Bacteria-tag: active learning to introduce concepts of bacteria and bioengineering

Abstract

Physically active learning is considered to enhance learning and additionally addresses health goals like increasing activity levels and reducing obesity. However, physically active learning has rarely been applied to science and engineering learning, or utilized with younger learners (e.g under sevens). This article describes a physically active learning approach to introducing one area of science and engineering, trialed with children from age 3 upwards. Specifically, the game bacteria-tag was designed to start discussions around bacteria and diseases and medicine selection, which can be extended in various ways, e.g. to introduce ideas around antimicrobial resistance, bacteria structure etc. Additionally, the game helps to highlight the role of bioengineers in society, helping to broaden perceptions around engineering, which is especially useful at a young age where misconceptions can lead to lack of interest and career rejection. Bacteria-tag has been successfully utilized in a range of schools and nurseries (PreK to 5^th grade), proving effective at engaging children and inspiring learning.

Keywords:

• Science education
• physically active learning
• bioengineering
• bacteria
• antimicrobial resistance

Introduction

Given the skills shortage and lack of diversity in science and engineering (Royal Academy of Engineering 2019a), recent work has focused on how early years science and engineering education can help to build science and engineering interest (Pattison and Ramos Montañez 2022), tackle stereotypes and develop science and engineering process skills, like problem-solving (McClure et al. 2017). A lot of this work concentrates on the preschool phase (3-5 years old). During this time children are often described as “natural engineers”, frequently demonstrating engineering behaviors in their play like identifying problems, creating solutions, evaluating and improving upon those solutions (Lippard et al. 2017; Ata-Aktürk 2023). Additionally, while Piaget described infants as “irrational and pre-causal” a wider branch of cognitive development research considers infants as “little scientists” or “theorists” continually conducting experiments in order to make sense of the world around them (Köksal 2022). Multiple studies have indicated how young children are capable of engaging in, and learning from, science and engineering experiences, increasing their motivation, problem-solving skills and creativity, and enhancing their understanding of science concepts (McClure et al. 2017; Lippard et al. 2017; Ata-Aktürk 2023).

However, literature suggests that teachers feel under-prepared to teach science and engineering, as well as suffering from a lack of confidence and experience, particularly for engineering topics (Bustamante et al. 2018). In general, both children and teacher perceptions of engineering are often relatively narrow, with the idea of what an engineer does, being limited to traditional ideas of fixing and building with construction and vehicles (Royal Academy of Engineering 2019b). In this article we introduce an activity based on biomedical engineering, illustrating to children how engineers support doctors to help people. Specifically, we discuss the issue of diagnosis and medicine selection; the initial concept was inspired by an ongoing research project and aimed to introduce the idea of antimicrobial resistance and how biomedical engineered diagnostic devices offer one potential solution to this challenge. However, given the complexity of the topic and the target age range (preschool, due to the above discussed stereotypes work) the focus of the activity became simplified, introducing bacteria as a concept and highlighting that selection of the correct medicine can be a challenge.

The activity presented here utilizes movement and physically active learning (PAL) to illustrate key concepts (Norris et al. 2020). PAL has been demonstrated to enhance learning, e.g. it has been shown that including a physical activity (PA) break to undertake e.g. star jumps, boosted learning performance (Norris et al. 2020), with an additional advantage that it simultaneously delivers on the health goals of tackling excess sedentary time and obesity (Norris et al. 2020; Daly-Smith et al. 2018). and. PAL incorporates work both into PA breaks and PA linked learning (Norris et al. 2020; Daly-Smith et al. 2018). Further evidence is required to accurately identify the potential learning benefits, across all subjects and ages, thus providing the data to increase/encourage school participation (Daly-Smith et al. 2018). Barriers to uptake in schools include resource challenges and teacher confidence (Daly-Smith et al. 2020). A recent study reported no difference in the benefits of PAL for children from different socio-economic groups, race/ethnicity or sex (Bartholomew et al. 2018), suggesting PAL could offer a way to engage typically under-represented in STEM groups.

