For several months before the invasion, I had already felt horrible due to the information pressure. My work had distracted me from full immersion into worries. I had had hope that the war would not start. However, on 24 February, I was shocked. I remember mechanically cleaning the flat, packing things. I was very scared, I felt despair, helplessness, anger, hatred. The next day I realized that we were at war and I wanted to help my country.

The first actions were chaotic, nobody knew what to do. My colleagues and I would sort medicines, collect things for displaced people. There were many internally displaced people in Chernivtsi and in our university dormitories at the end of February. We would go there all the time, bring the essential things. This chaotic running around, despite helping to deal with inner feelings, was not effective enough. Now I understand that volunteer work requires a systematic and professional approach. But, when I did not do anything for at least a day, I felt guilty for wasting time. This is what we call survivor’s guilt.

That pace of life led to exhaustion, it was me who needed help back then. When you don’t have your own resources, you have nothing to give away. I understood that I wanted my country to win, and the best decision is to do what you can the best. On 14 March, the educational process at the university was resumed, so I had to return to teaching. I made a decision for myself that I’d rather be regularly donating to charitable foundations and volunteers for the Armed Forces of Ukraine instead of helping chaotically.

CPD, self-development help me to feel my own resources. When learning, I have less time for immersion into negative information, which is duplicated in different media. Journalists sometimes cover the details of combat wounds, which cause physical pain and drain you morally.

In April, the Ukrainian-Swiss Project "Medical Education Development" suggested joining Module 3 of the teaching skills course. It became a saving straw for me. I knew it would be difficult — we did not sleep enough at that time, and had negative emotions which destroyed us from the inside, but I understood that I had to switch to learning. It fills you in, not exhausts. That April course was the most complicated for me. I was not able to concentrate or perceive the information, although the course was taught by the trainers I adore. I even hesitated about whether to make the final assignment, I thought about taking care of myself, as I do not study for certificates. But my colleague from Vinnytsia, Iuliia Tykholaz, convinced me that I had to finish the training, including the final assignment. I am grateful to her for this.

These days, no one is afraid of online learning – we have transferred from Covid-time online learning to a wartime one. Of course, these two periods cannot be compared: students did not cry during the Covid-time online sessions. While learning during the war, we barely kept down our emotions, I often had to stop the discussion and supported the students with necessary words which were difficult to find. During the war, the basic need for safety is disrupted. It is extremely difficult to speak about higher levels of vital needs. I cannot say that everything is fine and there will be victory tomorrow. We have to find some real support points because it’s unclear how soon we will win. I told them that each of us can make this victory closer, in particular, through good learning.

Although humanity and empathy already constitute an integral part of my life mission (laughing. — ed.), the creation of the course and its integration into the curriculum started from something else. In December 2020 I completed the course ‘Teaching Skills. Second Edition. Peer Groups for HEI Teachers’ and became a peer group facilitator. We worked with different trainers whom I am grateful for the new notions and practical cases, and an opportunity to study group dynamics.

The practical part, during which we worked with Anastasiya Leukhina, was the best. The basis of training was group work – every team presented its own problem. When our team presented the problem, I was a facilitator, and it was exciting. Good that everything worked out, and we had nice feedback. Gaining facilitation skills paved my way to further projects. Moreover, our small team, consisting of Olena Korotun (Bukovinian State Medical University), Nataliia Povar (Rivne Medical Academy), Iuliia Tykholaz (Vinnytsia Medical College), turned into a long-term partnership. Thanks to the course, we formed a great community of peer group facilitators, and we still keep in touch today. This interaction gave birth to the idea of creating the course and manual ‘Humanity and Empathy in Health Professionals’ Work’. A large part of those who took the course in facilitation joined the project of creating materials for the course – a workshop on humanity and empathy.

The beginning of this optional course for the fourth-year students of Bukovinian State Medical University coincided with the beginning of russia’s large-scale invasion of Ukraine. It was a real challenge for me! I tried to show that education, critical thinking, humanity and empathy are extremely important because that’s what distinguishes us from the enemy. In Ukraine, a human is the greatest value.

