Fifth day, the last day in Jakarta.
Workshop 3 concluded with a visit from all CHAPTER Sea partners to the Bogor Botanical Gardens to breathe in the fresh air while observing various types of Indonesian trees.

Inside this 200-year-old botanical conservation garden, the delegation was divided into two groups to explore various types of plants in the Nepenthes Garden, Bamboo Garden, and Gunting Lake. Guided by plant experts, the delegation toured and studied both newly planted and long-established trees that have been growing for hundreds of years. Don't forget, the delegation viewed the Presidential Palace in Bogor from the direction of Lake Gunting. The Bogor Botanical Garden tour was complemented by a wooden sandal race that challenged all participants to collaborate well, step accurately, and achieve victory.

"You must collaborate well, not only with your steps and brains but also with your teammates to achieve optimal, fast, and efficient steps." Start together with your left and right feet simultaneously as a team. Happy collaborating!

The male and female teams are each followed by various countries, with judges selected representatively from all delegations. All participants strive to show their best collaboration in the semifinals, and in the end, only the selected teams that can coordinate well are chosen as the winners. Today, the collaboration skills of all teams were tested in the wooden sandal race. Although it seemed simple, only the best teams could become champions. Congratulations to the champions.

The Bogor Botanical Garden tour concluded with an Indonesian-style lunch and the presentation of Workshop 3 graduation certificates, followed by a technical meeting regarding the next workshop.

See you all again at Solna, Sweden!

The fourth day is the busiest day at Workshop 3.

There are so many agendas to tackle today from morning until night. The morning began with the PSC Meeting – Financial & Administrative Matters from each institution for the continuation of the second year of collaboration. The discussion of a very tight schedule and outputs coloured the PSC Meeting.

The next session continued with a discussion on CASUS, a virtual patient platform that will be used in this collaboration, guided by Andrzej Kononowicz and Malgorzata Sudacka from Jagiellonian University, Poland. Not to be missed, the presentation of the progress outcome "Potential Publication" from institutions delivered by Universiti Putra Malaysia, Taylor University, and Universitas Islam Negeri Syarif Hidayatullah. Each provided an overview of the implementation of virtual patients at their institutions, including both benefits and challenges. The CHAPTER Sea team from Universiti Putra Malaysia shared about one of the articles that is already in the revision process in an international journal and reminded all partners to help expedite the revision process. Meanwhile, the CHAPTER Sea team from Syarif Hidayatullah State Islamic University presented the results of the Pilot Study on the Implementation of Virtual Patients at the Faculty of Medicine, Syarif Hidayatullah State Islamic University, highlighting the differences in the acceptance of virtual patients at the preclinical and clinical stages. Everything is interesting and stimulates participants to learn even more!

The next equally important schedule is the official consortium photo session at various locations organised by the Faculty of Medicine, Syarif Hidayatullah State Islamic University, as documentation for the Workshop 3 Jakarta Meeting.

Not to forget, the activities were interspersed with an Indonesian-style lunch, namely purple sweet potato rice with various side dishes served in besek, special boxes woven from bamboo, which support Syarif Hidayatullah State Islamic University in achieving a Green Campus.

The fourth day ended with an Indonesian Speciality Dinner in a warm atmosphere to bring all partners closer together.

Third day, still with the spirit of collaboration!

But today we will have more action and practical sessions from Workshop 3.

The initial session is led by Nadia Davoody from the Karolinska Institute, Sweden, regarding feedback, emphasising that giving feedback is very important in the development of collaboration but requires special skills to provide feedback that fosters collaboration.

To make the discussion more refreshing and energetic, the third day of the Workshop 3 was complemented with Indonesian snacks and es campur (mixed ice) that participants could take at any time to stay focused. Es campur is one of the Indonesian desserts that consists of various types of jelly, some fruits, sweetened condensed milk, syrup, and shaved ice, which is certainly the most effective remedy against drowsiness.

The afternoon session is divided into two parts, namely the interview session and the World-Café session. The interview session is conducted with Natalia Stathakarou and Nadia Davoody from the Karolinska Institute, Sweden, where all partners take turns providing information related to collaborative learning in their respective institutions. This information will be useful for understanding the state of collaborative learning across all CHAPTER Sea partner institutions.

The World-Café session was led by Andrzej Kononowicz and Malgorzata Sudacka from Jagiellonian University, Poland, where each institution opened a café and presented its ideas for other institutions to understand. By exchanging ideas between institutions in this short time, each partner and their institution can quickly grab examples of collaborative learning. The third day concluded with a take-home message about collaborative learning filled with innovation and challenges.

In the morning, to feel more refreshed, it started with a debriefing with Andrzej Kononowicz and Malgorzata Sudacka from Jagiellonian University, Poland, where each team was asked to solve a problem. Teams consisting of various university and country delegations, with a wide range of cultural differences, attempted to solve problems collaboratively. In line with the theme of Workshop 3 this time, which is Collaborative Learning Using Virtual Patients, participants are actively asked to play a role in problem-solving, making that morning the beginning of The Collabor-active Session!