Recent systemic reviews of the PAL field highlighted that the majority of work to date has concentrated on the age range 7-12 and subject areas like literacy, e.g. spelling races, and maths (Norris et al. 2020; Daly-Smith et al. 2018). Therefore, the activity presented here represents a novel extension of PAL to younger learners and science concepts. The aim was to determine whether a PAL learning approach would be successful with science and engineering content at younger ages. Our activity was tested with learners from ages 3-11 and we demonstrate that PAL can be used to engage learners as young as three in science and engineering content in a playful and active way, with ages 3-8 being the recommended age range. By sharing the activity protocol we hope to inspire and equip educators with the knowledge and confidence to deliver this activity themselves, and start to reduce barriers preventing a wider uptake of PAL in the classroom.

Methods

In order to describe how to play bacteria-tag a Materials list and Step-by-step Procedure have been provided. There is flexibility in the set-up, timings and learning objectives to enable educators to tailor the activity to their particular setting and learning goals. Key considerations for successful implementation are presented and discussed. In terms of safety considerations all of the materials are safe, everyday materials with no safety concerns. The activity can be a little messy and children should be supervised using the syringes and the ‘slime’. Furthermore, this activity is based on movement and involves an adaptation of the game ‘Tag’ or ‘It’ and therefore there is a risk of falls or collisions. The playing space should be selected to offer a safe place to move around and children should be reminded to pay attention to their surroundings and each other.

Materials list

• iPad (or other method) to access this web app: https://strayllama.github.io/tb-tag-helen/

• Six containers – we used 6 large clear tubs (check their size against the number of balls/colored items that you have)

• Four different colored balls (red, green, blue and yellow – the colors link with the web app). If you don’t have balls available you could use existing toys, e.g. bricks or blocks of those colors, or cut up pieces of paper or proceed with the children having to remember a selected color

• Grabber or similar could support students in wheelchairs to reach the balls in the containers

• See Figure 1 for images of the above along with the step-by-step instructions for set-up

• Colored vests/armbands or some way to distinguish taggers from other players (for a class of 30 we suggest about 4 or 5 bacteria)

• Syringes and containers (see next bullet point for what goes in the containers)– about 2 to 3 per class of 30 is fine depending on number of staff. This is likely to result in some queueing and waiting while children take their turns so doubling the number would probably be better if there are two staff members to manage this. Droppers/Pasteur pipettes can be easier for younger children to use than syringes which are typically stiffer and slightly more difficult to operate.

• Mix up some ‘slime’ with water, cornflour and food coloring that the children syringe into the system (check it is runny enough to pick up in the syringe). I usually refer to this as ‘snot’ during the game so a green/yellow color is good. Storing this in a plastic lunchbox like tubs is good for children to access with the syringes

• Paper towels are advised to mop up any mess! Have a plentiful supply of paper towels for round two of the game to try to contain potential mess

• Detection systems – one for every one or two syringes/containers of ‘snot’. We made detection systems out of some old recycling tubs utilizing old electronics in the bottom for visual interest (Figure 2)

• Space to move around – the amount of space required will depend on the number and speed of the pupils

Figure 1. The steps of playing bacteria-tag, from collecting a ‘medicine’ when you are tagged by a ‘bacteria’ (A), to checking if the medicine works (B) and placing it in the appropriate container – smiley face if the medicine worked and sad face if it didn’t in which you try another medicine (C). The additional step in round 2 of using a detection system to select the medicine is illustrated in D.

Figure 2. Detection system examples. This doesn’t need to be anything expensive – a container from recycling and some old electronics work well. Alternatively children could work together to construct detection systems themselves using recycling to junk model and craft items for internal components. In terms of the design of a detection system the one on the far left which utilizes an upside down bottle as a sample entry container is less messy than the alternative as children usually hold the syringe inside this area before releasing the liquid whereas the alternative designs had some issues with poor aim resulting in the ‘snot’ solution spraying everywhere.

