Application of project-based service-learning courses in medical education: trials of curriculum designs during the pandemic.

BACKGROUND: Due to COVID-19, face-to-face service activities in service-learning courses have become unfeasible. To address this challenge, this study aims to integrate project-based learning into medical education's service-learning curriculum. This study also seeks to evaluate the effectiveness of this instructional approach and identify factors that influence its success. METHODS: A total of 135 first-year medical students enrolled in a mandatory 1-credit service-learning course were recruited. The course involved various service activities aligned with the needs of the local community. The students were organized into 12 groups, each working on different service-learning projects, such as raising health awareness or educating the public about specific diseases. Following the completion of the course, a questionnaire was distributed among the students to gather feedback on the course, and 122 (valid responses were collected, representing a response rate of 90.3%). RESULTS: The results indicated that the project-based service-learning course significantly improved students' "interpersonal communication skills," their ability to "learn and grow from work," and their sense of "professionalism" (all p ≤ 0.037). Among the various aspects of service learning, the highest agreement was observed for "executing the project," followed by "group discussions and project formulation," "overall course review," "review of project outcomes," "outcome presentations," "teaching proposal writing and project brainstorming," "sharing of service-learning experiences by teachers," and "sharing of service-learning experiences by teaching assistants." Students also found certain factors to be beneficial in enhancing the learning effectiveness of service-learning courses, including "prize money for service-learning outcomes," "funding for service-learning activities," and "consultations from medical personnel" (all p ≤ 0.01). However, "course credit" and "photography software" did not show significant effects (both p > 0.05). The most preferred resources or activities for future service-learning courses were "course credit" and "face-to-face service-learning activities." CONCLUSIONS: The project-based learning method improved the learning effectiveness in service-learning courses. Students perceived that the number of course credits reflects the course value and plays a pivotal role in enhancing the learning effectiveness in service-learning courses. During the epidemic, students still expect to have face-to-face service activities in service-learning courses. Therefore, without the impact of the epidemic, service learning courses should return to face-to-face service activities.

Blood-Brain Barrier Disruption in Preclinical Mouse Models of Stroke Can Be an Experimental Artifact Caused by Craniectomy.

The pathophysiological features of ischemia-related blood-brain barrier (BBB) disruption are widely studied using preclinical stroke models. However, in many of these models, craniectomy is required to confirm arterial occlusion via laser Doppler flowmetry or to enable direct ligation of the cerebral artery. In the present study, mice were used to construct a distal middle cerebral artery occlusion (dMCAO) model, a preclinical stroke model that requires craniectomy to enable direct ligation of the cerebral artery, or were subjected to craniectomy alone. dMCAO but not craniectomy caused neurodegeneration and cerebral infarction, but both procedures induced an appreciable increase in BBB permeability to Evans blue dye, fluorescein, and endogenous albumin but not to 10 kDa dextran-FITC, leading to cerebral edema. Using rats, we further showed that BBB disruption induced by craniectomy with no evidence of dural tearing was comparable to that induced by craniectomy involving tearing of the dura. In conclusion, our data demonstrated that craniectomy can be a major contributor to BBB disruption and cerebral edema in preclinical stroke models. The implications of this experimental artifact for translational stroke research and preclinical data interpretation are discussed.