Volume 11 - Issue 55
/ July 2022
163
https:// www.amazoniainvestiga.info ISSN 2322- 6307
DOI: https://doi.org/10.34069/AI/2022.55.07.17
How to Cite:
Holomb, L., Rogachevskyi, O., Karbovanets, O., Senkevych, O., & Vivsyannuk, V. (2022). Modernization of theoretical and
practical aspects of the development of higher medical education in Ukraine. Amazonia Investiga, 11(55), 163-171.
https://doi.org/10.34069/AI/2022.55.07.17
Modernization of theoretical and practical aspects of the development
of higher medical education in Ukraine
Modernización de los aspectos teóricos y prácticos del desarrollo de la educación médica
superior en Ucrania
Received: July 15, 2022 Accepted: August 29, 2022
Written by:
Holomb Lyudmyla74
https://orcid.org/0000-0003-1864-4122
Rogachevskyi Olexandr75
https://orcid.org/0000-0002-8063-258X
Karbovanets Olena76
https://orcid.org/0000-0003-4429-7371
Senkevych Olena77
https://orcid.org/0000-0002-7968-1202
Vivsyannuk Volodymyr78
https://orcid.org/0000-0002-5192-6757
Abstract
The coronavirus pandemic has become a
challenge for national health care systems, a
global problem that has accelerated the processes
of reforming medical education in many
countries. The purpose of the article is to analyze
the modernization of theoretical and practical
aspects of the development of higher medical
education in Ukraine. The research uses general
scientific (analysis, synthesis, deduction and
induction) and specialized methods (prognostic,
axiological). The results trace the transformation
of the state regulation of higher medical
education, the use of research methods in
education, the use of modern teaching methods
aimed at making the medical education sector in
Ukraine more efficient. It has been proven that
transformations in higher medical education
were hampered due to a lack of funding. During
2015–2017, the first changes occurred: the
"KROK" testing system, based on American
samples was implemented. The latest teaching
74
Asistent Head of the department of microbiology, virology and epidemiology with the course Infectious Diseases Medical Faculty
State University «Uzhhorod National University», Ukraine.
75
Chief of Department, PhD professor of economics, PhD of medicine Department of simulation medical technologies Odessa
National Medical University, Medical Faculty №1, Ukraine.
76
Associate Professor, Candidate of Pedagogic Sciences (Ph.D.), docent Uzhhorod National University, Faculty of Мedicine,
department of microbiology, virology and epidemiology with a course of infectious diseases, Ukraine.
77
Assistant Professor (MD), Medical Faculty No.2, Department of Pediatrics № 2 Danylo Halytsky Lviv National Medical University,
Ukraine.
78
Candidate of Medical Sciences, assistant department of Internal Medicine, Higher Educational Institution of Ukraine «Bukovinian
State Medical University», Ukraine.
164
www.amazoniainvestiga.info ISSN 2322- 6307
methods, updated in recent years, are also
actively implemented in teaching practice. In the
conclusions, it is noted that in the future,
employers should play a more active role in the
formation of educational programs, as is
customary in the leading countries of the world.
In Ukraine, due to the aggression of Russian
troops and the destruction caused by them, the
further commercialization of medical education
may become an important trend for further
development.
Keywords: modernization, theory, practice,
higher medical education, Ukraine.
Introduction
The quest to update medical education is urgent
because of the rapid spread of the coronavirus
pandemic around the world. The new challenges
of declaring a global quarantine, finding and
producing vaccines, and other treatments have
entailed the emergence of updated training
methods for specialists. The COVID-19 problem
has re-presented the prestige of medical work, so
even in Ukraine, university education in this field
has interested a considerable number of potential
entrants (although medical professions have
traditionally been in steady demand). At the same
time, the experience of training specialists has
become the foundation stone for the formation of
medical systems in many countries. Ukraine in
this respect has been on the margins of similar
trends for a long time, as healthcare reform has
been extremely protracted in time, the traditional
lack of funding has significantly narrowed the
possibilities for improving the professional
training of future specialists. In addition, the
ability to join already applied programs and the
use of their own experience shows the promise of
similar endeavors. The main directions of such
structural transformations are relevant problems
for the study because on the basis of their
consideration it is possible to form specific
proposals.
