Slide 1: Preparation

This lesson is designed to be run by two facilitators visiting a school. It is aimed at students aged 12 to
14yrs and should take 50-60 minutes. The notes accompanying each slide describe how we have found
the lesson to work best. Feel free to adapt the activities to suit your needs let us know what works for
you at www.eurostemcell.org/contact

Before the school visit

Speak to the teacher to check both you and they know what to expect. Make sure the teacher
knows you will need the students in groups of 4 (or 3 if necessary) and is aware of your
equipment requirements (computer with internet, whiteboard/blackboard).

Collate the resources you will need. This involves some printing and folding. You will need a
class set of stem cell decision makers, cups and counters for the Stem cell decisions game; you
will also need a class set of Cell family cards and accompanying A1 body diagram. Make sure
you know how many students are in the class. See the separate resources and lesson plan for
more information and a materials checklist.

At the school

Get the classroom set up before the students arrive:

Set out the Stem cell decisions game: put one set of decision maker cups, a pile of 4 decision
makers and a dice on each table. Place about 16 blood stem cell tokens in the blood stem cell
cup.

Put the presentation on the desktop of the class computer and click through the slides, checking that
the links work.

Slide 2: Introduction

Facilitator 1 starts the session.

Tell students who you are and where you come from. Run through what you hope the students will
know by the end of the session. It is important for them to know the objectives. This slide also sets the
scene for the summary at the end of the lesson.

Slide 3: Introduction (cont.)

Briefly run through the parts of the lesson so that students know what to expect and are reassured that
you are not going to lecture them for an hour. There is no need to describe the activities at this stage,
just explain there will be opportunities to work in groups and discuss things.

Slide 4: Introduction (cont.)

Very briefly explain that stem cells are special cells because they can make other kinds of cells that the
body needs. Do not talk for more than about a minute or two at this stage you will discuss this in more
detail later and students will want to do something active. Just give a brief introduction for now, for
example:
The drawing on the left is a stem cell. It looks quite simple and plain just a round cell. But it can make
different kinds of cells that are useful in the body. Now were going to explore in a bit more detail what
exactly stem cells are, and what they can do.

You could first warm the students up by asking the class if anybody knows what a stem cell is, but save
the detailed discussion until after the Stem cell decisions activity so that students have a chance to
explore the concept for themselves first.

Hand over to facilitator 2 to introduce the next activity.

Slide 5: Stem cell decisions

Facilitator 2 introduces the Stem cell decisions game. This is a simple, quick activity. The aim is to allow
students to identify the two key things that stem cells can do:

1) self-renew AND 2) differentiate.

The best way to explain the activity is for the two facilitators to demonstrate it from the front, ideally
using a large version of the decision maker. Do this in BRIEF the students will be keen to do something
active and the aim is to let them explore the concepts themselves before you discuss the details. Once
youve demonstrated the principle of the decision maker very simply, give each group of 4 students a
Stem cell decisions student sheet so they can refer to the instructions as they play. Both facilitators
circulate around the classroom making sure students understand the task and prompting them to think
about what the decision maker tells them. Once students are out of the game, they observe the others
in their group and think about the questions on the student sheet.

Make sure you dont let this game run too long it only needs a few minutes until most students have
found the two possible routes the stem cell can take. If you let it run for a long time, students will get
bored and fidgety.

Activity instructions

Work in groups of 4. Start with two blood stem cells and one decision maker each.

You need to make some red blood cells and white blood cells, but you can only keep playing as
long as you have a blood stem cell.

Put your fingers in your decision maker and hold it closed.

Take it in turns to roll the dice.

When its your turn, roll the dice then open and close the decision maker the number of times
shown on the dice.

Ask the person next to you to choose a number from 1 to 4. Open the flap with that number on
it.

If you find a stem cell picture, take another blood stem cell. If you find a different kind of cell,
put your token in the cup with that type of cell on it.

Play until everyone has run out of red blood stem cells.
Now answer the questions on the sheet.

Slide 6: Class discussion hidden slide

This slide is hidden because you dont need to show it to the students. Its a guide for facilitators. After
the decision maker activity, get the class to put all their decision makers down in the centre of their
table and look to the front. By asking them questions, get them to tell you the key points you need to
draw the above diagram on the board. You might say something like:

Facilitator: Youve had a chance to find out a bit about what stem cells can do by using the stem cell
decision makers. Can anyone tell me one thing a stem cell can do?

