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DOI: https://doi.org/10.34069/AI/2022.55.07.12
How to Cite:
Radziievska, I., Trepet, G., Radzikhovska, N., Sukhostavets, N., Yuryk, O., & Saienko, V. (2022). Modern achievements and
prospects for the development of higher medical education: Ukrainian realities. Amazonia Investiga, 11(55), 114-123.
https://doi.org/10.34069/AI/2022.55.07.12
Modern achievements and prospects for the development of higher
medical education: Ukrainian realities
Сучасні досягнення і перспективи розвитку вищої медичної освіти: українські
реалії
Received: July 27, 2022 Accepted: August 27, 2022
Written by:
Radziievska Iryna48
https://orcid.org/0000-0002-5216-1928
Trepet Ganna49
https://orcid.org/0000-0001-8300-7117
Radzikhovska Nataliia50
https://orcid.org/0000-0002-1079-8488
Sukhostavets Nataliia51
https://orcid.org/0000-0002-2132-5037
Yuryk Olha52
https://orcid.org/0000-0003-2245-9333
Saienko Volodymyr53
https://orcid.org/0000-0003-2736-0017
Abstract
The purpose of the study is to research and
highlight modern achievements and prospects for
the development of higher medical education in
Ukraine. Theoretical and empirical methods
were used to achieve the set goal and solve
research problems. A modern doctor must
perfectly master his professional competence.
The main motive for reforming the medical field
is the desire of students to master professional
skills and practical skills, to deepen the acquired
theoretical knowledge and apply it in practice, to
develop skills regarding the standards of
providing medical care, to gain experience in
practical work, which will allow a modern
student to successfully work independently in the
future. It is also necessary to create a group that
48
Candidate of Pedagogical Sciences Vice-rector for educational work Cherkasy Medical Academy, Department of Fundamental
Disciplines, Ukraine.
49
Assistant Professor of the Department of Neurology, Deputy Dean of medical faculty N. 2, MD in Neurology, Master of Public
Administration Candidate of Medical Science, PhD Bogomolets National Medical University, Ukraine.
50
Assistant Professor of Neurology, PhD Bogomolets National Medical University, Department of Neurology, Kyiv, Taras
Shevchenko Boulevard, Academic degree – candidate of medical sciences. Academic title - assistant professor of the department of
neurology of the National Medical University named after O.O. Bogomolets. She graduated from the National Medical University
named after O.O. Bogomolets, Ukraine.
51
Candidate of Medical Science, Asisstant of the Department of Obstetrics, Gynecology and Family Planning Sumy State University,
Academic and Research Medical Institute, Ukraine.
52
Doctor of medical sciences, professor laboratory manager State Institution “Institute of Traumatology and Orthopedies of the
National Academy of Medical Sciences of Ukraine. Honored Doctor of Ukraine, Ukraine. (Decree of the President of Ukraine No.
241 of August 23, 2018).
53
PhD in Physical Education and Sports; Doctor of Science in Organization and Management, professor DSc. (in organization and
management) Academy of Management and Administration in Opole, Poland.
Radziievska, I., Trepet, G., Radzikhovska, N., Sukhostavets, N., Yuryk, O., Saienko, V. / Volume 11 - Issue 55: 114-123 /
July, 2022
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would carefully study and propose a number of
conceptual priority measures related to changes
in legislation and aimed at coordination between
universities in order to develop a clear, unified
strategy for reforming medical education, to
ensure the responsibility of higher education
institutions for the quality of education and its
guarantee, taking into account the interests of
society.
Keywords: medical education, professional
education, education in Ukraine, reforming
professional education, the realities of medical
education in Ukraine.
