Original Publication
Open Access

Mechanisms of Sickle Cell Anemia

Published: July 24, 2006 | 10.15766/mep_2374-8265.265

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Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


Team-based learning (TBL) is a well-defined instructional strategy that allows a single instructor to teach by conducting multiple small groups simultaneously in the same classroom. Learners actively participate in and out of class as they move through three phases: independent study assignments, readiness assurance testing, and group activities that force them to put knowledge into practice. Students prepare in advance by reading an assigned article. Class time is shifted away from learning facts and toward application and integration of information. The instructor retains control of content and acts as both facilitator and content expert. This TBL program is designed to supplement the first-year Molecular Basis of Medicine course covering quaternary protein structure. The session compares the impact of amino acid substation on HbA, HbS, HbF on quaternary structure and function. Protein solubility, role and rate of oxygenation, hemoglobin concentration, and rate of microvascular transient time relative to polymerization reactions are detailed to enhance appreciation as to mechanisms of disease impacted by quaternary structural defects. The TBL session features a readiness assessment test that is first taken individually and then later by teams, an applications worksheet that uses multiple-choice questions to integrate basic knowledge components into medical decision-making tasks, and a summary point review sheet that acts as a study guide for formal examination assessments used throughout the course. Included is a detailed instructor’s guide to facilitate use of the materials, all of which are appended to the instructor’s guide. No formal studies have been done, but the session has been used multiple times with a pediatric inpatient team made up of multiple levels of learners. Informal feedback has been uniformly positive that the case is realistic, useful, and practical.

Educational Objectives

By the end of this team-based learning session, learners will be able to:

  1. Demonstrate the importance of Hb in disease states seen in clinical practice.
  2. Understand the type of cellular morphologies that can result in HbS disease.
  3. Understand the polymer effects on erythrocyte membrane.
  4. Determine the mechanisms and importance of hydration status of a red blood cell.
  5. Understand the ion transport systems that impact cellular hydration.
  6. Determine the mechanisms involving vascular endothelium and vaso-occlusive disease.
  7. Identify the potential of therapeutic interventions from the disease concepts identified above.
  8. Know at which point in the mechanism of action these agents intervene.
  9. Identify measured benefits for these agents.
  10. Recognize the potential harm that may result with using these agents.

Author Information

  • Gary Onady, MD, PhD: Wright State University Boonshoft School of Medicine

None to report.

None to report.


Onady G. Mechanisms of sickle cell anemia. MedEdPORTAL. 2006;2:265. https://doi.org/10.15766/mep_2374-8265.265