Procedure

1. SET UP

   Set-up the resources before the lesson using a space where there is sufficient space for the children to move around, e.g. a dining hall, a large classroom with furniture pushed to the sides or if the weather is nice outside works well. There should be four tubs containing the different colored balls on one side of the space and two empty tubs, one with a sad face on it and the other with a smiley face on it, on the other side of the space next to an iPad. Depending on number of pupils, a number of iPads could be beneficial to reduce queueing and waiting times during the game; we used three iPads with a class of thirty which worked well. Connect the iPads to the web app given above and set the volume tab to 50% (see the description of round one below for an explanation). It is recommended that a teacher stands by the iPads to remind the children of what to do and support them.

2. INTRODUCE THE TOPIC

   Science and engineering learning works best when children can make connections between what they already know and the new ideas introduced, either building on existing knowledge or clearly relating to their everyday lives and experiences. Therefore, adjustment of the introduction is suggested when working with different ages, e.g. 3 year-olds are less likely to be aware of the word bacteria and for this younger age group linking with hand washing and germs provides a clear basis for them. Most children have also taken some kind of medicine making this a familiar notion for them. Start by asking if children know anything about bacteria as they may have an understanding of the idea that bacteria can cause illness. If not prompt them about germs which is a term they are more likely to be aware of. This can also be an opportunity to discuss how bacteria are really small and very hard to see, even with a microscope, and how important it is to wash our hands to avoid illness.

3. PLAY ROUND ONE OF THE GAME

   Invite the children to play a game of bacteria-tag and briefly explain the rules. Some pupils will play the part of bacteria and try to tag the other pupils. Give those pupils a colored vest (or some other means of identification) and make sure to swop a couple of times to give pupils the chance to play both roles. Alternatively, depending on the number of children and whether they wish to play the part of bacteria, teachers or learning assistants could act as the bacteria, e.g. when we ran this activity with a small class of special needs pupils none of them were keen to play the bacteria and learning assistants were the bacteria for the whole duration of the game.

   Tagged pupils are “infected” and can be cured if they take the right medicine. Therefore, once a child has been tagged that child should follow the below procedure (see instructions and Figure 1). Colored balls are used to represent different medicines (A). Tagged children run to the ball tubs and pick a color. To check if they have the correct medicine pupils click on the color chosen on an iPad/laptop (B) – if get a smiling face this shows the medicine has worked and the pupil can rejoin the game after putting the ball in the bin with the smiling face (C). If get a sad face this shows the medicine has not worked and the pupil should try another medicine, i.e. the pupil has to run back to the ball tubs and select a different color after putting the ball in the bin with the sad face (C).

   Please note that the laptop code is based on random chance andwhen the volume bar is set to 50% for this first section of the game this means that clicking a color will result in a smiley face 50% of the time and a sad face for the other 50% of the time. Given the probability of uncovering a sad face is 0.5 and there are four colors there is 6.25% chance that a child receives a sad face for each of the different medicines. Over multiple different occasions of delivering the activity in schools and nurseries this has never actually happened for me though the explanation that I would use would be to explain that they unfortunately had a very resistant infection that could not be cured. Alternatively, if you are worried about this possibility then you could increase the volume bar to 70% thus increasing the chance of getting a smiley face, and reducing the likelihood of a child receiving four sad faces in a row to less than 1%. In this case I would recommend to play the first round of the game for longer to ensure there are a reasonable number of experiences where the incorrect medicine was selected at least once (this can be monitored this by watching the game and seeing how many balls are building up in the sad face container).

4. DISCUSSION

   After playing the game for several minutes call the children back for a group discussion. Select the playing time based upon how long you have available overall, the number of children, the success probability that you selected in the webapp etc. Typically, we have used around about 5 mins of play for round one, though have allowed slightly longer with larger groups to facilitate for switching between different taggers. When the children return ask the group if it was difficult to select the right medicine. Children are likely to say yes to this and visually this is also clear by looking at the number of balls in the different containers. If you set 50/50 on the app then you should have roughly the same amount of balls in the sad and smiley face containers.