The request for this course was evident, judging by the number of students who selected the course: we formed 12 groups, and I taught five of them. After the course, about 50 students, from the five groups that I lead, gave their feedback. The majority were satisfied to have selected the course and think that the fourth year of studying is an ideal time for learning this discipline. The feedback included the requests to increase the number of academic hours for the discipline and to have more time for discussion.

In my opinion, this discipline should be made mandatory, not an optional one. In other countries, communication that is based on the principles of mutual understanding, empathy, and trust is an obligatory competence written in the curriculum.

The topics of privacy and confidentiality. In medicine, confidentiality is in the legal field, and privacy is more related to moral and ethical principles. We discussed coverage of professional achievements on Facebook, for instance. I remember a post from one doctor about saving a girl. The text contained various details about the girl’s trauma. We discussed what was the purpose of the SMM specialist using these details, for which target audience, and whether such information should be public even if it is depersonalized. If the city where this girl lives is small, residents will understand who it was about. Then we drew parallels with the war, and how relevant it is to show the photos of people tortured to death. A part thought that there should be a basic respect for human dignity, even after death. Privacy and confidentiality in medicine are sensitive topics. We worked on it so that students realized the basic notion of respect for human dignity.

We are now translating the Jefferson scale of empathy into Ukrainian. Foremost, we want to show the availability of this tool, the possibility to use it, and its validity. Then we will offer this tool for measuring empathy for different purposes. It will definitely come in handy for assessing empathy in students of medical HEIs, in particular, to study the impact of the introduction of the courses in humanity and empathy.

Additionally, we decided to popularize qualitative research and our topic among students. We chose Instagram for communication as a popular platform among students, where we created a page about our research. We cover the stages of our work, how to go from scratch to the final product of research — publication of the article in the international Scopus indexed journal. Also, we plan to make Instagram giveaways for the books important for every future doctor’s mindset. We have purchased and will soon draw the following books: ‘A Non-Scary Book’ by Anastasiya Leukhina, ‘Evidence-Based Medicine and Not Really’ by Andriy Semiankiv, ‘Do No Harm: Stories of Life, Death and Brain Surgery’ by Henry Marsh and ‘Get You Mantoux Test Wet’ by Ulana Suprun.

The research path is not easy, but we are grateful for the opportunity to learn from the best and work with researchers of such level. Our schedule is full by the end of the year! There is stability at least somewhere (laughing. — ed.). We meet in the evenings, discuss difficult and interesting topics, for example, analyse the research methodology in English. There is specific terminology that we have to learn, during the meetings one has to look it up in the dictionary.

When I work in a team, the most important thing for me is trust and a desire not to stand still. My ladies are true partners in crime, I am confident in these people! I have known Kateryna Bobkovych for many years, we were group mates. Our friendship has been proven over the years, we have a lot in common. If a time machine existed, it would bring you to the end of the 1990s to see how Katia and I were walking along Chernivtsi and singing Pikkardiyska Tertsiya (laughing. — ed.). I have also known Iuliia Repchuk and Mariana Semianiv since my student years, I love and value them a lot. And Golda is our volunteer and mental health saver (laughing. — ed.). At every meeting, everyone first asks: ‘Where is Golda? Show us Golda!’. She literally saved the team leader’s mental health, so let the research be!

I share information and ideas with colleagues wherever possible. I told about a human-centred approach in medicine at the online conference for educators and doctors at the invitation of Nataliia Povar from Rivne Medical Academy. In addition, several days before the full-scale invasion I conducted the master class ‘Secrets of Human-Oriented Counselling’, which was attended by the students from first to fifth years of study, doctors, educators, and peer group facilitators from different cities of Ukraine, who promised to share this knowledge at their meetings. My colleague from Bukovinian State Medical University Olena Korotun also conducts trainings for doctors. I know that the colleagues from Ternopil spread their ideas of teaching humanity and empathy in the advanced training courses for educators.

