Institutional Factors Affecting In-Person Clinical Training of Dental Students During Martial Law

Abstract

Background. The full-scale war in Ukraine has profoundly transformed higher medical education, particularly in dentistry, where clinical training traditionally depends on direct student–patient interaction. Security-related constraints, resource shortages, disruptions in the operation of clinical facilities, and heightened psychological stress have created significant barriers to high-quality in-person learning. Under these conditions, a comprehensive assessment of institutional factors influencing access to clinical practice, as well as an evaluation of simulation-based training as a compensatory tool, is urgently needed.
Objective. To identify institutional, organizational, and psycho-emotional factors that determine the accessibility and effectiveness of in-person clinical training for dental students during martial law, and to assess the role of simulation-based learning in developing clinical competencies under restricted patient access.
Materials and Methods. A cross-sectional anonymous online survey was conducted among dental students (n = 103) using the Google Forms platform. The questionnaire comprised sections on: accessibility of clinical facilities; barriers to participation in in-person practice; subjective evaluation of simulation-based training; perceived need for its intensification; and students’ psycho-emotional state during wartime. Data were analyzed using descriptive statistics, with results presented in pie and bar charts.
Results. The findings revealed alarmingly low regular access to clinical practice: only 4.8% of students consistently attended clinical facilities. For most students (71.4%), access was partial, while 9.5% reported complete absence of access. The leading institutional and organizational barriers included security concerns (61.9%), insufficient material and technical resources (57.1%), shortage of patients or clinical cases (52.4%), suboptimal scheduling (42.9%), and logistical difficulties such as geographical distance (28.6%).
Conclusions. In-person clinical training for dental students during martial law is critically constrained by institutional and security factors, resulting in reduced accessibility and disrupted regularity of practice (with only 4.8% of students maintaining stable patient access). Under these circumstances, simulation-based learning emerges as a key compensatory tool for preserving essential manual skills; however, it requires further institutional support and modernization of educational infrastructure.