Peer- elaboration and ranking of core values in general practice in post-Soviet Ukraine.

Pavlo Kolesnyk, Sabine Bayen, Ivanna Shushman, Andrew Kolesnyk, George Kuodza, Zalika Klemenc Ketiš, Thomas Frese

Keywords: general practice, WONCA, core values, implementation, Ukraine

Background:
The term “core values” (CV) can be defined as fundamental beliefs or principles in a social context. Though core competencies of family medicine (FM) have been clearly defined by WONCA, there has been an ongoing debate on what are the CV for family doctors (FDs). Ukraine is a low-income country, developing a modern European healthcare system, especially regarding FM. To implement WONCA standards and associated CV, it is mandatory to assess the ongoing understanding of CV in clinical daily practice among active FDs, working in different countries of Europe including Ukraine.

Research questions:
How do Ukrainian FDs define CV of FM in Ukraine and how important are these CV to a wider population of Ukrainian FDs?

Method:
A mixed method study was conducted in 2 steps during August and September 2020 in Ukraine. The first part was a qualitative Delphi round (n=3) design among Ukrainian FD who were familiar with teaching and terms CV. The second part was a quantitative survey among Ukrainian FD, not specially used to discuss CV A consensus list of CV has emerged from the Delphi round study. The list was suggested to 300 FD, to rank the values from 1 to 9 according to their subjective importance. Demographic characteristics have been assessed for all the participants of Delphi round and quantitative survey.

Results:
Different CV have been be generated by the Delphi round, including human and professional CV. Some values were spontaneously correspond to the values and competences defined in the WONCA tree, but some new or different definitions were emerge according to the specific authentic life-and work context of the participants.

Conclusions:
Defining CV for FM by F is crucial to optimize medical care and to guarantee an appropriate and successful implementation of WONCA standards in different countries especially in those where reformation of the health system is ongoing.

Points for discussion:
Why core values of FM different in different states?

What are similar core values in different states?

Is the example way of defining core values in Ukraine good enough for the other countries?