(Usually someone comes up with either copy or make blood cells or something similar at this stage; if
not then prompt them a bit more obviously what different decisions does your decision maker have in
it? What could happen to your stem cell counter?)

Student: Make a copy

Facilitator: Yes, brilliant, thats one thing a stem cell can do. (Draw appropriate part of diagram). Can
anyone tell me another name for making a copy? What is this process called? (If necessary, prompt
them to check the flap on their decision maker).

Student: Self-renewal.

Continue in this way to get the rest of the diagram. At the end, emphasise that stem cells can do BOTH
these things. You can do this by drawing a big plus sign or writing AND between the two processes.
Tell the students that no other cell in their body can do both these things.

Slide 7: Class discussion (round-up)

This slide is set up so that the diagram appears one step at a time. Explain that the stem cell is dividing
along the way. At the end of the process, you still have 1 stem cell but 4 new specialized cells. Practice
talking through the slide to find phrasing that you are comfortable with. The key take-home messages
are:

1) Self renewal is needed because if the stem cells didnt copy themselves, you would quickly run out. It
is important for the body to maintain a pool of stem cells to use throughout your life.

2) Differentiation is important because specialized cells are used up, damaged or die all the time during
your life. Specialized cells cannot make copies of themselves, but they need to be replaced for your body
to carry on working. Stem cells solve this problem.

Slide 8: Presentation

Facilitator 1 takes over again here. You have completed the first section of the lesson about what a stem
cell is, and now you are now moving into the part of the lesson that looks at tissue stem cells, with blood
stem cells as an example.

Explain that we all have stem cells in our bodies all the time. They are called tissue stem cells. There are
many different kinds, found in different parts of the body. They are essential for keeping us fit and
healthy. They replace cells that are damaged or die. Scientists are still learning about all the different
kinds of tissue stem cells found in our bodies and how they work.

Bone marrow is highlighted in red on the slide because it is the focus of the following example. You
may like to ask students if they know what kind of specialized cells are made in the bone marrow, but
young students can seldom answer this question.

Slide 9: Presentation

Tell the class that blood stem cells are found in your bone marrow. They are a type of tissue stem cell
and they can make the different kinds of cells in your blood. We saw that earlier with the stem cell
decision maker.

Ask the class how long they think a red blood cell lives. Take a few guesses, perhaps encouraging them
to adapt their answers by saying longer or shorter.

The answer is about 3 months (120 days). And white blood cells live for an even shorter time (different
types have different life spans). Thats why your body needs to make new blood cells all the time.

Slide 10: Presentation

The image on this slide is a link to a 1-minute movie of blood stem cells differentiating into white blood
cells (see below for full scientific legend and journal reference). The movie is on YouTube at
http://youtu.be/_td8Op8oHsA. If you do not have an internet connection, you can download the movie
file from http://www.eurostemcell.org/toolkititem/discover-stem-cells

Introduce this movie along the following lines:

Weve told you that blood stem cells can copy themselves and make different kinds of blood cells. Now
were going to show you some real blood stem cells in action. This movie shows some blood stem cells
in an experiment in the lab.

Show the movie clip. Add some commentary to the film as it plays. Point out that the cells are all
dividing at the start and they all look the same. Prompt the students to tell you when they spot
something different happening. Explain that in this experiment, the scientists added something to the
cells a particular protein that tells the cells to differentiate and make white blood cells. You can see it
happening. And thats happening all the time in your body. The movie is sped up (the timer counts up to
4 days) so each cell divides only once in a while, but you have lots of stem cells working together to
make all the cells your body needs.

Note: At this level, it would be too complex to describe how progenitor or transit amplifying cells
provide amplification of the number of cells made. We suggest you avoid use of the term progenitor.

Movie legend and reference

Continuous observation of a granulocyte-macrophage progenitor-derived macrophage colony at the

single cell level. Reproduced with permission from: Michael A. Rieger, Philipp S. Hoppe, Benjamin M.
Smejkal, Andrea C. Eitelhuber, Timm Schroeder, Hematopoietic Cytokines Can Instruct Lineage Choice,
Science 325, 217 (2009); DOI: 10.1126/science.1171461.Copyright for this movie belongs to Timm
Schroeder.
Slide 11: Presentation

This slide is just a marker slide to flag the start of the next interactive part of the lesson: a class activity
looking at how many blood cells your body makes and how long it takes. The object of this section is to
highlight the importance of stem cells in our bodies in a fun way the students play games that
illustrate what an enormous job blood stem cells have in our bodies all our lives. And this is just one type
of stem cell in our bodies.

