Enhancing medical training in conflict zones and remote areas through innovation: introducing the Canadian Virtual Medical University Initiative.

Background: The WHO projects a global shortage of 4.3 million physicians by 2030, with the largest deficits in developing and conflict-affected regions. Our aim is to train competent physicians rapidly and affordably through remote education programs.

Methods: We developed an online medical training curriculum with four levels, focusing on different aspects of human body systems using a competency-based, student-centered approach. This study evaluates the first three levels; level four (internship) is outside this scope. The 105 medical students from eight Afghan universities were randomly assigned to nine groups. The curriculum includes Entrustable Professional Activities (EPA) for the cardiovascular system: level 1 covers basic medical sciences, level 2 pathology and basic clinical skills, and level 3 full clinical competencies. EPAs were delivered asynchronously online via Lecturio, CyberPatient, and Zoom. The 30-day intervention included 4 h of weekly online classes for formative assessment, collaborative learning, and evaluation, supervised by medical faculty members. Virtual pre- and post-intervention evaluations used multiple-choice questions and objective structured clinical examination (OSCE). We also conducted a satisfaction survey and open interview forum. Data triangulation from observations, surveys, and interviews validated curriculum effectiveness. The benchmarking method assessed cost-effectiveness.

Findings: Pre- and post-intervention analysis showed a significant increase in clinical competencies and knowledge acquisition (P < 0.0001). The CyberPatient intervention improved clinical competency quality (P < 0.0001) and shortened decision-making time (P < 0.001). Cost analysis revealed that a virtual medical university would be 95% more cost-effective than traditional medical education.

Interpretation: Integrating virtual technology with modern curriculum concepts in pre-internship years can effectively address healthcare training gaps and enhance education quality for healthcare workers at a low cost.

Funding: Provided by CanHealth International. A UBC spin-off not-for-profit organization.