The article aims to analyze the modernization of
theoretical and practical aspects of higher
medical education development in Ukraine.
When considering this issue, smaller aspects are
highlighted, the study of which allowed to
generalize certain results and summarize the
results. We are talking about changes in the state-
regulatory aspect of higher medical education, the
organization of research work as an element of
modernization, the use of the latest teaching
methods capable of changing the medical
education industry in Ukraine. We should note
that the proposed analysis is of additional
importance due to the absence of similar studios
in Ukrainian medical science: against the
background of the pandemic and the deployment
of the Russian army aggression, the ways of
reforming the medical industry may be an
important material for European and American
scientists to study.
Theoretical Framework or Literature Review
The scientific understanding of the role of
medical education has been active since the end
of the twentieth century. The problem of
reforming or modernizing the educational
process in medical educational institutions was
mainly of interest to European authors. However,
the problem of reforming or modernizing the
educational process in medical educational
institutions was mainly of interest to European
authors. In particular, Custers & Cate (2018)
highlighted the problem of modern medical
education through a historiosophic prism.
However, these authors conclude in their article
that “given the high cost of medical care today
and the increasing demand for patient safety and
teaching effectiveness, the continuation of
historical models of non-standardized practices
will no longer be possible. Efforts are needed to
limit, restructure, and individualize training and
licensure times to optimize training. both in the
United States and Europe” (Custers & Cate, 2018,
49). At the same time, Ayaz & Ismail (2022)
characterized the main innovative technologies
to be used in medical education. They focused on
the problem of integrating simulation technology
into training programs. Ayaz & Ismail (2022)
believe that “this technology will become
important in medical education by providing the
Holomb, L., Rogachevskyi, O., Karbovanets, O., Senkevych, O., Vivsyannuk, V. / Volume 11 - Issue 55: 163-171 / July, 2022
Volume 11 - Issue 55
/ July 2022
165
https:// www.amazoniainvestiga.info ISSN 2322- 6307
means to practice and teach under the supervision
of qualified facilitators” (p. 301). The outbreak of
the Covid-19 pandemic has led to a new
rethinking of previously accepted concepts.
Distance learning began to take center stage in the
educational process. A lot of new author's
concepts of rethinking modern education
appeared in scientific literature, the authors
began to focus on the analysis of the effectiveness
of distance education and its reorganization. In
particular, Laufer et al. (2021) characterized the
features of the implementation of distance
models in the field of education. In addition,
Lekic et al. (2019) investigated the impact of
evidence-based medicine on learning and
decision-making in medical practice through the
lens of contemporary globalization issues.
Roberts (2020) explored the impact of COVID-
19 on the development of medical education and
outlined how medical teaching competencies
will help overcome the coronavirus outbreak.
Specifically, he believes that higher medical
school should incorporate last-year medical
student volunteers into practical clinical services
during a pandemic as “medical assistants”. This
would improve not only the practical skills of the
latter but also help to increase the staffing of
medical institutions. Also valuable to this study
are the findings of educational authors who have
generally studied a variety of educational
innovations. In particular, Demiray (2017)
investigated the characteristics of the
implementation of distance education, which are
also relevant to the current development of the
medical industry. Pinheiro & Santos (2022)
characterized the potential development of
distance education and analyzed the use of
various modern E-learning platforms. At the
same time, Ungerer (2019) also investigated the
specifics of the use of open-distance e-learning
platforms.
So, as can be seen from the analysis of the
literature, many European authors were
interested in the problem of modernization of the
educational process in the field of medicine.
Their developments serve as a valuable
foundation for this study. Taking into
consideration the European experience of
medical education reform, we can characterize
the possible prospects of medical education
development in Ukraine through both theoretical
and practical planes.
