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The practice and exploration of argument-based pedagogy through academic controversy in an eight-year medical immunology program: A case study of the

Liyuan Zhao1, Yijie Tao2, Min Zhang3, Sheng Xu1 


1National Key Laboratory of Immunology & Inflammation, Naval Medical University, Shanghai 200433, China. 

2Department of Physiology of Anesthesia, School of Anesthesiology, Naval Medical University, Shanghai 200433, China. 

3Department of Laboratory Animal Sciences, School of Basic Medicine, Naval Medical University, Shanghai 200433, China.


Address correspondence to: Sheng Xu, National Key Laboratory of Immunology & Inflammation, Naval Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China. Tel: +86-13564932474. E-mail: x.xusheng@163.com. Min Zhang, Department of Laboratory Animal Sciences, School of Basic Medicine, Naval Medical University, 800 Xiangyin Road, Yangpu District, Shanghai 200433, China. Tel: +86-18764201333. E-mail: zhangmin_vet@126.com.


DOI: https://doi.org/10.61189/466869iuwenb


Received October 28, 2025; Accepted December 4, 2025; Published April 1, 2026


Highlights 

● A single two-hour, debate-based seminar embedded within an eight-year medical immunology curriculum significantly improved students' critical thinking (Cohen' s d=2.3) and ethical sensitivity. 

● Utilizing the high-profile "Liping Chen–PD-1/PD-L1 Nobel priority controversy" as a structured academic controversy (SAC) case enabled students to master key immuno-oncology concepts without requiring additional curricular time. 

● The scalable SAC model provides an efficient, evidence-based pathway to cultivate ethically-minded physician-scientists within the constraints of crowded medical curricula.

Abstract

Eight-year medical programs aim to train physician-scientists capable of critically evaluating evidence and navigating complex ethical dilemmas. Medical Immunology, straddling multiple disciplines, can nurture these abilities. We hypothesized that a structured academic controversy (SAC), centered on a high-profile scientific dispute, could simultaneously reinforce conceptual understanding and foster higher-order thinking. A two-hour, debate-based seminar was conducted one week following the lectures on B-lymphocyte and antibody-mediated immunity. The case focused on the "Lieping Chen Nobel Prize controversy" concerning priority in the discovery of the PD-1/PD-L1 pathway. A pre-class micro-packageincluding an original article from Proceedings of the National Academy of Sciences of the United States of America, excerpts from the Nobel white paper, and a three-minute animationwas provided to prime students. In class, students were randomly assigned to pro or con teams and engaged in a 50-minute timed debate, followed by rebuttals after switching sides. Real-time scoring rubrics, a 6-item Likert scale (assessing critical thinking and ethical sensitivity), and 60-second post-class audio reflections provided multi-source evaluation data. The mean critical-thinking score rose from 3.2 to 4.1 (p<0.01), and the ethical-sensitivity score from 3.4 to 3.8 (p<0.05). A one-month transfer test showed that 83% of students accurately applied PD-1/PD-L1 concepts to novel immunological contexts, while 47% extended their critical inquiry to new targets (e.g., CD47, LAG-3). Qualitative analysis revealed an increased appreciation for collaborative credit and a decrease in ad hominem language. In conclusion, a single, tightly integrated 2-hour SAC debate significantly enhanced conceptual mastery, critical appraisal, and ethical reasoning without requiring additional curriculum time. This model can be scaled to other contentious scientific discoveries as a practical method for developing evidence-based and ethically-minded physician-scientists.

Keywords: Eight-year medical program, Medical Immunology, Debate-based instruction, PD-1/PD-L1, Lieping Chen, Nobel Prize, Critical thinking

Cite

Zhao LY, Tao YJ, Zhang M, Xu S. The practice and exploration of argument-based pedagogy through academic controversy in an eight-year medical immunology program: A case study of the "Nobel Prize Controversy Involving Liping Chen". Prog Med Educ. 2026 Apr; 2 (1): 10-15. doi: 10.61189/466869iuwenb

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