Educational innovation in virtual and augmented reality for health professional education: a Southeast Asian model

1. Introduction

The integration of virtual reality (VR) and augmented reality (AR) into health professions education opens new possibilities for experiential learning, particularly in contexts where patient access or specialised equipment is limited. These constraints often stem from patient safety concerns, decreasing clinical case exposure, and ethical sensitivities around student-patient interactions. As Schmid Mast et al. [1] note, VR can lower psychological barriers and enhance learner confidence by simulating high-risk scenarios in a controlled setting. Global literature further supports the use of immersive environments to develop clinical reasoning and procedural skills in repeatable, safe contexts [2,3].

In response to these challenges, we at IMU University initiated a strategic initiative to integrate VR and AR into our simulation-based teaching framework. I remember vividly the first faculty meeting where this idea was met with cautious optimism and a fair bit of scepticism. Yet, over time, the shared enthusiasm from our students and partners helped us build momentum. This commentary outlines our motivations, key steps taken, early outcomes, and the broader educational and institutional implications. By sharing this journey, I hope to contribute to a growing dialogue on innovation in health professions education in Southeast Asia and offer a personal reflection on what we have learned along the way.

2. Rationale and theoretical foundations

VR offers fully immersive, interactive, three-dimensional (3D) environments, while AR overlays digital content onto real-world surroundings. Together, these tools enable flexible, high-fidelity simulation experiences that support the acquisition of cognitive, psychomotor, and affective competencies [4].

Several factors motivated our initiative. First, the opportunity to practise clinical skills repeatedly in a risk-free setting supports patient safety while enhancing learner preparedness. Second, clinical exposure in teaching hospitals is increasingly constrained, making alternative avenues for skill development essential. Third, we observed a persistent disconnect between preclinical knowledge and clinical application, an area where immersive learning may bridge the gap [5].

Our approach is grounded in constructivist learning theory, which holds that learners actively construct knowledge through experience and reflection [6]. VR supports this by situating learners in dynamic contexts requiring active problem-solving. Kolb’s experiential learning model further supports our design, emphasising concrete experience, reflective observation, and active experimentation as essential to deep learning [7]. The concept by Vygotsky [8] of the zone of proximal development emphasises the importance of scaffolded, guided VR activities that facilitate skill acquisition beyond the learner’s current capabilities. Beyond pedagogical justifications, this initiative also reflects strategic thinking. In an increasingly competitive global education world, immersive learning technologies enhance institutional appeal and support contemporary trends toward personalised, student-centred education.

3. Implementation strategy

Our strategy evolved along two main paths. In the early stages, we engaged with faculty across programs to understand their teaching needs. These conversations helped us prioritise key areas such as pharmacy dispensing and dental analgesia, leading to the acquisition of suitable commercial VR products. At the same time, we forged collaborative partnerships with two local multimedia universities. This was one of the more rewarding aspects of the project. Our medical faculty offered content expertise, while the multimedia students, under supervision, developed the technical components as part of their academic coursework. I found it particularly energising to see our disciplines intersect in such creative ways. From this collaboration, we co-created several VR modules, including a virtual lab, operating theatre, trauma case, and cardiopulmonary resuscitation scenario. These are now integral parts of our simulation-based teaching across various programs. While similar initiatives in high-income settings often rely on commercial software and infrastructure-heavy solutions [2,3], our approach has been shaped by the need for contextual relevance, cost-effectiveness, and local co-creation.

Student feedback has consistently highlighted higher engagement, enjoyment, and perceived knowledge retention. One student remarked that it was the first time they truly felt “present” in a classroom, an insight that resonated deeply with me. A formal evaluation of our VR microbiology lab has shown that over 70% of students experienced improved knowledge transfer and learning satisfaction [9]. Additional evaluations are underway, and early trends suggest similarly positive outcomes across other modules. These outcomes affirm the educational promise of immersive tools in promoting curriculum relevance and interprofessional collaboration.