Introduction
The modern system of medical education is
undergoing significant changes. The list of
medical specialties is expanding, so many future
specialists in addition to general medical
education receive additional, narrow medical
specialties. Genetic research methods are being
introduced into many subspecialties, for
example, in reproductive medicine. This
approach requires dosed information for future
specialists, when the general outlook of medical
knowledge is preserved, and in addition to it,
highly specialized knowledge is given. The use
of distance education (including in connection
with the COVID-19 pandemic) is expanding, as
are methods of rapid online testing. Ukraine, one
of the former republics of the Soviet Union, is
still at the beginning of reform. Ukraine's
educational system (including medicine) is still
dominated by the Soviet educational system,
which is already morally and intellectually
obsolete. Students are most often offered
textbooks that are 40 years old. At the same time,
there have been some positive shifts. New
educational technologies are being introduced for
Ukrainian medical students. Ukraine remains
today an attractive country for foreign students
wishing to study medicine. At present, the theme
of assessing the quality of education of Ukrainian
medical students remains relevant, since no
research in this direction has been conducted.
This has determined the necessity of this
research.
The purpose of the study is to research and
highlight modern achievements and prospects for
the development of higher medical education in
Ukraine.
The tasks of the research are:
− to determine the current directions of
reforming medical education;
− to determine ways of implementing
interdisciplinary connections in educational
activities;
− highlight the conditions for implementing
the updated system of medical education in
Ukraine.
The research questions to the goals and
objectives are as follows. What is the quality of
medical education in Ukraine today? What areas
of reforms in the system of medical education in
Ukraine are the most relevant? Is there a
possibility to implement interdisciplinary and
international relations in the system of medical
education? What are the conditions for
introduction of innovative approaches in the
system of medical education in Ukraine?
Theoretical Framework or Literature Review
Levels of Reform in the Global Medical
Education System. The successive level system
of higher education - bachelor's and master's - has
recently become a new and unknown system for
higher medical education in Ukraine, which was
previously represented only by a specialist
(Srichawla et al., 2022).
The reform of the healthcare system provides for
updated requirements for education and training
of specialists in accordance with new standards.
The modern development of medicine makes it
necessary to make corrections in the training of
future medical personnel and improve the
qualifications of medical workers in accordance
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with international standards. That is, medical
education should ensure high-quality training of
students and become an important component of
reforming the health care sector and
implementing the social priorities of the state,
since the quality of medical care for the country's
population and the quality of life of the
population depend on the level of training of
future doctors (Matalon et al., 2020).
A modern doctor must perfectly possess his
professional competence, communication skills
and personal and professional culture, be able to
explain and transfer knowledge to students or
colleagues, as well as adapt to changes in the
legislative nature, to the performance of
professional duties. This will enable health care
specialists to work in a single, generally accepted
professional space, using global experience in
protocol management (Akoob et al., 2022).
Ways to optimize the medical education
system. To create an updated model of the health
care system, it is necessary to change the basic
secondary and higher medical education in order
to optimize the opportunities of medical students
and strengthen the competitiveness and prospects
of future nurses and doctors. After all, it is
common knowledge that the decrease in the level
of knowledge and the quality of educational
services of future specialists in the medical field
has a negative effect on the quality of providing
medical care to the population, on the
knowledge, skills and desire to help the patient.
The World Federation of Medical Education
(WFME) developed standards for doctors called
"Continuing Professional Development" back in
2003. The following motto is embedded in the
series of these standards: "Education cannot be
considered preparation for life, because
education is life."
Upcoming directions for the development of
the medical education system. That is why it is
necessary to single out the key strategic
directions for the further development of medical
education in the context of reforming the
healthcare sector of Ukraine and preparing
priority measures for implementation in
universities (Srichawla et al., 2022).
Thus, higher medical education in the
magistracy, according to the current version of
the List of areas of training for higher education
- magistracy, can be obtained within the
framework of two areas of training: “public
health” and “nursing management”, but at the
moment it is implemented only 1st direction of
preparation (Nickerson, 2019).
Methodology
The study was conducted from September 2020
to December 2021 in Ukraine (Kyiv, Sumy,
Cherkasy).
The theoretical methods of research were used to
disclose the research question of the relevance of
medical education and its quality. Theoretical
and empirical research methods were used to
investigate the state of implementation of
interdisciplinary relations in the system of
medical education. Finally, empirical methods
were used to identify the ability to implement the
latest methods of education. The essence of each
of methods is given below.
