Innovative Hospital Exploration and the Evolving Role of Virtual

Reality Tours in the Learning Process of Medical Students During

Clinical Clerkship

Hery Dian Septama

1,* a

, Lukmanul Hakim

, Meizano Ardhi Muhamad

, Fidha Rahmayani

and Siska Lania

Department of Electrical Engineering and Informatics, University of Lampung, Bandar Lampung, Indonesia

Department of Medicine, University of Lampung, Bandar Lampung, Indonesia

Education and Training Installation, Abdul Moeloek General Hospital, Bandar Lampung, 35145, Indonesia

Keywords: Hospital Tour, Clinical Clerkship, Virtual Reality.

Abstract: One of the stages in the process of implementing clinical clerkship is the activity of visiting hospital facilities.

The medical students are divided into groups and visit various clinical facilities that are available. The process

of physical visits requires time and expenses. Additionally, the crowded condition of the clinic facilities often

poses a problem when trying to find a suitable visiting time. For this reason, a new method is needed that is

efficient and cost-effective, which can facilitate this activity. The purpose of this research is to design a virtual

reality-based virtual tour of a hospital. With this technology, students will still be able to experience virtual

tours of healthcare facilities that are comparable to or even as good as physical tours. Since it is virtual-based,

there will be no issue with visit time as it can be done anytime. This research will utilize the Multimedia

Development Life Cycle (MDLC) development model. There are a total of six steps in its development,

namely Concept, Design, Material Collection, Assembly, Testing, and Distribution. The hospital's virtual

reality tour facility has been constructed effectively after all the stages of the MDLC approach have been

completed. The test results indicate that all functional requirements have successfully met expectations. Users

can utilize virtual reality headsets for a more immersive experience. The concept of a virtual tour of hospital

facilities based on virtual reality has been successfully developed. The presence of virtual tours will facilitate

medical education students during their clinical clerkship to observe the available facilities without being

limited by time.

1 INTRODUCTION

The implementation of clinical clerkship is a crucial

stage in the medical education system. This process is

an important moment when aspiring medical students

transition from theoretical learning to gaining

practical experience (Konsil Kedokteran Indonesia,

2012). During this transformative journey, there are

several components, and one of them involves

visiting hospital facilities. This activity is important

because it enables medical students to gain a

comprehensive understanding of the actual processes

https://orcid.org/0000-0002-4032-8831

https://orcid.org/0000-0001-6868-7134

https://orcid.org/0000-0002-9421-4207

https://orcid.org/0000-0002-1088-4159

involved in healthcare. In the traditional approach to

clinical education, students are typically organized

into groups and assigned to visit different clinical

facilities. These facilities function as the crucibles of

medical practice, where students observe the practical

application of theoretical knowledge in real-life

scenarios. However, the traditional practice of

conducting in-person visits is not without its

difficulties, which poses a dilemma that requires a

thoughtful and subtle approach. First and foremost,

the process of conducting physical visits requires a

substantial investment of both time and resources.

During times of high demand, the hospital clinic

340

Septama, H. D., Hakim, L., Muhamad, M. A., Rahmayani, F. and Lania, S.

Innovative Hospital Exploration and the Evolving Role of Virtual Reality Tours in the Learning Process of Medical Students During Clinical Clerkship.

DOI: 10.5220/0013672100003873

Paper published under CC license (CC BY-NC-ND 4.0)

In Proceedings of the 1st International Conference on Medical Science and Health (ICOMESH 2023), pages 340-346

ISBN: 978-989-758-740-5

services may experience a high volume of activities.

Management and students frequently encounter

difficulties in coordinating their schedules to align

with the operational hours of the clinical facilities.

Participating in this time-consuming endeavor not

only places an additional burden but also stretches the

already limited resources of educational institutions.

Moreover, the cost of these in-person visits should not

be disregarded. The costs related to transportation,

accommodation, and other logistical factors.

Given these challenges, it is evident that there is a

clear necessity for a paradigm shift. This shift should

involve the adoption of a new approach that surpasses

the constraints of conventional clinical clerkship

implementation. The request is for a method that is

not only efficient but also cost-effective, relieving the

burdens placed on both students and educational

institutions. The experience during the Covid-19

pandemic, where there were physical contact

restrictions, was a valuable lesson that we need to

prepare alternative processes with less physical

contact (Hassan et al., 2022).

The advancement of information technology

enables us to develop technologies that can assist in

that matter. The incorporation of contemporary

technological tools offers the potential to transform

the manner in which medical students interact with

clinical facilities. Virtual clinical experiences, which

are facilitated through innovative platforms, provide

a feasible alternative to in-person visits (Dinh et al.,

2020). This transformative approach utilizes the

potential of digital connectivity to bridge the divide

between theory and practice, without being limited by

time and space constraints.