Selection of topics for VR/AR development prioritised core competencies that are difficult to teach via conventional means, such as 3D anatomy or emergency response, and scenarios with cultural or ethical sensitivity, including obstetric procedures. Our approach also ensures that content can be reused across multiple programs, maximising institutional benefit. Our Southeast Asian context also influenced content decisions in ways that differ from those of commercially produced modules developed in other regions. For example, in one international VR product we reviewed, an iodine-based antiseptic was used by default. However, in our setting, the use of iodine has been phased out in favour of normal saline for specific procedures due to updated clinical guidelines and local patient sensitivities. This kind of localisation highlights the importance of adapting educational content to reflect regionally appropriate practices, rather than relying on imported simulations that may not align with current standards of care and best practices in our region. This work has garnered recognition nationally and internationally, receiving several innovation awards, including accolades at the International Invention, Innovation, Technology Competition & Exhibition (ITEX) in Malaysia, as well as the International University Carnival on E-Learning (IUCEL). Such recognition underscores the value of interdisciplinary partnerships in advancing medical education.

4. Challenges and reflections

Despite encouraging outcomes, we have encountered several challenges that have impacted our ongoing approach. Technological limitations continue to be a recurring issue, including the need for high-speed internet, sufficient physical space, and user-friendly systems. Some VR setups, especially in their early iterations, were bulky and unintuitive, occasionally leading to user discomfort such as motion sickness, a complaint I heard directly from a few students in our initial sessions.

Faculty development has also emerged as a crucial piece of the puzzle. Moving from familiar lecture formats to student-led, tech-mediated activities requires a genuine shift in mindset. I have observed hesitation among some colleagues who are unsure about how to evaluate learning within immersive scenarios or worry about the time investment required. These concerns are valid and have prompted us to design targeted training and peer-sharing sessions.

Students, while enthusiastic, are not exempt from challenges either. Some initially found the VR environment disorienting or overwhelming, particularly when required to multitask or collaborate in virtual spaces. We have had to iteratively adjust the onboarding process and embed more scaffolding to support their adaptation.

We also encountered challenges related to institutional silos. Initial efforts were often confined to individual departments, limiting cross-disciplinary uptake and resource sharing, leading to multiple platforms, duplicated content, inconsistent quality, and limited cross-programme use. Valuable resources were underutilised, and the full potential of immersive learning remained unrealised. Our university responded not with more tools, but with a deliberate strategy: to embed immersive learning as a shared pedagogical model across programmes. This approach enables students to explore flexibly, make mistakes safely, and engage meaningfully. It has transformed isolated initiatives into a coordinated ecosystem that supports interprofessional education and cross-disciplinary collaboration. Governance is supported through internal academic structures, while external advisory input ensures benchmarking and alignment with academic and professional standards. The initiative aligns closely with our university’s learning model, which emphasises self-directed, reflective, collaborative, and experiential learning, and supports our national accreditation agency’s outcome-based education framework. With centralised support for procurement, copyright, and research, this integrated model ensures sustainability, educational value, and strategic coherence, marking a bold shift from fragmented innovation to institutional transformation.

Finally, cost remains an ongoing concern. The financial burden of equipment, content development, and maintenance is significant, and we are acutely aware of the risk of passing these costs on to learners. Our strategy has been to pursue institutional funding and external grants while exploring scalable models of development that maximise resource sharing. Ensuring long-term sustainability is not just a financial issue. It is an ethical one. Sustaining equitable access to these innovations aligns with the Sustainable Development Goals (SDG), particularly SDG 4 on Quality Education and SDG on Reduced Inequalities [10], by fostering inclusive and high-quality learning opportunities that are accessible regardless of institutional or geographic context.

5. Future directions

Looking ahead, I am particularly excited about expanding the interdisciplinary use of immersive content and exploring ways to sustain innovation through strategic commercialisation. Selected VR modules are being developed into proof-of-concept products, with the intention of pursuing patenting and licensing. We also plan to investigate instructional design strategies, long-term learner outcomes, and scalability across diverse educational settings. By embedding research and evaluation into our development cycle, I hope we can build an evidence-based, adaptable model that other educators in the region can take inspiration from and tailor to their own contexts.

6. Conclusion

The adoption of VR and AR in our medical education programme was driven by the need to enhance clinical preparedness in a constrained learning environment. Through intentional collaboration and pedagogical alignment, we have developed scalable solutions that demonstrate both innovation and contextual relevance. Reflecting on this journey, I believe our experience highlights the real-world value of interprofessional partnerships, iterative design, and pedagogical adaptability in embedding immersive technologies into medical education. The challenges, whether faculty hesitancy, resource constraints, or technical limitations, are not insignificant. However, the progress we have witnessed, from student enthusiasm to external recognition, reinforces our commitment. I hope this commentary not only informs but also encourages fellow educators and institutional leaders across Asia to experiment boldly and share openly as we collectively contribute to the future of health professions education.