   Key learning objectives: children will understand that different types of medicine are required for different diseases or for differentbacteria; children will appreciate that it can be difficult for medical professionals to select the most effective medicine

5. SET-UP ROUND TWO

   Put all the balls back in their original containers, organized by color. Usually, the children are very keen to help with this task. As before there should be four tubs containing the different colored balls on one side of the space and two empty tubs, one with a sad face on it and the other with a smiley face on it, on the other side of the room next to an iPad. Check the iPad is still connected to the web app given above and set the volume tab to 100% (see the description for round two below for an explanation). Set out a detection system, a container of ‘slime’ and some syringes. Depending on the number of children a couple of detection systems and containers of ‘snot’ will be best to stop a queue building up; with a class of thirty I used two detection systems and four containers. The most time-consuming step for the children is utilizing the syringes, especially for the youngest learners. Keep paper towels handy to mop up any mess. On some occasions I have set-up the detection system next to the iPads in order to be able to supervise both. However, if there is sufficient staff it is better to separate the detection system from the iPads to avoid any potential spillages. I suggest a teacher stands by the iPads and detection systems to remind the children of what to do and support them. The person overseeing the detection systems needs to have some kind of electronic device with them, e.g. a laptop, iPad or mobile phone. I usually use my mobile phone for this purpose, which is to ‘receive’ the data from the detection system, as described below.

6. PLAY ROUND TWO OF THE GAME

   In the second round of the game a detection system is used to determine which color ball to select. Once tagged instead of selecting a color at random the child runs to the teacher/leader and uses a syringe to inject some slimy liquid into the detection system. For older children concepts of numeracy and measure could be introduced by highlighting the markings on the sides of the syringes and potentially asking them to insert between e.g. 10-20mL. Pretend the detection system is connected to your mobile phone, or other electronic device, ‘read’ out the result and randomly pick a color medicine that will work for that infection. The child then goes and picks that color and double-checks on the iPad. Explain this variation before playing the game; again, remember to take turns at being bacteria so that everyone can try using the detection system. As the detection system works well pupils will always get a smiling face (D).

Please note to make this work, adjust the volume on the game code fully to the right which means a smiling face will be always be shown.

CODE LINK: https://strayllama.github.io/tb-tag-helen/

Extension discussions and activities

The game was originally developed as part of a research project into tuberculosis (TB) detection so you could tailor the discussion to a specific bacteria, e.g. TB if that links with wider learning aims. For example one time we visited a school to run the activity and they had been learning about the first world war and we were able to link this topic to TB through discussion of diseases that were prevalent at that time and were major causes of death during the war. Obviously, you could also adapt the game to cover other pathogens, e.g. viruses (though evidently you should talk about antiviral medicines here and not antibiotics), protozoa, fungi though this is unlikely to be relevant for the younger age groups.

Depending on the time you have available, the age of your pupils and the level of detail you wish to cover you could have a more in-depth discussion about bacteria structure and growth and how antibiotics work. This could be implemented in between Round One and Two of the game, along the below lines, using as much or as little as is relevant for you and your children. Alternatively, this line of questioning could be adapted for use after the activity.

• Q: was it difficult to select the medicine that works? YES!

• We’re going to talk about why it is difficult but first we’re going to review what we know about bacteria

• Q: how big are bacteria?

  Very very small – fit 50-200 across the width of one of your hairs! Difficult to see in the microscope

• Bacteria grow very fast (a powerpoint animation to show this could be useful or describe exponential growth. Bacteria reproduce by growing and then splitting into two bacteria, each of those two bacteria then grow and split, and so on. Some bacteria split every 20 mins so if you started with one at the start of the day by the end you would have millions!)

• Medicine that we take when we are infected with bacteria are called antibiotics.

• Q: how do you think they might work?

Destroy the bacteria

Stop them growing

• Show a bacteria model: in the center it has the instructions for growing, surrounded by lots of chemicals all enclosed inside a wall that keeps everything inside (as an extension you could get them to build one in pairs after the active lesson)

• For the antibiotic to work it has to: 1) get through the wall; 2) travel to the center; 3) stick to the instructions. It works by messing up the instructions so the bacteria are destroyed or can’t grow, e.g. like a Tipp Ex covering up some of the instructions so they can’t be read or a pen writing over and changing the instructions so they are wrong

• Q: how do you think the bacteria can fight back against the antibiotic?

