Features of medical education in Ukraine during wartime Poltava State Medical University (Poltava, Ukraine)

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Features of medical education in Ukraine during wartime Poltava State Medical University (Poltava, Ukraine)

Bezkorovayna I. M., Voskresenska L. K., Ryadnova V. V.

Ukrainian medical education is constantly being improved with a focus on European integration. Its significant achievement has always been the possibility of practical training, which constantly attracted many international students to Ukrainian educational institutions. However, with the beginning of a full-scale war, corrections must be made in the field of education in Ukraine, as several educational institutions are located in occupied territories or those subject to bombing, which denies the possibility of face-to-face education. The Ministry of Health, taking this into account, changed the procedure for admission to medical specialities and, in some institutions of higher medical education due to the proximity to the war zone, planned distance learning. The authors of this article investigated the possibility of conducting it during the training of health care professionals by analyzing modern literary sources. The experience of distance learning, including for obtaining medical specialities, was accumulated during the Covid pandemic. With a combination of its varieties, distance learning has proven itself well. Students' perception of online clinical training can be compared to the method of self-study, where the effectiveness depends on the student's interaction with the previously prepared educational materials. However, even distance medical education requires the student to observe the clinical experience of the teacher and face-to-face practice of action algorithms to ensure the development of practical skills, without which it is not possible to examine and treat the patient. Therefore, there is a need to reschedule classes with the allocation of a month or several to acquire practical skills within the scope of practice in safe areas.

Key words: medical education, distance learning.

Introduction

Medical education has consistently ranked first among dream professions and specialities necessary for the state. Constantly improving and focusing on European integration, the method of medical education has reached a high level. After adopting the Bologna process, Ukraine reformed its education system, thus adapting it to the standards of the European Union. A significant advantage of Ukrainian medical education has always been the possibility of acquiring practical skills, which annually attracted many Ukrainian and international students to Ukrainian educational institutions. However, the military situation in Ukraine made its adjustments. Thus, with the beginning of a full-scale war, the entire sphere of education found itself in a difficult situation. With this in mind, the Ministry of Health has already proposed a particular procedure for admission to medical specialities during martial law. Namely, it was suggested to enter higher education institutions based on the results of the national multi-subject test and the absence of increased requirements regarding the minimum number of points from the entrance tests for admission based on a complete general secondary education.

Of the 93 existing higher education institutions in Ukraine with the field of study "health care", only a small part is located in more or less "quiet zones". But the work of those has been disrupted due to energy problems. A significant number of institutions were often bombed. Some highly qualified teachers were forced to go abroad to save their lives or children. All this created difficult conditions for obtaining a full-fledged medical education and working in medical and educational institutions. It was reported that five institutions of higher medical education, in particular in Kharkiv, were already planned for online distance training at the beginning of the year due to the proximity to the war zone. And in these conditions, medical education must find ways of further work and development. Therefore, questions about teaching methodology arise very acutely.

The aim of the study

According to the analysis of literary sources, to identify ways of possible development of medical education during the martial law in Ukraine.

Research results and their discussion

The first of the methodology issues of medical education is the possibility of distance medicine learning, which is extremely necessary for higher education institutions located in occupied territories, in constantly bombarded areas, or in institutions whose infrastructure has been destroyed.

In this regard, it is essential that distance learning consists of a variety of learning activities mixed to form one well-planned course. One of the foreign authors said that distance learning is: Individual study of specially prepared educational materials, as a rule, printed (which is essential in the conditions of a possible "blackout") and sometimes electronic, supplemented by integrated educational resources, other educational experiences, including personal training and practical experience, feedback on training and student support [1]. Students' perception of online clinical training can be compared to the method of self-study, where the effectiveness depends on the student's interaction with the previously prepared educational materials [2, 3]. Distance learning allows working with recorded images, videos, and practical exercises with step-by-step instructions and questions that control and increase self-education.

However, even distance medical education requires the student to observe the clinical experience of the teacher to ensure skill development. Distance learning medical texts can be written to simulate ward rounds, provide clinical information, conduct case studies, ask and answer questions, and focus on learning objectives. Also, the use of simulation moments is interesting (simulation of the operating room, endoscopic simulators, simulators of various types of injections, delivery, emergency care, etc.). Video reports on examined patients, development of treatment plans and demonstration of manipulations and operations carried out during the day are very useful in terms of the practical development of clinical knowledge. According to El-Hussein M.O., Cronje J.C.: "Mobile learning is any type of learning that takes place in a learning environment that takes into account the portability of technology, learners, and learning"[4]. And Garcia Vazquez et al. reported that operating room simulation could be made available through mobile phone applications, facilitating online surgical training of the acquirers [5].

Five main distance learning strategies in medical higher education institutions are described in foreign literature. First, it is a telecommunications strategy [6]. In second place is learning based on modelling [7]. Agarwal et al. vote for technological, clinical training [8]. Mobile learning [9] and mixed learning [10] are also significant in the literature.

Thus, a properly designed distance learning platform can effectively deliver medical education. medical education distance learning

But is it within the power of individual higher education institutions? Can they create the right distance learning platform on their own? Obviously not. Today, most institutions followed the path of pressure on the teacher - he must have all possible means of communication and work with the applicant. Of course, the Zoom, Skype, and Google Classroom platforms provide invaluable opportunities for accessible remote communication today. But creating virtual platforms for practical training requires special professional skills of a photographer, web designer, etc., and special equipment. It is the prerogative of individual specialized firms or departments. And here, centralized management and financing are necessary. Of course, under the conditions of war, the underfunding of the educational sphere calls into question the involvement of additional paid structures in the creation of the necessary programs. But similar platforms and programs already exist in Europe and the USA. For example, the MERLOT multimedia educational online course or IVIMEDs International virtual medical school. Addressing their owners of the central management of medical education, or even the heads of medical education institutions would undoubtedly contribute to the possibility of using these invaluable resources. The question would be only about translation, where you can already use your capabilities.

But it is difficult to ensure the full development of clinical knowledge of future doctors on a distance course without integrated face-to-face training. Suppose all training takes place only remotely, even with the best IT support. In that case, the practical side of knowledge suffers because the future doctor must independently study and master many practical skills and independently examine patients with various diseases. Is there a way out of this situation? We see this way out in the complexation of institutions of higher medical education. Moreover, distance learning does not exclude traditional learning processes and is often used with professional training procedures and practices.

Of course, such complexation should be directed and organized by the Ministry of Health, under whose auspices all medical educational institutions are. Fortunately, several higher education institutions in safe areas today can provide face-to-face training for higher education students. Obviously, there is a need to reschedule classes with a month or several dedicated to acquiring practical skills within the walls of such higher education institutions. It can be regulated as an internship, including mastering the necessary list of practical skills.

Conclusions

1. It is possible to use distance education in medical institutions.

2. Distance medical education should be integrated using all existing distance learning models and strategies.

3. In the period of martial law, it is essential to integrate medical institutions of higher education for students to acquire professional practice in face-to-face mode.

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