Methodology
When writing this work, both general theoretical
(logical) methods of research and special
pedagogical methods were used. Among the
general theoretical methods, we will distinguish
analysis, synthesis, induction, and deduction. The
method of analysis involves the division of the
subject of research into certain parts (coverage of
scientific understanding of the problem,
characterization of the main transformations in
medical education in Ukraine through the prism
of state-regulatory aspect, etc.). At the same time,
the method of synthesis implies combining the
above-mentioned selected parts. Such methods
as abstraction and concretization are also used in
the work. The principle of abstraction implies the
study of general theoretical problems. At the
same time, based on using the method of
concretization it was possible to study the
problem of changes in medical education in
Ukraine based on the analysis of the main state-
regulatory mechanisms. Among the special
pedagogical methods, we shall single out
observation, prognostic and axiological methods
of research. In particular, by means of the
prognostic method of research, it was possible to
forecast the main vectors of development of
medical education in Ukraine in the future. The
axiological method of research assumes the
highlighting of the main values and reference
points of the medical education system of
Ukraine. Based on systematic method of research
the field of medical education is considered as a
complex system consisting of many components,
and the research of some of them are the key task
of this work. Additional methods of research are
systemic, functional, comparativists methods. At
the same time, the main empirical data of this
study are materials of the Ministry of Education
and Science of Ukraine, the Ministry of Health of
Ukraine. Analysis of the data is a valuable source
for the article. Consequently, this work is based
on the principles of consistency, objectivity,
retrospective, and scientific.
Results and Discussion
The system of Ukrainian medical education since
the end of the XX century is still in search of new
ways of modernization and reforming. The
system of Ukrainian medical education by the
end of the XX century is still in search of new
ways and methods of modernization and
reforming in accordance with the changes
occurring in the history of the state and society,
the requirements of the European Union on the
quality of professional training, the direction of
the introduction of new models of education. New
challenges put new demands on the educational
system to act effectively. For this reason, one of
the main problems is the professional burnout of
medical education specialists, which is a
complex consequence. Outlining the key
166
www.amazoniainvestiga.info ISSN 2322- 6307
objectives facing modern education, many
scientists admit the optimal solution to this
problem is to apply the principles of
humanitarianization, to promote diverse
individual (it is said about creative, cultural)
development of education applicants.
Changes in Medical Education: State-Regulatory
Aspect
The need to reform the system of medical staff
training in Ukraine has been discussed at the
highest state level. In particular, an important
function of the Ministry of Health of Ukraine is
to establish requirements for quality control of
professional training of medical and
pharmacological specialists. Specialists of the
state management of the medical industry found
that a critical need is forming to improve the
system of university training, its harmonization
with the leading modern standards operating
primarily in European countries and the United
States (Lekic et al., 2019). Achievement of
relevant indicators was considered in 2017-2018
a condition for the successful implementation of
the reform of the whole industry, which was
actively implemented. Expert interdepartmental
working groups, which have been working for a
long time on solving strategic problems of
adapting national higher medical education to the
leading standards of our time, have identified the
main backbone areas of overcoming the current
educational crisis and formed recommendations
for short- and long-term development
perspectives:
1. To organize and conduct a comparative
assessment of the content of Ukrainian
higher medical education in comparison with
international standards, in particular those
adopted in the United States. Assessment of
the Ukrainian system of medical higher
education based on the formation of
generalized conclusions.
2. Reducing the number of students trained at
the expense of the state budget. It is a
question of gradually replacing quantitative
indicators with qualitative ones - also by
increasing the funding of higher medical
education institutions.
3. The formation of more transparent
conditions for the competitive selection of
the best applicants, who in turn have
demonstrated the best results in drafting,
will allow the selection of truly talented
students for the future medical profession.
4. Development of an incentive system for
students, and employment of capable
graduates in state medical institutions
(Roberts, 2020).
5. Establishment of unified requirements for
the formation of professional competencies
of graduates and teachers (Kelly, 2021).
6. Introduction of predetermined requirements
for the final objective assessment of the level
of theoretical and practical training of
students and interns. We are talking about
conducting an evaluation of their
knowledge, skills, and abilities in front of an
independent commission capable of
assessing their competence (Kelly, 2021).
7. Ensuring the implementation of updated
standards of higher education, reforming the
state of educational and methodological
support, and bringing it in line with modern
requirements for highly qualified medical
specialists, the introduction of modern
treatment protocols, the introduction of high
standards of diagnosis (Kem, 2022).