There are numerous benefits to virtual hospital

tours. One of the most significant advantages is found

in its inherent flexibility. In contrast to traditional in-

person visits, virtual experiences have the advantage

of not being bound by operational hours (Satrya,

2023). This means that students can engage with

clinical facilities visit whenever it is convenient for

them. This flexibility not only empowers students to

balance their educational pursuits with other

commitments but also addresses the perennial

challenge of finding suitable visiting times amidst the

chaotic schedules of clinical facilities. Furthermore,

the significance of the cost-effectiveness of virtual

hospital tours cannot be emphasized enough. The

financial barriers that hinder access to practical

experiences are eliminated, as students no longer

struggle with the economic burdens associated with

physical visits. The elimination of travel and

accommodation expenses democratizes access to

quality medical education. This ensures that every

aspiring medical professional, regardless of their

financial background, can benefit from immersive

clinical experiences.

In order to address these concerns, a potential

solution could be to adopt a hybrid approach that

leverages the advantages of both virtual and physical

experiences. The thoughtful incorporation of virtual

platforms into the current structure of hospital or

clinical tours enables students to take advantage of

the flexibility and cost-effectiveness of virtual

experiences. The advancement of virtual reality

technology enables the creation of virtual visits to

healthcare facilities. The purpose of this research is to

design a virtual reality-based virtual tour of a hospital.

2 RELATED WORKS

Virtual reality (VR) refers to a technologically

simulated experience that utilizes pose tracking and

3D near-eye displays in order to provide users with an

immersive sensation of being present within a virtual

world. Virtual tours using VR technology have

emerged as a new and innovative way to explore and

experience remote places and educational

institutions. VR technology allows users to create

their own customized reality and provides a realistic

and immersive experience. It has been applied in

various industries such as education, tourism, and

hospitality. VR virtual tours have been found to

enhance visualization, understanding, and learning

quality in students (Kishor et al., 2023). Kishor et al

discusses the concept of using extended reality,

specifically virtual reality, to create a virtual tour of a

college campus with a voice assistant service based

on IoT technology. Leshchuk et al (2023) discusses

the use of virtual tours in education, specifically using

VR technologies. It explores the advantages,

disadvantages, and skills that can be developed

through virtual tours. It also provides instructions on

creating virtual tours using the Panotour Pro program

(Leshchuk et al., 2023).

In other works, Firmansyah et al discusses the use

of virtual reality technology for virtual tour training,

which aims to promote school media and shape

visiting patterns (Firmansyah et al., 2023). While

Shuta et al presents a Web-based multi-user Virtual

Reality system for a virtual tour of remote places,

supporting 360-degree images and live 360-degree

videos (Shuta et al., 2023). The exploration of virtual

tourism and the potential of virtual reality (VR) to

enhance the tourism industry is presented by

Polishchuk et al. It mentions the use of VR

technologies to immerse people in a virtual

Innovative Hospital Exploration and the Evolving Role of Virtual Reality Tours in the Learning Process of Medical Students During Clinical

Clerkship

341

environment that recreates touristic destinations and

experiences. However, it does not specifically

mention the concept of a virtual tour using virtual

reality (Polishchuk et al., 2023). Ferbangkara et al

also explore the usability of the Lampung Heritage

Virtual Reality Tour, which is a virtual reality tool for

educating about Lampung's historical heritage

(Ferbangkara et al., 2023). The work of Arago et al

also show that the development of a virtual tour

system using virtual reality technology to offer an

immersive user experience of selected tourist spots in

Manila (Arago et al., 2022).

In the field of healthcare, VR tours have recently

emerged as an innovative tool in the learning process

of medical students during their clinical clerkship

(Nguyen et al., 2023). Virtual reality (VR)-based

learning modules have demonstrated their efficacy in

enhancing pharmacology knowledge among medical

students, as evidenced by previous studies (Vignaraja

et al., 2022). Moreover, these modules have garnered

positive feedback from undergraduate medical

students. Virtual clerkship curricula in anesthesiology

have effectively integrated video-recorded

simulation-based scenarios to offer trainees a

simulated clinical experience (Wang, 2021). The

paper concluded that the virtual format provides a

valuable and informative learning experience. Roni

work shows that most undergraduate medical

students are receptive to VR as a learning tool (Roni

et al., 2023). The COVID-19 pandemic has expedited

the implementation of virtual platforms for medical

education, encompassing the utilization of virtual

reality (VR) technology (Shrivastava & Shrivastava,

2023). The work by Tyastuti et al even advise

community medicine clerkship modules need to be

redesigned for the COVID-19 pandemic. The work

concluded that modifications and variations in

learning methods and coordination are necessary

(Tyastuti et al., 2023).

