Education in Adversity: A Pioneering Initiative to Enhance Surgical Knowledge in Wartime Ukraine
*Ali Dzhemiliev1, *Solomia Semeniv2, *Marta Antoniv1, *Inesa Huivaniuk3, *Michael Kochis4, *Mariana Kuryk5, *Galyna Shabat6, *Maksym Danylyshyn1, *Polina Zmijewski7, *Nelya Melnitchouk1
1. Surgery, Brigham and Women`s Hospital, Boston, MA, United States. 2. Krakow Hospital, Krakow, Poland. 3. Kyiv Regional Oncological Dispancer, Kyiv, Ukraine. 4. Massachusetts General Hospital, Boston, MA, United States. 5. Danylo Halytsky Lviv National Medical University, Lviv, Ukraine. 6. U.O.C. Chirurgia Generale e Centro Esofago IRCCS Policlinico San Donato, San Donato, Italy. 7. University of Alabama, Birmingham, AL, United States.
Background:
The Russian invasion disrupted Ukraine's healthcare and surgical education. Our previous research assessing weaknesses in Ukrainian residency highlighted a lack of evidence-based lectures across programs, along with the urgent demand for high-quality surgical care. We established and evaluated a year-long online course intended to increase our Ukrainian colleagues? surgical knowledge and confidence in patient management.
Study Design:
?Principles of Surgery? course involves 40 one-hour weekly virtual lectures from September 2023 to May 2024, taught in English by US and European surgeons, covering core topics and student-requested additions. Applicants were selected based on credentials and motivation. Lectures are recorded for public access. Evaluation includes pre- and post-course self-assessments on topic understanding and patient management confidence, analyzed with the Chi-square test.
Results:
Forty-two learners were selected from 204 applicants, including 23 residents (54.7%), 16 early-career surgeons (38.1%), and 3 (7.1%) physicians from other specialties. By January 2024, 24 lectures had been completed, receiving positive feedback. After 10 lectures, the percentage of learners who rated their understanding of topics as ?good? or ?excellent? increased from 50.2% to 81.2% (p<0.05). Similarly, the percentage of people who rated their confidence in managing patients as ?good? or ?excellent? rose from 44.4% to 69.3% (p<0.05) (Table 1). Despite wartime challenges, all course participants were able to attend over 80% of the lectures.
Conclusions:
Our online course begins to address critical gaps in Ukrainian surgical education and can serve as an example to enhance surgical education in times of crisis.
Table 1. Course participant demographics and self-confidence tests results
| Course participant demographics | |||
| Total number of students | 42 | ||
| Male | 25 | 59.5% | |
| Female | 17 | 40.5% | |
| Surgical residents | 23 | 54.7% | |
| Surgeons | 16 | 38.1% | |
| Other specialties | 3 | 7.1% | |
| Self-confidence tests results | Pre-test | Post-test | P-value |
| Understanding of surgical topic (mean percent who answered ?Good? or ?Excellent?) | 50.2% | 81.2% | <0.05 |
| Confidence in management and treatment of patients (mean percent who answered ?Good? or ?Excellent?) | 44.4% | 69.3% | <0.05 |
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