An effective consequence of the implementation
of the proposed changes in practice was the
assessment of compliance of the content of
Ukrainian pregraduate and postgraduate medical
education with international indicators in the
field of physician training. To determine the
professional level of undergraduates and interns,
a system of annual licensing and integrated
examinations “KROK” was introduced. In order
to form the test tasks base, it was proposed to use,
first of all, the American experience and use the
USMLE (the United States Medical Licensing
Examination) and IFOM (International
Foundations of Medicine) test tasks. These tasks
were developed by the United States National
Board of Medical Examiners (NBME) and
adapted to the current requirements of the medical
industry, so they meet all the necessary criteria
(Roberts, 2020).
The introduction of the KROK test system took
place in 2017. The first results were an objective
indicator of the vulnerability of the then-existing
system of medical personnel training, the quality
of educational programs approved by higher
educational institutions in accordance with the
program documents of the Ministry of Health of
Ukraine. Unsatisfactory results of the first
examinations demonstrated the need for acute
reform of the management decision-making
system, new program documents were
developed, on which higher education in
medicine would be based. According to the
results of the evaluation of the graduates of
higher education institutions, specific proposals
were formed to change the basic provisions of
the curricula for training students and interns. In
fact, there was a gradual change in the working
Volume 11 - Issue 55
/ July 2022
167
https:// www.amazoniainvestiga.info ISSN 2322- 6307
value paradigm: from a focus on “learning” a
considerable amount of information with limited
application, the transformation was aimed at
approving broad academic disciplines that had a
practical orientation. The next direction of
practical reform of medical education training
was the increase in the cost of education, bringing
it closer to European standards. Approximation of
the approximate average cost of training of one
medical specialist to the European standards
allowed to improve the material base of
universities and to accumulate certain funds for
conducting their own medical research. We
should also note that the foundations were
formed of the relevant legislative framework
aimed at the formation of motivational activity of
young specialists after graduation from the
master's degree and internship of higher
educational institutions (Kelly, 2021). We are
talking about employment guarantees in a
particularly vulnerable area of medical protection
of Ukraine - in rural areas. In particular, certain
aspects of the demand for certain medical
specialties in the labor market were investigated.
The adopted Laws of Ukraine guaranteed certain
social obligations to young specialists, who
would continue to work in rural areas. For
example, they spoke about providing housing for
free use - the peculiarities of this process were
regulated by a separate agreement concluded
between the local authorities and a graduate of a
higher medical school. It should be noted that
together with additional funding these changes
allowed to attract a certain number of young
specialists to the implementation of the program.
In the future, we believe, the development of
higher education in the medical sector will move
to the next stage. We are talking about a broader
adaptation of the requirements of educational
programs to the realities of the market of services
of the medical industry (Lekic et al., 2019). For
example, the practice of introducing family
physicians has positively shown itself. Despite all
the criticism, the principle underlying the work of
this medical “institution” (money follows the
client) has led to positive results. Experienced
family physicians due to their skills and
knowledge were able to form a significant base of
clients of medical services on a voluntary basis.
The implementation of a policy in the medical
field based on competitive democratic selection
(when patients themselves determine which
specialist to trust) will be the cornerstone for
further transformations. Also, not only
consumers of medical services, but also
employers are interested in specialists of the
highest category. The gradual introduction of
insurance and fee-for-service medicine will be a
vector for the future development of this
industry. Unfortunately, the Russian aggression
against Ukraine resulted in considerable material
losses, so in the future, the sphere of medicine will
develop with a combination of paid and free
services - in view of the devastation caused, the
financing of social expenses will be reduced
several times. Under such conditions, private
clinics and other medical institutions (the number
of which increased significantly during the
COVID-19 pandemic) will be interested in
employing well-trained specialists (Roberts,
2020).
Participation of stakeholders (employers) in the
formation of the educational process is the reality
of the European and American educational
systems. Gradual transition to such system of
training and formation of educational programs in
Ukrainian reality was denied. At the same time,
as the practice has shown, employers' advice
deserves to be taken into account during training,
since private medical companies, academic
institutions of research direction interact more
actively with global companies or other scientific
institutions. Accordingly, their experience in
training deserves to be taken into account.