You dont need to spend any time on this slide, perhaps just say something like:

So these blood stem cells are busy in your body making white and red blood cells all the time. Its a
pretty big job because youve got a lot of red blood cells. Now were going to see if we can take on a
class challenge together: to figure out just how hard these cells have to work.

Slide 12: Presentation

Set the class a challenge:

Youve got a lot of red blood cells. Each one is really tiny smaller than the head of pin. If you lined
them all up end to end, how far do you think they would stretch?

Take guesses. Make it a game by giving clues, asking students if they think the cells would stretch as far
as a nearby landmark, for example. Reveal the answer after you have a few guesses.

Slide 13: Making red blood cells

Weve seen that there are a LOT of red blood cells in the body and that they dont live very long. So now
we want to look at how efficient your body is at replacing them.

Start by asking the class to guess how long it takes your body to make 2 million blood cells. Theyve just
heard that there are a LOT of red blood cells in their bodies so they will probably guess quite a long
time. Take a couple of guesses but dont reveal the answer. Continue along the following lines:

Okay, so you think it takes your body anywhere between x and y to make 2 million blood cells. Before
we find out the answer, were going to do a quick check to see if we think your guesses are in the right
kind of area. I need 2 volunteers.

Select two volunteers from the class and ask them to come out to the front. Ideally, select one boy and
one girl. Try to pick students who have not been the most vocal so far. If students are reluctant to
volunteer, reassure them that all you need them to do is count to 20. Once you have you two
volunteers, click on the link How quickly can you count to 2 million? This opens up an online stop clock.

Hint: It is a good idea to open the stop clock before you start the lesson so that the browser is already
open in another window. This gives you quicker access to it when you click on the link. If you cant get an
internet connection, use a normal handheld stop clock and write the times on the board.

Record how long it takes each student to count to 20 on the board. Make this fun by encouraging the
students to compete with each other. If you have time, it can be fun to join in as facilitators see if you
can go any faster, perhaps making boy/girl teams with the students. Now move on to the next slide.

Slide 14: Making red blood cells (cont.)

It generally takes students 3 or 4 seconds to count to 20 if they are really focussed on doing it quickly.
When you show this slide, only the buttons on the left appear. Click the one that matches the average
time your students took to count to 20. This will reveal how long it would take to count to 2 million if
you carried on counting at that speed, without any breaks for breathing, eating, sleeping, going to the
toilet etc.

Now click anywhere on the white part of the slide and the text To make 2 million red blood cells it takes
your body will appear. Ask the students to guess again how quickly your body can make 2 million red
blood cells. Then reveal the answer. This helps illustrate how amazing it is that your body makes so
many blood cells every second.

Students sometimes ask how many cells there are in your whole body. Your body has about
25,000,000,000,000 red blood cells.

If you have a lot of time, you could get a volunteer from the class to help you use a calculator to work
out how long it would take them to count to 2 million. If you are running the session within a 1-hour
lesson, there is not sufficient time to do this.

Slide 15: Your body is more than just blood!

Facilitator 2 takes over here. This is just a marker slide to signal that you have finished with the blood
example and are now going to move on to think about the other types of tissue stem cells in the body.

Slide 16: Stem cells in your body Cell families card game

The best way to explain this game quickly and clearly is to demonstrate it together at the front, with
each facilitator holding some cards. Do not spend too long on this, just give a quick demonstration and
let the students get going. Explain that the aim of the game is to collect families of four cells. Each
family contains one stem cell and three kinds of specialized cells that the stem cell can make. Each pack
of cards includes an embryonic stem cell family that does not belong in the body. This will become clear
in the class discussion at the end of the game and leads neatly into a short discussion on embryonic
stem cells.

Once you have explained the game, hand out a set of cards and student instruction sheet to each group
of 4 students. Tell students they only have a short time to play so its important to keep the game
moving. You can make this a competition by telling students to see if their group can be the first to get
all the families out (without cheating!). Both facilitators circulate around the classroom helping students
with the task and prompting them to think what the cells within a family have in common. While the
students are playing, pin up the large body diagram on the wall or board, positioned to the right of a
board you can draw on.

Stop the game when each group of students has managed to collect at least one or two families. If one
group gets all the families quickly or is starting to lose concentration, get them discussing the questions
on the sheet while the other groups finish. There is no need to write the answers down and it doesnt
matter if most groups dont get to the questions you will cover this in the class discussion at the end of
the game.

