Meeting time and style

The course convened eleven times on Tuesdays and Thursdays, with each session lasting two hours, totaling 22 contact hours (Table 1). The class size ranged from 10 to 14 students. Each lecture was divided into two sections: Sect. 1 consisted of prepared lectures, during which students were encouraged to complete follow-along worksheets for engagement and study purposes. In Sect. 2, students engaged in team-based group activities that applied lecture material, including case studies and group assignments. In-lecture assignments were collected, graded, and returned. Students demonstrated their understanding of cancer’s clinical impact through conceptual case studies. They underwent assessment for learning retention via a final examination consisting of multiple-choice, short-answer, and essay questions.

Student learning outcomes

Our approach merges both didactic learning modules with cooperative learning strategies to educate students on recent cancer advancements [7]. Additionally, we exposed students to various career paths through an interactive panel discussion encompassing fields such as epidemiology, law, consulting, biomedical sciences, engineering, physics, medicine, and academia. The assessment of learning benchmarks spread across four modules was conducted as follows: (1) Students were evaluated on their ability to develop a solid understanding of basic cancer biology terminology, including terms such as cancer, tumor, oncogene, and tumor suppressor. (2) Student assessment involved exploring the fundamental characteristics of cancer, known as hallmarks, and gaining insights into how cancer cells behave differently from normal cells. (3) Students were tasked with investigating the factors and mechanisms contributing to the development and transformation of cancer cells. (4) Student evaluation included the role of epigenetic regulation in cancer. (5) Students’ understanding of the relationship between the immune system and cancer was assessed, exploring how immune responses can impact disease progression. (6) Assessment involved the influence of the microbiome on cancer prognosis and examining how the diverse gut microbiome in our bodies can affect cancer outcomes. (7) Evaluation included students gaining knowledge about different types of cancer therapies, both traditional and innovative, and understanding their mechanisms of action in treating cancer. (8) Students were exposed to different career options in cancer. Further details about student learning objectives and assessment methods can be found in Table 2.

Course lecture design

The course incorporated several key cancer hallmarks [8] structured into four modules to provide smaller, more manageable units. This approach facilitated a more cohesive and interconnected learning experience, allowing students to build upon and establish connections between concepts as they progressed through each module. Each module was divided into two lectures.

Case study assignment

Students were divided into two cohorts, formed through a random selection process. The students were provided with a rubric outlining the following prompts: Prompt 1: Present the findings related to the development, efficacy, safety, and culmination of a novel drug candidate for glioblastoma in clinical phase 4 trials. Prompt 2: Demonstrate the process of developing a novel diagnostic method for Chronic Myeloid Leukemia (CML), from hypothesis formulation to its implementation in clinical practice. Both cohorts were required to incorporate elements of in vitro and in vivo studies, team collaboration, data analysis and interpretation, clinical trial designs, and clinical implementation and evaluation. Students’ presentations were to be 15 min, followed by 5 min of questions by the audience and instructors.

Escape room review

Students participated in examining seven multipart interactive challenges, utilizing their lecture notes to apply a comprehensive understanding of the course material (Additional file 1). The learning objectives (Additional file 2) encompass foundational knowledge of cancer hallmarks. Additionally, students could participate in a case study aimed at the practical application of the principles governing cancer hallmarks (Additional file 3).

Panel discussion

Students were assessed to gauge their current career interests, and the panelists were selected based on students’ feedback. The career panel was divided into two parts. The first part was a brief 10-minute presentation about potential careers in science, technology, engineering and mathematics (STEM) given by one of the course instructors. The second and central part was a moderated panel discussion between the different STEM professionals and the high school students. Panelists with expertise in various fields, including engineering, physics, biomedical sciences and research, medical practice, and venture capital and consulting, were invited to participate in the cancer-centric panel discussion.

More details of each module and course components are discussed in the extended methods (attachment 5).

Pre and post questionnaire

On the first day of the course, students were evaluated on their baseline knowledge of cancer-related topics and their expectations for the course. The assessment was adopted as previously described [10], lasted 5 min, and included questions on cancer knowledge and hallmarks, treatment options, and their research interest. The students were re-evaluated on their knowledge on the final day of class. Figure 2 presents the distribution of responses for each question.