− theoretical: comparative analysis of
pedagogical and medical literature,
retrospective analysis, synthesis,
comparison and content analysis during the
study of normative documents in the fields
of medical education, educational programs,
curricula of professional training of future
specialists, study and generalization of the
experience of scientific and pedagogical
activity - to analyze the state of development
of a scientific problem in pedagogical theory
and the educational process of domestic and
foreign institutions of higher education;
abstraction - to determine the essence and
structure; specification and detailing - to
identify and theoretically substantiate the
pedagogical conditions for the development
of medical education in Ukraine; system
analysis, modeling and generalization;
− empirical: observations, questionnaires
during the study of the current state of
formation of the professional identity of
future specialists in physical therapy,
occupational therapy in institutions of higher
education.
Results and Discussion
The analysis of literary sources on medicine and
methods of teaching medical specialties in higher
education institutions, as well as legal norms,
revealed such trends. The analysis was
performed separately for bachelor's and master's
degrees Quality of medical education for
different specialties in Ukraine. The direction of
training "nursing" (bachelor's degree) as a
specialty is presented in the law "On the approval
of the Regulations on internships" (Srichawla et
al., 2022).
Qualification requirements for medical and
pharmaceutical workers with higher education in
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the direction of training "health and medical
sciences" (hereinafter - Qualification
requirements) for the specified specialty provide
for the following positions: general practice
nurse, palliative care nurse, preventive care
nurse, nurse for rehabilitation.
Thus, bachelor's degree graduates in the direction
of training "nursing" have formal opportunities
in terms of professional implementation.
The situation is different with the direction of
training "public health", which is not in the
Nomenclature of Specialties of Specialists with
Higher Medical and Pharmaceutical Education,
and therefore does not appear in the Qualification
Requirements. For the direction of training
"management of nursing activities" the situation
is similar due to its recent appearance. In turn, the
Qualification Requirements include the specialty
“Nursing Management”, which was acceptable
according to the scheme of vocational education:
a specialty in the specialty “Nursing” and an
internship in the specialty “Nursing
Management”, which is currently not possible for
implementation due to abolition of specialty and
internship (Oswald et al., 2020).
It is also necessary to note the presence of the
specialty "organization of healthcare and public
health" in the Qualification requirements. For
this specialty, the following requirements for the
level of professional education are established:
higher education - a specialist in one of the
specialties: "General Medicine", "Pediatrics",
"Dentistry", "Medical Preventive Care".
Preparation for internship / residency in the
specialty "health organization and public health".
This specialty (“organization of health care and
public health”) is noted here due to the obvious
similarity with the direction of preparation of the
master’s program “public health”.
The scale of implementation of undergraduate
and graduate programs in the field of education
"health and medical sciences" can be assessed by
the volume of admission targets for these
programs (Figure 1).
Figure 1. Total volumes of target figures by years of admission to educational programs of higher education
at the expense of federal budget appropriations.
The presence of admission targets in the direction
of training "nursing" (bachelor's) is
understandable, but for "health science and
preventive medicine" (master's) - not quite. This
aspect is considered here from the point of view
of the admission of graduates of the educational
program to medical activities, since the direction
of training "public health", related to the field of
education "health and medical sciences", is not
presented in the Qualification requirements.
Thus, at present, in the direction of training
"public health", masters cannot carry out medical
activities in any specialty, although their first
graduations have already taken place, taking into
account the fact that the term for obtaining full-
time education is 2 years. Since there is no
corresponding medical specialty for them
(masters), the procedure for primary
accreditation of specialists is not possible.
Master's degree in the direction of training
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"public health", as one of the areas of
professional activity, the field of "health" is
provided (in the field of organizing the health
care system in order to ensure public health).
Thus, taking into account the terms and stages of
accreditation of specialists, as well as categories
of persons with a medical or other education and
subject to accreditation of specialists, it is
obvious that it is necessary to amend the
Qualification Requirements.
Ways to reform and optimize the system of
medical education in Ukraine. One of the
directions for the development of higher medical
education in the magistracy "public health" and
"nursing management") could be a purposeful
continuation of the education of bachelor's
graduates in it in the direction of training
"nursing". Such “purposefulness” can be
achieved by regulatory and legal improvement of
admission to medical activities, i.e., amending
the Qualification Requirements and Professional
Standards (if any).