Thus, government measures to improve higher
medical education in Ukraine have had positive
effects. It is true that the slow pace of their
implementation, the partially biased criticism of
their methods, the insufficient funding, and the
outdated material and technical base create
difficulties for subsequent transformations in the
field of medicine. We believe that a more active
cooperation of higher educational institutions and
potential employers will speed up this process
and find the necessary financial, methodological,
and human resources for its subsequent
continuation.
Organization of research work as an element of
modernization
Notable importance for the modernization of
practical activities of students of higher medical
institutions is research work (hereinafter - HDR),
which is a key stage in the formation of quality
education. In Ukraine, the implementation of this
activity by students is provided by legislative
documents (“National doctrine of education
development”, the Law of Ukraine “On scientific
and scientific-technical activity”). We consider
that the R&D of students of Ukrainian higher
educational institutions is a significant means of
increasing the quality of training and education
of professionals, who will be able to creatively
use the achievements of medical science in
168
www.amazoniainvestiga.info ISSN 2322- 6307
practice. Such involvement of students to
scientific cognition contributes to the fact that
they will be able to use the acquired creative
potential to solve urgent (as well as typical)
problems of medical education, to practically
implement the recommendations of teachers.
Research activity also plays the role of a kind of
continuation and deepening of the general
educational process (Ungerer, 2019). It should be
divided into research included in the educational
process and activities carried out outside of class
time. For example, extracurricular research
includes student activities in science, learning
labs, and personal (or collective) faculty-led
research (Oseredchuk et al., 2022). However,
students' participation in various scientific
events: conferences (including international
ones), research contests, Olympiads, etc., plays a
prominent role in this part of the work. Such
events can be attended by students both in person
and remotely. In this way, the universal nature of
scholarly conferences will help both develop
students' research, communication, and practical
skills (Pinheiro & Santos, 2022). Before a
discussion or conference, students choose topics
for papers. At the same time, learning excursions,
where students have the opportunity to gain
practical knowledge, have a separate place in this
system. To develop students' skills, in addition to
standard lecture classes, a significant role is
played by practical seminars, final conferences,
additional professional lectures where new
teaching methods should be applied: project
method, brainstorming, storytelling, scientific
debates, etc. Mas-Verdu et al. (Mas-Verdu et al.,
2020). The use of innovative methodology based
on research activities will contribute to the
modernization of the practical aspects of medical
education. Note that the project method involves
both individual and group projects. Atypical tasks
of these projects will contribute to the formation
of critical skills in students. Note that the seminar
(as a typical form of teaching) should contain
elements of conversation and dispute. The
conducting of practical training sessions
influences the implementation of a variety of
practical tasks, experimental experiments based
on the content of the subjects. Such classes are
less regulated, they focus on the formation of
independence in students (Cherng & Davis,
2019). In general, research activity should
consist of students' exploratory work, which is
primarily expressed in individual, independent
research. It is aimed at explaining processes and
phenomena, establishing their relationships,
identifying logical connections, theoretical and
exploratory explanation of facts in accordance
with scientific methods of knowledge. The main
related components of students' research work
are highlighted in Table 1.
Table 1.
Interrelated components of research work
Interrelated components of research work
1. Teaching students the basic aspects of research activities
2. Formation of skills of methodology and organization of scientific work
3. Research work of students serves as an element of the educational part of science in general
4. Scientific research - the consequence of self-session development of a particular problem of the
student, containing the results of their own scientific search, conclusions, hypotheses, and predictions, etc.
Created based on the author's analysis
Using the latest teaching methods to modernize
medical education
Currently, the implementation of the concept of
modernization of medical education is possible
only in case of the formation of a modern
educational space taking into account the
innovative changes of society, education of a
modern type of vision and culture (Laufer et al.,
2021). One of the innovative tasks mentioned
above is the implementation of a modern concept
of learning European higher education space. We
are talking primarily about student-centered
learning, the basis of which is a competence-
based approach to the formation and execution of
educational programs, comprehensive
integration of national qualifications boundaries,
modern higher education system, current
generation standards, academic programs, etc.