If you have plenty of time, you can also play this game as follows: Deal the cards as above. Instead of
letting each player decide which card to give away, make them offer their full hand of cards to the
player on the left (without showing what the cards are). The player on the left then chooses a card for
themselves. This introduces an element of chance and makes the game more challenging, but also
requires more time.

Slide 17: Stem cells in your body Cell families card game (cont.)

Stop the card game and ask students to put the cards down, leaving their families displayed on the desk.

Ask who has a family of 4 cards. Choose a volunteer to come forward with their family. Get them to tell
the class what family theyve got (brain cells, blood cells etc). Prompt them to tell you what kinds of cells
are in the family e.g. all types of blood cells. Then ask them to stick the stem cell from their family on
the body diagram in the part of the body where the cell family belongs. You might like to have some
spare stem cell cards ready for this so that the pack of cards used by the student group remains
complete.

Repeat until you have all the families represented on the body diagram. If youre short of time or its
clear the students have got the point, stop after a couple of families. If you have plenty of time, you
could ask students if they know the functions of some of the organs represented in the game the
pancreas is a good one to point out because you can mention diabetes, which most students have heard
of (it is a good idea to check first with the teacher if any of the students have diabetes to avoid any
embarrassment of individuals). This provides a good example of a disease where stem cell therapies may
be useful in the future.

Summarise: These are just some of the types of stem cells in your body. You have different types of
stem cells making the different kinds of cells you need in your body. But each type of stem cells can only
make certain kinds of specialized cells the brain stem cells can only make brain cells, the lung stem
cells can only make lung cells.

Now ask if anyone has a family of cards that doesnt fit in the body anywhere. Get them to tell you what
the family is (embryonic stem cell family). Ask if anyone has any idea where this kind of stem cell is
found. At 12-14 years old, most students cant answer this. Many do not know what an embryo is.
Explain what embryonic stem cells are and what they can do, drawing a diagram next to the body
picture (see hidden slide 18 for example diagram).

Slide 18: Class discussion hidden slide

This slide is hidden because you dont need to show it to the students. Its a guide for facilitators. Draw
the blastocyst and explain that it is a very early embryo an extremely early stage of development of a
baby, about 5 days after the sperm fertilizes the egg. It is a ball of 100 to 150 cells. Tell the students that
embryonic stem cells are found inside the blastocyst and they can make all the cells in the body. Draw
arrows as you explain that this is the starting point for making all the different kinds of tissues in the
body diagram the class has just be working with.

Ask students if they have any ideas why scientists might be interested in embryonic stem cells. They may
be able to suggest that these cells could be useful for disease treatment, they may not. Collect answers,
praise good responses and hand over to facilitator 1 to explain a bit more.

Slide 19: Plenary

Facilitator one takes over from here. The aim is to highlight briefly why embryonic stem (ES) cells are
interesting. Do not try to cover all the possible aspects of ES cells and their application. That is
something that needs to be treated in a separate lesson. On this slide, briefly explain that:

1. Scientists around the world are trying to understand how and why embryonic stem cells
produce skin, blood, nerve or any other particular kind of specialized cell. What controls things
so that the stem cells make the right amount of each cell type, at the right time?

2. The big challenge for scientists is to learn how to control these fascinating cells. If we could force
embryonic stem cells to make whatever kind of cell we want, then we would have a powerful
tool for developing treatments for disease. For example, perhaps we could grow new insulin-
producing cells to transplant into the pancreas of a patient with diabetes. But there is a great
deal to learn before we can do this. Scientists also want to use stem cells to:

Understand what goes wrong in diseases

Test drugs in the laboratory

Slide 20: Plenary

The bullet points are revealed one at a time on clicking. As you reveal each heading, try to get students
to tell you what theyve learnt in this area. This is a quick summarising exercise to remind students of
the main points.

At the end, thank the students for their hard work and ask them to complete a feedback form before
leaving. Explain that it is important to know what they thought of the lesson so that we can keep
improving it for other students. The form has two sides but it should only take five minutes to complete.

Pack away your materials or set up for the next lesson while they complete the forms. There is also a
form for the teacher, and a leave-behind student sheet that the teacher can use to follow up with their
class after the visit. It is helpful to arrange to get some verbal feedback from teachers at the end of your
visit too.

We hope you enjoy using the lesson. Dont forget to send us your comments and experiences at
www.eurostemcell.org/contact