An option for such an improvement could be the
addition of the section “Level of professional
education” of the specialty “nursing
management” of the Qualification requirements
for medical and pharmaceutical workers with
higher education in the direction of training
“health and medical sciences” with the following
formalization (Table 1).
Table 1.
Specialty "management of nursing activities"
Level of professional
education
Higher education - specialty in the specialty "nursing". Internship
training in the specialty “Nursing Management” or Higher education - bachelor's degree in the direction of training "nursing"
and master's degree in one of the areas of training: "public health",
"management of nursing activities"
Source: author's development
The second direction of development of higher
medical education in the magistracy can be the
alternative of the magistracy in the direction of
training "public health" to residency in the
specialty "health organization and public health"
(Table 2).
Table 2.
Specialty "health organization and public health"
Level of professional
education
Higher education - a specialist in one of the specialties: "General
Medicine", "Pediatrics", "Dentistry", "medical and preventive work".
Training in internship/residency in the specialty “organization of health
care and public health” or training in the magistracy in the field of study
“public health”
Source: author's development
Such alternativeness can be brought to life not
only by making additions to the Qualification
Requirements, but, most importantly, to the
relevant professional standard. By introducing
the necessary additions and changes to the
specified professional standard, it is possible to
achieve selective differentiation in the positions
of medical workers, taking into account
generalized labor functions and skill levels.
Interdisciplinary and international connections.
It is worth noting that in 2018 the Ukrainian-
Swiss project “Development of Medical
Education” was launched (Figure 2).
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Figure 2. MED Project.
Source: author's development.
The Medical Education Development Project
(Project, MED) is implemented in Ukraine by the
Swiss Institute of Tropical and Public Health
(Swiss TPH) with the financial support of the
Swiss Agency for Development and Cooperation
(SDC). The first four-year phase of the project
started in December 2018 and will last until the
end of 2022. The budget for the four-year
implementation phase is 4.9 million Swiss
francs. The project is implemented in
cooperation with the Ministry of Health of
Ukraine, focusing on priorities that are
established with the aim of providing medical
education effectively and meeting the existing
needs of health care in Ukraine. It is widely
recognized that the availability of properly
trained and motivated staff in highly resourced,
equipped facilities is a critical factor in delivering
quality interventions that will improve
population health outcomes. Therefore, the
overall goal of the "Development of Medical
Education" Project is to improve the quality of
health care in Ukraine by improving the medical
education system for representatives of the
primary health care sector. The main focus of the
project is on primary health care (doctors and
nurses), both in terms of practical primary health
care and in building the capabilities and skills of
management personnel. The project covers all
levels of medical education - undergraduate
medical education, postgraduate education
(internship), as well as continuous professional
development, providing expert, regulatory and
educational support in the process of improving
the quality of education for primary care workers
(Medical Education Development, 2022).
The increased demand of society for progressive
changes in the modern conditions of global
competition in medicine determines the
consideration of medical universities as
important drivers of the transformation of
medical education. The integration of medical
education into the European space involves the
coordination of the methods and content of
education with the holistic picture of the modern
world, the relationship and mutual influence of
social and humanitarian disciplines in the
formation of personality through the use of
interdisciplinary integration; selection of
problematic tasks and arguments that require
creative thinking and intelligence combined with
knowledge (Pietrzak et al., 2018). The
development of innovative integrated courses
with the use of modern technologies develops the
competencies necessary for a modern physician
in practical activities." That is why the reform in
medical education is considered as a collective
matter of students, teachers, scientists, doctors,
managers, even politicians, in accordance with
international standards and processes in
educational policy (Cheng et al., 2020; da Silva,
2018).