Open in a separate window

Fig. 2

Results of the pre-and post-assessment. (A) Definition of cancer: Students’ responses to defining cancer in one sentence, with scores ranging from 1 to 10. (B) Cancer therapies: Students’ responses naming cancer therapies. (C) Hallmarks of cancer: Students’ responses naming hallmarks of cancer. (D) Likelihood of curing cancer: Students’ ratings on a scale of 1 to 10 on the likelihood of scientists curing cancer. (E) Likelihood of pursuing research: Students’ ratings on a scale of 1 to 10 on the likelihood of pursuing a research-focused career. (F) Likelihood of pursuing cancer research: Students’ ratings on a scale of 1 to 10 on the likelihood of pursuing a career focused on cancer research. (G) Perceived difficulty of the course: Students’ ratings on a scale of 1 to 10 on the expected difficulty vs. actual difficulty of the course. A paired parametric Student’s t-test was used to calculate the p-values. Error bars represent standard errors of the mean. The data is assumed to be normally distributed

Evaluation of student knowledge comprehension

The final grade averages served as a comparative assessment between years. We included 2017 and 2018 as a reference point for the curriculum prior to modifications in 2021. In 2017 and 2018, the course was taught in person by previous instructors [1]. In 2021, the course was taught virtually amid limitations in place via COVID-19. In 2022 and 2023, the course was taught in person following the removal of COVID-19 restrictions. We cannot account for the differences in educational backgrounds among cohorts. However, students are generally selected from similar regions each year. Moreover, we cannot account for the differences in how prior course instructors implemented the curriculum. We altered the curriculum in 2021 to comply with remote learning restrictions. When the restrictions were lifted, we adopted the same approach for future cohort installments (2022 and 2023), and we observed steady rigor in the grades tracked. We also observed improvement in the minimum grade average in 2022 and 2023 (Table 3). It is important to note that while we do not want to compare between cohorts, we do want to emphasize that the changes we made throughout 2021–2023 did not significantly worsen student performance. We also must note that the improvements we implemented may have altered final performances throughout the years, and we observed that some cohorts had closely distributed cumulative grades while others did not. This may be due to differences in foundational knowledge and variations in instructors’ delivery of the material. We believe adding follow-along assignments and student-led cooperative group assignments improved students’ autonomy and comfort with the subject area.

When we asked students to define cancer in one sentence, we observed a significant increase in the quality of the responses in the post-course assessment compared to the pre-assessment (Fig. 2A). For instance, general responses submitted for the pre-assessment included “a foreign body that can spread throughout the body” and “cell mutation in the human body.” In contrast, in the post-assessment, we observed higher-quality responses such as “a mutation in a cell that leads to the uncontrolled dividing and spreading of malignant cells.” We also noticed that some students incorporated cancer hallmarks and terms (“defect of cells resulting in oncogenes that multiply quickly, spread throughout the body, and cause tumors”) in the general responses after the course, which indicated that students retained general information throughout the course. Moreover, students also demonstrated the ability to connect key concepts over the duration of the course. For example, some students recognized the link between genomic instability and the potential for cancer-associated antigen presentation, recognizing avenues for targeted therapy or immunotherapy.

We next asked students to name as many cancer treatments as they could (Fig. 2B). During the pre-assessment, a lot of the answers were traditional therapies such as “radiation,” “chemotherapy,” and “surgery.” In the post-assessment, the variety of responses significantly improved to include both standard therapies as well as more precision-based therapies such as “immunotherapies (CAR T cells),” “gene therapy,” “hormone therapy,” “fecal microbiota transplant (FMT),” and “bone marrow transplants,” among others. Our focus throughout the course was to increase exposure to targeted therapies and novel therapies not commonly discussed, for instance, “adoptive cell therapy” and “small tyrosine-kinase inhibitors.” The interactive group learning assignments covered novel therapeutic approaches, likely aiding students’ high retention of the course material.

The most remarkable findings emerged when students were asked to identify as many cancer hallmarks as they could (Fig. 2C). Initially, during the pre-assessment, responses ranged from “What is a hallmark?” and “not sure” to some leaving the question unanswered. However, following the course, there was a statistically significant increase in the quantity and quality of the responses, exceeding our expectations. For instance, one student provided a summary list including “sustaining proliferative growth, metastasis, tumor-promoting inflammation, developing immune escape, senescent cells, dysregulated cell metabolism, resisting cell death, genome mutations,” and another answered “angiogenesis, cell proliferation, evading cell death, polymorphic biomes, irregular cellular regulation.” Notably, the students correctly identified cancer hallmarks within the allotted time.

Another notable trend between pre-assessment responses and post-assessment responses is the likelihood of pursuing research (Fig. 2D), specifically cancer research (Fig. 2E). Although no statistical significance could be observed throughout the course, there was a noticeable upward trend in median responses after the course ended. Furthermore, when assessing the course difficulty responses, the data indicate that some students did not feel like the course was as challenging as initially thought (Fig. 2G). However, the responses from that survey were non-statistically different.

