO -

Bioinnovation and Entrepreneurship: A Knowledge

Alliance for Biotech Entrepreneurship Education,

Grant no 539427) (A.L.H) and by the Italian Ministry

of Education, University and Research Brain Gain

Professorship to A.L.H.

1Department for Innovation in Biological, Agro-food, and Forestsystems, University of Tuscia, Via S. Camillo de Lellis, Viterbo01100, Italy

*Correspondence:aharfouche@unitus.it (A.L. Harfouche).

https://doi.org/10.1016/j.tibtech.2020.05.005

© 2020 Elsevier Ltd. All rights reserved.

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