The organization of the educational process in
medical universities is regulated by the current
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regulatory and legal documents of Ukraine, the
standards of higher education of Ukraine, taking
into account the principles of the formation of the
European area of higher education. The
educational process is carried out taking into
account innovative educational technologies,
mechanisms and procedures determined by the
Ministry of Education and Science and the
Ministry of Health of Ukraine, which correspond
to the principles of medical education of the
European Higher Education Area (Komarraju et
al., 2018). The content of training of specialists
is determined by industry standards of higher
education, and the content of higher education in
the medical direction is implemented in unified
approaches to educational and qualification
characteristics and educational and professional
programs at the stages of undergraduate and
postgraduate training of specialists, developed in
accordance with the order of the Ministry of
Education and Science of Ukraine. It is important
to note that the educational and qualification
characteristics of a graduate of a higher
educational institution reflect the goals of
educational and professional training, determine
the specialist's place in the structure of the health
care system and the requirements for his
competence (Pesapane et al., 2018a).
The educational and qualification characteristics
establish branch qualification requirements for
social and industrial activity and state
requirements for the characteristics and qualities
of a person. Though there is no supervisory
committee that would monitor and check
compliance with all the listed standards in
educational institutions and identify gaps in the
training of specialists (Idowu, 2018).
Introduction of new methods and technologies in
the system of medical education in Ukraine.
Despite the fact that institutions of higher
education have enough autonomy, conservatism
levels modern approaches both to learning and to
the cultural and ideological component of the
modernization of the teaching process; the
passivity of thinking of the teaching staff has a
destructive effect on the initiative and creativity
of students; insufficient quality control of
practical training leads to inappropriate
professional competence in the future; improper
material and financial stimulation of the work of
teachers makes it impossible to desire to form the
professional competence of students; insufficient
funding of science, outdated or missing
educational base inhibit progressive and
innovative approaches, etc (Wartman and
Combs, 2019).
However, not all teachers use modern
information technologies in the educational
process; there is no single developed and agreed
modern textbook that students could use when
preparing for qualifying exams, because most of
the textbooks are from the last century, and the
educational material is completely outdated and
out of date; there are no models on which medical
students should improve practical skills, that is,
there is a gap between theoretical knowledge and
practical skills (Abuzaid et al., 2018).
Therefore, the social significance of medical
education involves, first of all, its modernization
in accordance with the regulatory, legal and
educational and methodological world standards
of the field of medicine, preventive measures and
preservation of the health of the nation thanks to
the actualization of educational policy problems
taking into account European standards, ensuring
and implementing the latest achievements of
medical science. Therefore, professional training
in higher education institutions of Ukraine
should be aimed at students' mastery of modern
competencies, which are based on the culture,
morality and ethics of the individual as the basic
components of medical education (Duong et al.,
2019). The scientist singles out the following
components in the content of professional
competence: adaptation and civilization; social
and organizational; subject-methodical;
communicative; value and content, which
medical students should acquire in the process of
studying in medical institutions of education.
Everyone knows that the Ukrainian system of
continuous professional development for doctors
does not meet the standards of the WFME
(Spieler et al., 2020).
Over the past two years, new forms of continuous
professional development have been actively
developed, discussed and implemented (Smith et
al., 2018). The representatives of the European
Commission in Ukraine have developed the
Concept of higher education, which is based on
the following forms: training and internship
based on improvement cycles (from one to four
weeks), distance learning, internships in
Ukrainian clinics and abroad, participation in
meetings, congresses, work meetings and other
scientific forums, gaining experience in modern
clinics, sharing experience, etc (Park et al.,
2019).
However, this Concept was not actively
supported and implemented in the educational
process.
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The patient's life and health should be the basic
human and professional values of medical
professionals. High-quality medical care is
impossible without changing the cultural
paradigm and creating a new professional
environment - self-reproducing and independent
(Pesapane et al., 2018b). The implementation of
the Strategy is designed for 10 years and involves
the creation of a high-quality system of medical
education with a high level of training of
specialists, namely:
− improving the quality of higher medical
education;
− qualitative change in postgraduate
education;
− provision of effective financing and
management;
− rethinking of academic culture;
− stimulating the development of scientific
research.
It is worth noting that medical education should
be developed based on the latest achievements of
medical science and practical achievements of
world medicine, which requires knowledge of a
foreign language.