(Cherng & Davis, 2019). The implementation of
the Bologna Process system in training is a
significant incentive for the application of
innovation in education (as well as in medical
education), information and communication
technologies that contribute to improving the
efficiency of the educational process and the
organization of distance learning (Oseredchuk et
al., 2022).
Volume 11 - Issue 55
/ July 2022
169
https:// www.amazoniainvestiga.info ISSN 2322- 6307
Taking into account the analysis of European
countries' experience, one of the ways to
modernize educational content and learning
technologies is the development and gradual
introduction of educational innovative methods
and technologies (Kelly, 2021). Nevertheless, we
believe that one of the main directions of
educational medical policy should be the
development of both innovative and scientific
work in education in general, improving the
quality of education based on innovative
methods (Kem, 2022). Based on this there is a
problem with the effectiveness of innovative
learning processes, the results of which consist in
students' deep awareness of the content of the
studied, the formation of critical thinking skills.
Taking into account modern trends in pedagogy
development, the following innovative
pedagogical methods are important for
application in higher medical education: case-
study method, training learning technologies,
application of special quest-tasks, elements of
distance education, and humanistic learning.
Table 2.
Pedagogical methods of education and the organization of learning and their implications
Pedagogical methods of education and organization of training
Consequences of use
Personally oriented learning
Will promote independent thinking, the ability to make personal choices
Developmental education
Influences the formation of students' skills for self-improvement, active creative thinking, and
learning
Distance learning
It is based on the principle of independent learning of
the student. At the same time, modern technologies of
online education contribute to the possibility of
constant dialogue between the teacher and the student based on the latest means of communication.
Learning as an element of research
Formation of students' research skills, experimental work, stimulation of new knowledge.
Humanistic learning
Influences the education of conscientious citizens.
Contributes to the development of the student based on
humanization and democratization of the education
system.
Information and computer technologies
Promotes information transfer, which in turn deepens
students' knowledge and skills and influences the
development of their ability to manage social and technical problems
Case-study method
This method involves solving certain situations that
activate students' critical thinking skills. It promotes the
development of analytical and communicative
abilities.
Quest Assignment Method
The above method promotes the practical solution of
certain problems, which allows you to practice the
necessary skills as part of the training of future
doctors. The main goal of the quest is to find an
appropriate solution or achieve a certain result faster
than the competitors. For students of higher medical
institutions, an important task will be to solve a certain
clinical situation, in particular the prevention of
disease recurrence, stopping bleeding, etc. Thus, using
this method, students have the opportunity to
practically use the acquired theoretical knowledge.
Brainstorming method
Promotes rapid response to certain medical situations and influences the development of
teamwork skills.
Training technologies
They involve solving complex algorithms for solving typical application problems.
Formed based on the author's analysis
170
www.amazoniainvestiga.info ISSN 2322- 6307
In order to fulfill these technologies, higher
medical institutions must also search for and
develop the content of innovative educational
programs and modern educational technologies,
productive methods of managing the educational
process, etc.
Conclusions
Consequently, the study of ways to reform higher
medical education in Ukraine remains an urgent
problem of scientific research. The way of
modernization of this industry was hampered by
the lack of funding, but also by the lack of
development ideas. In fact, only in 2015-2017
real fundamental decisions were made, which
changed the paradigm of training of highly
qualified specialists. At the state-regulatory level,
new developmental benchmarks were adopted,
resulting, for example, in a final test system
“KROK,” based on American samples of task
formation. Also adopted important in the
Ukrainian realities incentives, primarily for
young professionals who agree to continue
working in rural areas (where there is the greatest
shortage of personnel in Ukraine). The
educational environment has also been improved
by the introduction of a closer combination of
training and research work. However, in order to
modernize both theoretical and practical aspects,
important attention should be paid to innovative
methods of education and organization of
training. In particular, the use of the case-study
method, training learning technologies, special
quest tasks, humanistic learning will contribute
to the formation of critical, creative, practical
skills of higher education students. At the same
time, the latest teaching methods actualized in
recent years should be actively introduced in the
teaching practice. Note that employers should be
more actively involved in the educational
process. Word of the future stakeholders in the
formation of educational programs is taken into
account in many universities in Europe and the
United States. For Ukraine, due to the obvious
lack of funding due to martial law, the
commercialization of education and focus on
employers can become a defining trend of
development.