From the most recent stories of our city: a modern clinic with powerful equipment and professionals of higher class. A good friend of mine shared her impression from the consultation. The doctor silently examined her and, without explaining anything, just gave her a conclusion. So her impression from visiting this facility appeared to be lower than she expected. By the way, we considered a similar case called ‘How to lose a patient?’ with the students during the course in humanity and empathy. The need for information is one of the components of the human-centred approach, along with a need for physical comfort and joint decision-making. A patient, having a choice, will choose a clinic with an optimal ratio of professionalism and a human attitude. For a modern doctor the human-centred approach and communication skills mean investment in long-term and trust-based relations with a patient, but not a burden, as some mistakenly believe.

In my opinion, when you work and do not have this competence, you already lose, specifically, making mistakes in communication, which often leads to conflicts with patients and, as a result, professional burnout. I would call this competence a conventional vaccination that can protect doctors and nurses from burnout.

Because of the lack of competence that was not developed in time, there is a risk of losing a patient, as I mentioned in the story above.

For me, it is important for the CPD format to be practice-oriented, to allow development of competences, rethinking the values and broadening horizons. I’ll give you examples of some events. I was pleasantly surprised by Lugano Summer School. For me, this event is about training through practice — it’s an invaluable experience. We had lectures that alternated with cases and work on projects in mini-groups. This event also helped me to realize the importance of speaking English because a foreign language multiplies our opportunities.

I also remember the Ukrainian-Swiss Summer Club. Every day I received a huge amount of information which, despite being indirectly related to my professional activities, is important for the formation of every professional’s personality. I could not even think that one can gather such a unique panel of experts involved in the changes in our country in different areas in one place. Mychailo Wynnyckyj (PhD, lecturer at Kyiv Mohyla Academy and UCU — ed.) is one of my favourite speakers! He interestingly told about the creative class and its role in society. Speeches by Pavlo Sheremeta (economist, Minister of Economy and Trade in 2014. — ed.) about innovativeness and Andriy Zelinskyy about leadership were memorable. I paid special attention to the Manifesto of Healthy Society. And all this special atmosphere. Imagine, there is a discussion and Arsen Zhumadilov’s daughter (Director General at Medical Procurement of Ukraine. — ed.) is drawing on the flipchart — even such a small detail shows how everything around facilitated the discussion, and the surrounding people were open and sincere. I rarely see this format.

I dream about victory to live and work peacefully in my country. I see what a high price we pay in this war, and I do not want all this to be in vain. I want that people that have the same values as those who died for our country used the achievements. This is my biggest dream now. I also dream for the educational environment to be built on the principles of meritocracy (a management principle in which political power is vested to the most talented people regardless of their social or economic origin. — ed.), for the gifted people to be supported because it is usually easier to average the results. Support of the gifted requires more resources and effort. One should understand that the best will drive the defining processes in the country’s life. It is important that Ukraine has this policy in all areas.

I remember we had a cinema evening at the Summer Club. We came there joyful and relaxed and thought that we would watch ‘My Thoughts Are Silent’. It appeared that we would watch ‘Homeward’ by Nariman Aliev. I remember absolute silence in the hall after it. Over 50 people were sitting there and no one could say a word. The film was very difficult, it struck us through. I felt the pain of a father and son from losing each other, losing their native land. If only we understood back then which level of pain we would have to feel in half a year.

And also, together with the students, we watch and discuss the documentary ‘You Still Have to Survive’. The matter is that the first topic of the discipline ‘General Practice – Family Medicine’ studied by the sixth-year students is about health sector organization, its reform, and principles of financing. This topic is difficult if you learn it by the principle of ‘read and tell’. So this film is highly relevant. The main character is doctor Ivan Chernenko. In the context of health care, I can also recommend reading his book ‘Laughter at the End of Tunnel. Notes of a Ukrainian Anaesthesiologist’, where Ivan expresses his thoughts clearly, boldly and with humour.

There is a saying ‘Find your own and calm down’. I’ll rephrase it: ‘Find your own and make this world better together’ (laughing. — ed.). For me, the Project team is the people with whom you can improve not only education but do a lot more.