Etude De Faisabilite Sur la Mise en Oeuvre du Concept "One Health" au Togo (2023-2024)

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## **Peer Groups for Primary Healthcare Providers in Ukraine: Professional Development and Burnout Prevention during the COVID-19 Pandemic**

**Olga Korolenko, Tetiana Stepurko, Martin Raab, and Renato Galeazzi** Ukrainian-Swiss Project "Medical Education Development", Swiss TPH, Kyiv, Ukraine

The peer groups (PGs) for primary healthcare (PHC) providers were launched in Ukraine in 2020 as a continuing professional development (CPD) activity. The aim of this study is to assess the experience of participants on the PGs' role in professional development. The case study approach was applied for data collection and analysis. The feedback and reporting forms collected from PGs participants were the first source of data. The presented cases during the First Ukrainian Congress of PGs Facilitators in October 2021, regular discussions during supervision meetings provided information on how PGs contribute to the quality of CPD, motivation, interaction in teams, and burnout prevention. PGs are small groups of specialists with equal positions who meet regularly to discuss their medical practice critically and learn from each other's experience to improve the quality of care [1]. Currently, around 50 PGs for PHC professionals operate in Ukraine, covering around 500 participants. At the beginning of the COVID-19 pandemic, PG meetings were frequently devoted to cases of COVID-19 patients, vaccination, and coordination between different healthcare levels. This helped PHC professionals to update knowledge timely, reduce the stress level, and develop action plans for the facilities. For a long time, PG meetings were the only offline CPD format available for PHC professionals, which ensured regular skills building and experience sharing. Among the PGs' key advantages, physicians mention active communication, the possibility to learn from each other and to strengthen relationships in teams. For nurses, this format became a possibility to study continuously as other options are limited in Ukraine for them, as well as feel more competent and confident. PGs seem to be an important contribution to CPD in Ukraine and address those challenges that require urgent communication, knowledge, and experience sharing. Also, this format contributes to better interaction in a team.

Olga Korolenko, Tetiana Stepurko, Martin Raab, and Renato Galeazzi

Ukrainian-Swiss Project "Medical Education Development", Swiss TPH, Kyiv, Ukraine

#### Background

A Ukrainian–Swiss Medical Education Development Project, implemented by Swiss TPH under financial support from the Swiss Development Cooperation Office, launched the peer groups for primary health care (PHC) providers in Ukraine in 2020. Peer groups are seen as one of the continuing professional development (CPD) activities for health care providers. Before 2020, this CPD format was not present in the country at all, for either nurses or doctors. The peer groups format changes the approach of medical professionals towards their CPD. They become proactive and ready to take on a leading role in and responsibility for their learning.

*Figure 1. Peer group from Lviv.*

**Peer groups are small groups of specialists with equal positions who meet regularly to critically discuss their medical practice and learn from each others' experiences to improve quality of care. [1].**

Study Design

The aim of the study is to assess the experience of peer group members regarding the peer groups' role in their development, in professional life and beyond.

The study applies a case study methodology, and data comprise the feedback and reporting forms from peer group facilitators and members. Also presented are cases from during the training, meetings, and supervisory sessions providing additional information on how peer groups contribute to the quality of CPD, the motivation of PHC professionals, and interactions in teams.

*Figure 2. Map of the distribution of peer groups for medical professionals across Ukraine.*

#### Implementation Process


Peer groups continued to operate during martial law, as they were among the limited CPD options available for medical professionals.

#### References

1. Beyer, M.; Gerlach F.M.; Flies U; Grol R.; with contributions by Król Z.; Munck A.; Olesen F.;O'Riordan M.; Seuntjens L.; Szecsenyi J. The

development of quality circles/peer review groups as a method of quality improvement in Europe. Results of a survey in 26 European countries. Family Practice 2003; 20: 443–451.

*Figure 3. Peer groups from Kharkiv, Chernivtsy, Rivne, Kherson.*

#### Implementation Results

Peer groups proved to be accessible, flexible, and tailored to the real needs of medical professionals. During the COVID-19 pandemic, peer group meetings were the only possibility for medical professionals to meet offline and to learn and share key updates on COVID-19 treatment in real time. During the military invasion of Russia, peer groups have become a unique opportunity for lots of medical doctors and nurses to continue CPD at the workplace or online, in cases where medical professionals have been temporally displaced.


• *'COVID-19 treatment was a very important and urgent topic to discuss. Thank you for bringing us together and sharing this knowledge. I was looking for this information for some time already', family doctor, Chortkiv town, Ternopil region.*

Among the key advantages of peer groups, medical professionals also mention open communication, reduction in stress levels, and team building, which leads to burnout prevention, as there is a safe space within medical facilities to share concerns and look for solutions for existing problems, as well as to devote time to special training to prevent professional burnout.


*Figure 4. Peer group facilitators, Autumn 2021.*

#### Conclusions

Peer groups contribute significantly to the development of CPD systems for medical professionals in Ukraine. In particular, they address challenges which require urgent communication between colleagues, or knowledge and experience sharing under unpredictable circumstances. Also, this format contributes to better interaction in a team, ensures trust- building, and ensures the delivery of necessary support in crisis situations and burnout prevention.

Peer groups have raised a lot of interest from medical professionals and promote the further development of the medical professional community in Ukraine.

#### Acknowledgments

The peer groups were launched by the Ukrainian-Swiss project "Medical education development", funded by the SDC, and later supported by the USAID project "Health Care Reform Support". The Project is financed by the Swiss Agency of Development and Cooperation. Views and ideas published here belong to the author(s) and do not necessarily reflect views of the Swiss Agency of Development and Cooperation.