Stop it getting through the wall (Wall)

Destroy it while it is traveling (Destroy)

Hide/protect the instructions so it can’t stick (Hide)

• Once the bacteria has worked out a way to fight back it adds this to the instructions so it can pass on the information

• This is why we found it difficult to select the right antibiotic because the bacteria had learnt ways to fight back and this is a big problem for diseases caused by some bacteria as there are lots of types of bacteria now that have learnt how to protect themselves from lots of the antibiotics we have so it is much more difficult to treat. That is why bioengineers are working to make detection systems to help doctors figure out which bacteria are infecting a patient, if those bacteria know how to protect themselves and therefore which antibiotics will work

Learning objectives: children will learn that bacteria are very small and grow very fast; Children will learn the word antibiotics, thus being able to name the types of medicines thatare used to treat us when bacteria make us ill. Children will gain an overview of the mechanisms by whichantibiotics work Children will discover that bioengineers make detection systems to help doctors choose the right medicine for patients

Further discussion extension suggestions include extending the discussion around bacteria to examples of ‘good’ and ‘bad’ bacteria. Evidently, in the bacteria-tag game the bacteria were making people ill. However, not all bacteria cause disease and there are multiple examples of useful bacteria, e.g. bacteria turn milk into yoghurt, bacteria inside our stomachs support digestion of food, bacteria can be used to make medicines or to clean up oil spills and bacteria can be engineered to perform these tasks, and a variety of other tasks (for example engineers are working on bacteria which could help recycle plastic and reduce issues of plastic pollution more efficiently.

Cross-curricular extensions

A fun arts and crafts activity following bacteria-tag is for children to design their own bacteria and describe what they do. Bacteria junk modeling is very easy to complete with just a few key components required, e.g. a bacteria wall (in Figure 3A this is manufactured from strips of cards but a simpler solution is to make a paper nest structure like in Figure 3B), some flagella, i.e., long-thin ‘tail-like’ appendages that help the bacteria move around (these can be all over the bacteria wall or there might only be a couple concentrated at one point), some internal chemicals (e.g. food and energy supplies for the bacteria) and some instructions, which tell the bacteria what to do (in Figure 3A this is encoded as a sequence of DNA whereas in Figure 3B learners wrote English sentences to describe what their bacteria could do).

Figure 3. Bacteria junk-modeling. A) a bacteria made from cardboard (wall), a pipe cleaner (flagella), some pom poms (internal chemicals) and a strip of paper (DNA/instructions). B) a bacteria made from paper (wall), ribbons (flagella), some pom poms (internal chemicals) and a strip of paper (DNA/instructions).

Describing the components of a bacteria utilizing a pre-built existing model is recommended so learners can visually appreciate the different parts of the bacteria and refer back to the model when making their own creations. Encourage them to decide on size, shape and other design factors, e.g. number and placement of flagella as well as to reflect on what they would like their bacteria to do. It might be helpful to suggest ideas, e.g. a bacteria that turns milk into chocolate flavored yoghurt or one which turns someone who eats it into a superhero or one which helps to clean up the environment.

Another option is for children to build their own diagnostic test kits, utilizing filter paper and litmus paper. This activity was developed as part of the Let’s Do Engineering project and full instructions are available on the website as the final part of the make a blood model lesson plan. The lesson plan starts with discussing what is in blood and in this example “blood” is tested rather than snot: https://www.letsdoengineering.com/activities/make-a-blood-model

This diagnostic test kit making has been tested with children from age 3 to 7 and can inspire future play with multiple test kits being manufactured to rest a range of e.g. PlayMobil toys (Figure 4)

Figure 4. A) The activity being undertaken in a school setting. B) close-up of test strips, one on the left showing a positive result by turning red and the one on the right showing a negative result. C) the activity being undertaken with 3 to 5 year olds and inspiring on-going play with a large testing regime applied to PlayMobil characters.