The SSTP program director also gathered feedback from students regarding the course difficulty and design (Fig. 3). Students were asked to rate three prompts on a scale of 1–5, where 1 indicated “strongly disagree” and 5 indicated “strongly agree.” To the first prompt (overall, this course was a valuable educational experience), 50% of students answered 4, and the other 50% gave a score of 5, indicating the students found the course to be of educational value. This was coupled with additional feedback, with one student stating: “The case studies were a lot of fun and provoked critical thinking in a way I’ve never experienced”.

The second prompt interrogated if the course activities and assignments improved the students’ ability to analyze, solve problems, and/or think critically. While most students (62.5%) gave a rating of 5, one student gave a response of 2, another gave a score of 3, and the other gave a score of 4. Additional feedback highlighted the effectiveness of educational activities such as escape rooms and case studies, with responses like: “The educational activities we did at the end of class (e.g., escape room, case studies)” and “Learning about cancer and getting to work in groups and play games” further reinforcing the curriculum style. The final prompt asked whether the course content (e.g., readings, activities, assignments) was relevant and valuable. Once again, most students responded with a rating of 5 or 4 (50% or 37.5, respectively), with only one response rating of 3. Overall, we felt confident that these students benefited from the course and enhanced their learner autonomy.

Students were also encouraged to provide additional comments, and only one did so. The response mentioned, “The terminology was difficult to fully understand, and the lessons felt a little rushed each time. Adding more assignments would help us understand the information more and apply it.” Although the course is condensed into 22 contact hours, future curriculum revisions may consider providing optional pre-reading assignments to help students grasp more challenging concepts.

Final assessment

Due to the limited time and course lecture design, we could not proctor the final assessment. However, to ensure academic honesty, we added safeguards to the evaluation. We added a time limit of 95 min, randomized the assessment questions, and locked submitted assessments until the instructors graded all assessments. These steps would allow students enough time for multiple-choice and short-answer essay questions while discouraging academic dishonesty. We also noted how long it took for each student to complete the assessment and the time and date of completion. There is no indication of academic dishonesty for the final examination (data not shown).

Lessons learned and applications

Some of the essential skills required for a successful career in STEM include the ability to effectively communicate, lead, think critically, collaborate, and summarize and interpret scientific literature and data. Throughout the course, these students participated in several peer-to-peer activities that prompted them to independently improve all of these skills. We observed improvements in student-led leadership and the enhancement of shared ideas when students engaged after didactic lectures. Moreover, the students were more resourceful, taking the initiative to look up and understand the case studies and assignments during that time.

Students also presented case studies and self-coordinated with each other to determine sections to present. This case study presentation was timed, and students effectively communicated a lot of information on a topic they had not previously known. During the escape room, we observed peak performance in student collaboration, with students working together to connect main ideas across lectures to decode the escape room.

Additionally, students participated in a career overview panel. The panelists were from several fields in STEM and are described in the extended methods (Attachment 5). During this time, students were prompted to develop several questions to ask the panelists. Most of the students were unfamiliar with all aspects of STEM, especially careers outside of medicine in cancer, and found the panel informative. Other studies have addressed that students generally have limited knowledge of STEM careers and that early exposure can enhance their interest in pursuing other STEM-related careers [13, 14]. Our study showed a non-statistical mean increase in students likely to pursue research, specifically cancer research. Altogether, students not only improved their general knowledge but demonstrated improvement in all the skills required to navigate future careers in STEM. This is corroborated by prior literature that has shown collaboration improves these skills [4, 5].

The authors thank the University of Florida Center for Precollegiate Education and Training for administering the Student Science Training Program and the Frances C. and William P. Smallwood Foundation for partial funding. Thank you to the UF-Health Cancer Center for providing a space for the students to gain knowledge that can be passed along and a platform that has allowed us to design and implement a curriculum for aspiring scientists. Furthermore, we thank Dr. Kathryn Stofer for her guidance and expertise in seeking IRB approval. We also acknowledge Dr. Dietmar Siemann for his time supporting our research and community outreach ideas and his training grant that has supported our research. We would also like to state that the research reported in this publication is partially funded by the National Cancer Institute of the National Institutes of Health under Award Number T32CA257923. And importantly, we want to thank the students for their patience with the instructors and for being exemplary students eager to learn. To the many previous course instructors, we thank you for your dedication in laying the foundation and building a course that has impacted generations of students.