Bibliographic references
Ayaz, O., & Ismail, F. W. (2022). Healthcare
Simulation: A Key to the Future of Medical
Education – A Review. Advances in
Medical Education and Practice, Volume
13, 301-308.
https://doi.org/10.2147/amep.s353777
Cherng, H.-Y. S., & Davis, L. A. (2019).
Multicultural Matters: An Investigation of
Key Assumptions of Multicultural Education
Reform in Teacher Education. Journal of
Teacher Education, 70(3), 219-236.
https://doi.org/10.1177/0022487117742884
Custers, E.J.F.M., & Cate, O.T. (2018). The
History of Medical Education in Europe and
the United States, Concerning Time and
Proficiency. Academic Medicine, 93(3S),
49-54.
https://doi.org/10.1097/acm.0000000000002
079
Demiray, U. (2017). Is digital age “A tsunami”
for distance education.: Functional Roles of
Scaffolding and Meta-Communication in
Digital Learning Environment. In Digital
Tools for Seamless Learning (pp. 179-194).
Igi Global. https://doi.org/10.4018/978-1-
5225-1692-7.ch009
Kelly, A. (2021). Measuring competition and
competitiveness. Dynamic Management and
Leadership in Education. Routledge,
218-224. doi: 10.4324/9781003217220-22
Kem, D. (2022). Personalised and adaptive
learning: Emerging learning platforms in the
era of digital and smart learning. International
Journal of Social Science and Human
Research, 05(02), 385-391. Doi:
10.47191/ijsshr/v5-i2-02
Lekic, L., Lekić, A., Alibegović, E., Rahimić, J.,
& Maša, A. (2019). Analysis and Impact of
Evidence Based Medicine in the Process of
Education and Decision Making in Medical
Practice. Research Journal of Pharmacology
and Pharmacy. Doi: 10.28933/rjpp-2019- 07-
1406
Laufer, M., Leiser, A., Deacon, B.,
Perrin de Brichambaut, P., Fecher, B.,
Kobsda, C., & Hesse, F. (2021). Digital
higher education: a divider or bridge builder?
Leadership perspectives on edtech in a
COVID-19 reality. International Journal of
Educational Technology in Higher
Education, 18(1).
https://doi.org/10.1186/s41239-021-00287-6
Mas-Verdu, F., Roig-Tierno, N.,
Nieto-Aleman, P.A., &
Garcia-Alvarez-Coque, J. (2020).
Competitiveness in European regions and
top-ranked universities: Do local universities
matter? Journal of Competitiveness, 12(4),
91-108. doi: 10.7441/joc.2020.04.06
Oseredchuk, O., Drachuk, O., Demchenko, O.,
Voitsekhivska, N., Sabadosh, Y., &
Sorochan, M. (2022). Application of
Information Technologies is a Necessary
Condition for Qualitative Monitoring of
Higher Education and Modernization of
Volume 11 - Issue 55
/ July 2022
171
https:// www.amazoniainvestiga.info ISSN 2322- 6307
Educational Process. ICSNS International
Journal of Computer Science and Network
Security, 22(3), 501-509.
https://doi.org/10.22937/IJCSNS.2022.22.3.
64
Pinheiro, M. M., & Santos, V. (2022). Building
the future of distance and online learning.
Online Distance Learning Course Design
and Multimedia in E-Learning, 114-141.
https://doi.org/10.4018/978-1-7998-9706-
4.ch005
Popovych, I., Chervinskyi, A., Kazibekova, V.,
Chervinska, I., & Machynska, N. (2021).
Estudio empírico de la tipología de
expectativas sociales del individuo.
Amazonia Investiga, 10(43), 112-122.
https://doi.org/10.34069/AI/2021.43.07.11
Roberts, C. (2020). How medical education can
help in a COVID ‐19 crisis. The Clinical
Teacher, 17(3), 241–243. Doi:
https://doi.org/10.1111/tct.13183
Ungerer, L. (2019). Digital storytelling: Possible
applications in an open distance E- learning
environment: In Storytelling: Global
Reflections on Narrative, 74-87. Doi:
https://doi.org/10.1163/9789004396401_012