Linked with this activity on Let’s Do Engineering, there is also opportunity to watch a short film with a real biomedical engineer and read an interview with him about his role, how he got into engineering and what he loves about engineering: https://www.letsdoengineering.com/engineer/ameya

Results and discussion

The learning is focused on science and engineering practices, encouraging the children to ask questions and make observations, supporting children to make sense of germs and medicine. To link further with the Next Generation Science Standards connections with natural world process, e.g. decomposition and tackling misconceptions about bacteria; and the activity would help underpin later studies into antimicrobial resistance and natural selection.

No formal evaluation of the activity occurred and the results and discussion presented here are based on observations during implementation of the activity across a range of settings. Observations were undertaken by the author, and we acknowledge therefore the potential of bias due to the author creating, delivering and evaluating the activity. Some further observations were provided by independent trained observers at one science festival event. This was supplemented by informally asking the educators for their feedback via e-mail after the activity.

Bacteria-tag has been utilized with pupils from nursery (aged 3 to 5) up to pupils in P6 in the Scottish education system (aged 10-11) in a variety of different school and nursery settings, including complex and additional needs settings, as well as at science festivals (Figure 5). In the US this would translate to Pre-K to grade five. Older children could still enjoy the game and it has also been utilized with adults once; however, older children are liable to figure out how the webapp works and be distracted by this. When working with older P6 (grade five US equivalent) pupils we noticed that some older children were more curious about how the technology worked, e.g. how the web app functioned, as opposed to accepting the web app and detection systems as a fun part of the game. Therefore, we would recommend that the ideal ages for this activity are between 3 and 8 years old, i.e., Pre-k to grade three.

Figure 5. Various images of the bacteria-tag game in action.

Children love various aspects of the game, from being physically active to using the iPads and getting to use syringes to inject ‘snot’ into the detection systems. In addition, to building science and engineering understanding children practice both their gross and fine motor skills. The use of the balls provides a clear visual demonstration of the benefits of detection systems for bacteria, with clear differences in the numbers of balls in the smiley and sad face containers in different rounds of the game. Teachers and nursery practitioners have described bacteria-tag as “a fun, engaging and innovative way of delivering science and engineering”, enjoying the link with physical activity and how the tag game offers a “physical and visual approach to simplify and communicate quite complex concepts”.

Conclusions

Bacteria-tag is a physically active learning game designed to communicate science concepts related to bacteria and to introduce the idea of biomedical engineers, who, for example, design and develop detection systems to support doctor decision making in the prescribing of effective medicines. Most children can effectively link this to their everyday experiences of germs, being ill and taking medicines, while expanding their understanding of how medical decisions can be made, and how engineers help doctors in this process. The game also introduces a broader perspective of the areas included in engineering, tackling common stereotypes about engineers, e.g. that they wear hard hats and construct building or fix vehicles. The game is popular with children and works especially well in the age range of 3-8 years-old. There are very few examples of physically active learning lessons for this age group, particularly in science, which is the main novelty of the activity. Advantages of PAL are still being established, especially in relation to learning outcomes for younger children and in subjects beyond literacy and numeracy. However, there is evidence of improved learning with the additional benefits of reducing sedentary time and thus contributing to tackling issues like obesity.

Educator feedback has also been positive. However, in-depth evaluation has not been completed as yet, with plans to correlate the levels of physical activity, using e.g. activity trackers, with learning to make a greater contribution to the field of physically-active learning. Future research is planned to explore this area. Despite this, we have shown that bacteria-tag enables delivery of science and engineering content simultaneously with meeting health and wellbeing and physical activity goals. Additionally, there are various extension possibilities to bring in further areas of the curriculum, e.g. design and technology where children can create their own bacteria or design their own diagnostic test kits.

Disclosure statement

No potential conflict of interest was reported by the author(s).

Additional information

Funding

This work was supported by European Commission; Engineering and Physical Science Research Council.