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In difficult times of war, total unity in all areas of activity is necessary. Medicine is particularly important during martial law. As part of the development of an integrated military field surgery curriculum, the use of simulation-based learning is challenging due to limited resources at the university level. The aim of this paper is to propose a model for the conceptual design and implementation of an integrated simulation training programme with competency assessment for the development of surgical skills in medical students in the subject of military field surgery. Methods: an educational curriculum development method, specifically tailored for military field surgery training. The method involved defining a context-appropriate goal, which in this case is the integration of a simulation curriculum into the military field surgery curriculum. The results evaluated the logic model methodology that was used to identify learning objectives, available resources and describe the process of implementation and evaluation of the simulation training programme. The logic model methodology was used to develop the logic model methodology, which consisted of five steps: 1) defining the goal, considering the context; 2) using resources; 3) conducting activities; 4) targeting groups; 5) obtaining results in the short, medium, and long term. The model for the conceptual design and implementation of an integrated simulation training programme will allow to integrate simulation into the process of military field surgery education with a realistic approach, considering local resources and continuous evaluation (student satisfaction, activation of competencies in the provision of medical care and impact on the organisation of care). In conclusion, following the approach to competencies in the military field surgery programme, the logic model will lead to the design, implementation, and evaluation of the simulation training programme with the potential for change throughout the project. [ABSTRACT FROM AUTHOR]

The aim. To analyze treatment approaches and tactics and improve acutely complicated duodenal ulcers (DU) treatment results. Materials and methods. The results of the analysis of the surgical treatment of acutely complicated duodenal ulcers (a combination of 3 and/or 4 combined complications) are presented for 2 periods: the 1st (2000-2014) years (group A) - 47 patients, the 2nd (2015-2021) years (group B) - 34 patients. Results. 81 (100 %) patients were operated on for acutely complicated duodenal ulcers, of which 68 (84.3 %) patients had a combination of three complications, and 13 (15.7 %) had four complications. Out of 81 patients, 72 had bleeding complications, which is 89.3 %. Complications of ulcer perforation - in 36 patients, 44.7 % of all other complications. Based on the obtained analysis data, there is a steady trend towards an increase in the share of organ-sparing operations (OSO) by 1.6 times (from 50.9 % to 81.4 %), a decrease in the number of gastric resections (GR) by 2.9 times (from 14.9 % to 4.9 %) and palliative operations (PO) by 3.2 times (from 15.8 % to 4.9 %) with a relatively stable number of performed organ-preserving operations (OPO): in group A - 17 (24.6 %) interventions, in group B - 4 (21.1 %). Conclusions. The use of modern measures of endoscopic hemostasis made it possible to adequately prepare and operate on patients in the delayed period, and their share from the first period to the second increased by 2.9 times. The number of patients who underwent emergency surgery with ulcer perforation and bleeding as combined complications decreased in the second period compared to the first by 2.5 times, which is associated with the widespread use of modern proton pump inhibitors (PPIs) in the conservative treatment of DU. The number of complications and mortality of this cohort of patients also significantly decreased due to the use of endoscopic hemostasis methods, making it possible to stabilize and prepare patients on the operating table. According to the analysis results, it became known that the chosen active-individualized tactics and the use of developed algorithms for choosing the type of surgical intervention made it possible to achieve a stable level of postoperative mortality at 8.1 %. [ABSTRACT FROM AUTHOR]