In order to be able to use the achievements of
world medicine and be a competitive specialist,
one must be motivated, adhere to bioethical and
ethical-deontological norms, and be a highly
qualified and humanistically oriented specialist
(Hall et al., 2020).
It is worth noting that the Internet plays a great
role in the training system of a modern specialist
in the medical field. Internet self-education has
become a new and quite effective form of self-
education with the application and use of a
computer and the Internet, which must also be
used in the process of training medical students.
Its possibilities are extremely diverse: from
instant access to a huge amount of information to
the possibility of taking online courses that allow
you to watch video lectures by well-known
specialists in various fields of medicine and
dentistry, test your knowledge using tests,
communicate with other students, teachers,
exchange experiences, opinions, participate in
forums, conferences (Cassidy et al., 2020).
It is worth noting that continuous professional
development is necessary not only for doctors,
but also for teachers of medical universities. In
order to teach students, one must be aware of the
latest news, treatment tactics or diagnostic
techniques, innovations in medicine at the
international level, etc. That is, educational
programs must correspond to the latest
achievements of medical science. However,
without changing the paradigm of basic
secondary and higher medical education in
Ukraine, it is impossible to bring the health care
system closer to world standards, carry out its
reform, and provide quality medical care to the
population in the future (Sivarajah et al., 2019).
Therefore, the need to reform the medical field is
reinforced by the regularity of overcoming the
contradictions that exist in the modern medical
education system, since the Ukrainian medical
field is in a long process of reformation, therefore
the full use of university clinical bases should be
a priority direction for students to master
important professional competencies and
necessary practical skills for undergraduate stage
(Bank et al., 2019).
Having analyzed the problems and outlined the
directions for the development of medical
education, which will be implemented by the
Ministry of Health of Ukraine in the future,
special attention should be paid to the
environment that forms the personality and lays
the necessary character qualities (Awan et al.,
2019). The educational environment generates
motivation regarding the model of behavior that
students observe in the educational institution,
take an example from teachers, focusing even on
the manner of conducting a dialogue or treating a
patient (Koontz et al., 2018). Therefore, a
successful and cultural environment plays an
important role in the formation and development
of the future doctor.
Scientists believe that the educational process
should correspond to the available scientific and
pedagogical potential, the material and
educational and methodological base of the
university; a mandatory condition should be
modern information technologies of education
with a focus on the formation of an educated,
harmoniously developed personality, capable of
constant updating of scientific knowledge,
academic and professional mobility, rapid
adaptation to changes and development in all
areas. That is, the quality of education in higher
educational institutions must be improved
through effective organization and
informatization of the educational process,
introduction of advanced scientific developments
into teaching practice, ensuring high
professionalism of teachers, creation of a modern
educational and methodological base in all
educational fields, in particular, medical
(Randriambelonoro et al., 2018).
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Conclusions
The quality of medical education for different
specialties in Ukraine and ways to reform and
optimize the system of medical education in
Ukraine. The authors believe that the main
motive for reforming the medical field is the
desire of students to master professional skills
and practical skills, to deepen the acquired
theoretical knowledge and apply it in practice, to
develop skills regarding the standards of
providing medical care, to gain experience in
practical work, which will allow a modern
student to successfully work independently in the
future. Interdisciplinary and international
connections. The implementation of
interdisciplinary connections in educational
activities is one of the necessary didactic means
of forming students' professional knowledge and
skills, that is, the opportunity to comprehensively
solve the tasks of medical practice based on
interdisciplinary integration. Introduction of new
methods and technologies in the system of
medical education in Ukraine. The updated
system of medical education should be based on
modern approaches, guarantee quality and ensure
compliance with higher education standards,
should be focused on informatization and
implementation of the high potential of computer
and telecommunication information technologies
in the process of teaching professional
disciplines. It is also necessary to create a group
that would carefully study and propose a number
of conceptual priority measures related to
changes in legislation and aimed at coordination
between universities in order to develop a clear,
unified strategy for reforming medical education,
to ensure the responsibility of higher education
institutions for the quality of education and its
guarantee, taking into account the interests of
society.
We see the prospect of further research in a
comparative analysis of the system of higher
medical education in Ukraine and the United
States of America.
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