Based on the aforementioned related works, the

utilization of virtual reality holds immense promise in

revolutionizing the delivery of medical education.

This is because it provides a platform for dynamic and

adaptive learning experiences. The utilization of

virtual induction programs, specifically through the

implementation of video tours, has been discovered

to significantly improve the confidence and

orientation of medical students within hospital

settings. The evolving role of virtual reality tours in

medical education shows promise, as it offers

immersive and experiential learning opportunities for

students during their clinical clerkship.

3 RESEARCH METHODOLOGY

This research will utilize the Multimedia

Development Life Cycle (MDLC) development

model depicted in Figure 1 (Luther, 1994; Rickman

Roedavan et al., 2022). This method offers a well-

organized framework that aims to assist multimedia

developers in navigating the intricate process of

developing interactive and captivating multimedia

content. This type of material may encompass a blend

of textual information, visual graphics, auditory

elements, video clips, animated sequences, and

various other interactive components. The

Multimedia Development Life Cycle (MDLC) plays

an essential role in ensuring the successful execution

of multimedia projects that align with the intended

objectives and user expectations.

Figure 1: Multimedia Development Life Cycle (MDLC)

There are a total of six steps in its development,

namely Concept, Design, Material Collection,

Assembly, Testing, and Distribution (Luther, 1994).

The Concept phase is the initial stage of the project,

where goals and audience are defined. Design

involves the creation of a comprehensive project

blueprint. The Material Collection is responsible for

gathering the necessary assets, such as text, graphics,

and media. Assembly incorporates these elements

through the utilization of authoring tools and

programming. Testing ensures the functionality of a

system or product by identifying and addressing any

potential issues or problems. Finally, Distribution

releases the multimedia project through a variety of

channels. These stages collectively serve as a guide

for the systematic development, ensuring both quality

and effective delivery to the target audience through

an iterative process.

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4 RESULT AND DISCUSSION

4.1 Concept

In the Concept phase, there is a plan to create a virtual

tour media for hospital facilities based on virtual

reality. The main objective is to improve medical

education through delivering a fully immersive

experience for students learning medicine. The target

audience comprises of medical students and

healthcare professionals who are looking for a

thorough understanding of hospital environments.

Feasibility is evaluated by taking into account

technological requirements, budget limitations, and

the potential for collaboration with hospitals. The

scope has been defined, which outlines the specific

hospital areas that will be included. This ensures that

the project remains focused and manageable.

Collaborating with stakeholders, such as hospital and

university management, medical students and VR

developers, ensures that a wide range of perspectives

are taken into account. The conceptual framework is

of greatest significance as it defines the essential

characteristics and interactive components, including

360-degree views, informational overlays, and

interactive simulations. The Concept phase plays an

essential part in ensuring that the VR project is in line

with educational objectives. After discussing with

every stakeholder involved, it has been agreed upon

that there are two levels of user role for this system,

namely administrators and users shown in Table 1.

Table 1: User role and requirement.

Role Re

uirement

Administrator The administrator is able to manage

the virtual tour effectively by

adding spots, reducing them, and

datin

the s

stem.

User Users can view the virtual tour that

has been developed.

4.2 Design

During the complicated design phase of developing a

virtual hospital tour for medical education, a thorough

analysis is conducted. This analysis explores various

aspects such as visual aesthetics, user interface

design, information architecture, navigation

strategies, interactive elements, and the alignment of

storyboarding with educational objectives. Visual

aesthetics serve as a canvas for innovation, as

designers properly create an immersive and visually

captivating environment that goes beyond simple

simulation. Their goal is to elevate medical education

to unparalleled levels.

The design of the user interface takes center stage,

requiring a seamless blend of functionality and user

engagement. The strategic positioning of interactive

elements and the development of an intuitive

interface are intended to empower users to

effortlessly navigate the virtual hospital tour. At the

same time, information architecture is carefully

organized, ensuring that the flow of medical

information is logical and easy to navigate within the

virtual realm. Storyboarding serves as a dynamic

blueprint, aligning the narrative flow of the virtual

tour with educational objectives. The visual roadmap

serves as a guide for the progression of the

experience. It helps refine the structure and pacing to

ensure that each interaction contributes meaningfully

to the overarching educational goals. The design

phase, in essence, involves a meticulous orchestration

of creativity and purpose.

4.3 Material Collection

During the Material Collection phase, an image-

taking activity is conducted at each predetermined

location. A 360-degree image is a photograph with a

2:1 aspect ratio. The length of the X-axis is twice that

of the Y-axis, resulting in an equirectangular shape

for the photo. It is essentially a 360-degree fully

immersive photograph. The capturing of a 360

Equirectangular Image is carried out by team

members using a 360 camera depicted in Figure 2.

Another camera is also used to capture images that

will be used as icons for each location. The results of

the graphic that is collected in this phase will be

analyzed and stitched in the subsequent phase. The

photo shoot is scheduled during non-peak hours at the

pre-determined location to ensure optimal photo

taking and minimal disruption to the clinic's

activities.

Figure 2: 360 Equirectangular panoramic image taking

Innovative Hospital Exploration and the Evolving Role of Virtual Reality Tours in the Learning Process of Medical Students During Clinical

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4.4 Assembly

The subsequent stage is Assembly, which involves

the connection (stitching) of the collected images to

produce a wide panoramic image and its integration

into the virtual tour application. The assembly phase

for a virtual hospital tour in medical education is a

complex process with multiple facets. The process

includes integrating multimedia assets, programming

interactivity, implementing user controls, fine-tuning

visual and audio elements, creating interactive

simulations, iteratively refining, and integrating

assessment mechanisms. This phase plays an

essential role in converting the gathered materials into

a unified and engaging educational experience that

aligns with the overall objectives of the hospital

virtual tour in relation to medical education during

clinical clerkship. The sample of original 360

equirectangular image, taken from the 360 camera

depicted in Figure 3, was processed as shown in

Figure 4.

Figure 3: 360 Equirectangular image

Figure 4: The result of processing a 360 equirectangular

image

4.5 Testing

The Phase Testing is conducted to test the virtual tour

system that has been created, ensuring that every

feature functions as intended. After conducting

testing on the created virtual tour system, all

navigation menus within the system are functioning

properly. According to black-box testing shown in

Table 2, all features are working properly. This

system can be used as a virtual tour medium for

students during clinical clerkship to convey

information about existing health facilities. Through

this virtual tour system, students can see the health-

care facilities that the hospital has, such as clinic

rooms, administration areas, laboratories, and other

common facilities.

Table 2: Testing scenario and results

No. Scenario Expected Results Result

Functional Feature

1 Explore virtual

hospital locations.

User visit hospital

spot in Virtual

Reality

Pass

2 Access

information

regarding virtual

hospital facilities.

Information

displayed on

hospital facilities

spot

Pass

3 Choose a virtual

hospital location

using the

location panel..

User teleport to a

chosen location.

Pass

Non Functional

4 Can make a

selection by

using the view

option,

specifically

through Gaze

Control.

Processed in 1,5

seconds

Pass

5 User may use

stereoscopic

display

Display in

stereoscopic

Pass

6 Place switching

can occur

instantly.

(Teleport)

Teleportation Pass

7 Can return to the

home menu from

any screen

Home menu button

and functional

Pass

8 Can exit the

application

Exit button and

functional

Pass

4.6 Distribution

Once the virtual tour has been refined and is ready for

deployment, the next step is to consider strategies for

widespread dissemination. This task entails

determining the most efficient channels and platforms

for reaching medical students and management. One

potential distribution avenue could be online

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platforms, which would ensure convenient access for

students in various locations. The presentation of

each location is in the form of a 360-degree

panoramic photo depicted in Figure 5.

Figure 5. Web-based 360 Hospital Virtual tour

The Distribution phase also takes into account the

technical requirements for end-users, ensuring

compatibility with a wide range of VR devices. Clear

documentation and support mechanisms have been

established to assist users in accessing and navigating

the virtual hospital tour effortlessly. Figure 6 depicts

the final product that was delivered to the medical

students, who are the users.

Figure 6. Final product of hospital tour by using VR

5 CONCLUSIONS

The concept of a virtual tour of hospital facilities

based on virtual reality has been successfully

developed. According to black-box testing, all

features are working properly. The presence of virtual

tours will facilitate medical education students during

their clinical clerkship to observe the available

facilities without being limited by time. Users can

access the virtual tour either through web access on a

computer device or by using a VR device.

ACKNOWLEDGEMENTS

We would like to express our sincere appreciation to

the Higher Education for Technology and Innovation

(HETI) Project Unila for their support in funding this

research through the Innovation and Domestic

Collaboration Research Scheme for the year 2023.

We would also like to express our gratitude to Abdul

Moeloek General Hospital and the Faculty of

Medicine at the University of Lampung for their

collaboration in this research project.

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