The following sessions, guided by Natalia Stathakarou, Nadia Davoody, and Maxine Harjani from Karolinska Institute, Sweden, all SEA partners were trained through face-to-face workshops on the use of virtual patients with a collaborative learning approach as the initial foundation for students to learn collaboratively. The themes to be discussed in depth include collaborative learning pedagogy, collaborative learning methods utilizing virtual patients to strengthen collaborative learning in student-centred learning.

To boost energy and spirit, the catering team provided a beautiful tumpeng surrounded by eight richly flavoured side dishes from Indonesia. For the Indonesian people, tumpeng rice is not just food but also full of local wisdom philosophy, symbolising gratitude, prayers to God, and harmony between humans, nature, and God the Creator. Shaped like a cone resembling a mountain, tumpeng symbolises the straight path to God (tumapaking gusti pangeran tumindak), and is often interpreted as a Javanese acronym yen metu kudu mempeng (if you go out, you must do it sincerely).

Of course, the enthusiastic learning of Indonesian participants on this second day is not just a curiosity about collaborative learning, but also a part of emulating the inspiration of the Indonesian nation from one of Indonesia's national female heroes, Raden Ajeng Kartini. On Kartini Day, which falls on April 21, all Indonesian women remember the efforts of Kartini in advocating for the advancement of education for Indonesian women, including studying virtual patients with a spirit of collaboration.

Delicious Collaborative Tumpeng in Kartini Day !

Let’s collaborate !!!

Selamat Datang di Jakarta !

Workshop 3 CHAPTER SEA this time is held in Jakarta from April 20 to 24, 2024. Located in the meeting room on the 4th floor of the Faculty of Medicine at UIN Syarif Hidayatullah Jakarta, all delegates gathered again to strengthen their collaboration with the main theme of Collaborative Learning Approaches.

The morning session began with a Cultural Session to boost enthusiasm and better understanding of Indonesian culture. Strengthened by four "Cultural Challenges," all participants actively engaged in taking on these challenges!

The first challenge was to perform a very energetic traditional dance that requires quick movement coordination, namely the Saman Dance from Aceh. Five amazing women dared to take on the challenge and performed it very well.

The second challenge, wearing a pair of traditional outfits from Java, Bali, and Padang. Each traditional outfit is equipped with detailed accessories that should not be mismatched. Three great men and three beautiful women successfully wore the outfits and explained "kebaya," "udeng," "keris," and "jarik" very accurately.

The third challenge, singing the traditional Indonesian song, Ampar-Ampar Pisang, in its original language, and the next vocal group was able to sing the song accurately and in its original language. Magnificent!

The fourth challenge was to explain traditional Indonesian snacks, and the very talented team managed to explain "pastel," "risoles," "combro," "kue lapis," and "lemper ayam" with the quality of a journal reviewer! Overall, the morning session was filled with storytelling, enjoying snacks from various countries brought by the delegates, with a strong atmosphere of collaboration to achieve the best results. The morning session was closed with Biannual Meeting Orientation and Deliverables Overview from the CHAPTER SEA Coordinator Project, Dr. Lee Yew Kong, and Jakarta CHAPTER Sea Project PIC, Dr. Fika Ekayanti. After the morning session, nasi liwet enriched with coconut milk and empal beef meat were ready for lunch.

So delicious and yummy !!

The afternoon session continued with the opening of the Jakarta Workshop of CHAPTER Sea by the Rector of UIN Syarif Hidayatullah Jakarta, Prof. Asep Saipudin Jahar. In this meeting, Rector Asep expressed his support for the virtual patient collaboration as part of the development of UIN Jakarta's cooperation. The opening ceremony was also complemented by speeches from the Dean of the Faculty of Medicine at UIN Jakarta, Dr. dr. Achmad Zaki, and the CHAPTER Sea Coordinator Project, Dr. Lee Yew Kong. The afternoon session included a discussion on Lesson Plans and Evaluation among the delegates.

The afternoon session was concluded with an Evening Walk at Situ Gintung Lake accompanied by a Bakiak Race between groups, as one of the experiences of playing traditional Indonesian games. A game that requires excellent coordination and teamwork between the team.

Prepared by: Dr Panagiotis Antoniou, A/Prof Dr Lee Yew Kong, Hafsa Mahbub

1. Background
On 16/10/2025 the multiplier event titled “Southeast Asian Collaborations for Digital Healthcare Education Transformation” for two closely aligned EU projects in Southeast Asia took place.

CHAPTER SEA (Culture and Health system Adaptation of virtual Patients as collaborative learning eResources SouthEast Asia, Project Number: 101178356) and DISCERN-DSS (DIgitally enhanced SCenario basEd leaRNing for Digital Soft Skills, Project Number: 101179391) project teams held a multi-faceted event for proliferating their first results and building synergies for digital health in the SE Asia region. Both projects are capacity building Erasmus+ projects, funded by the European Union. They both aim to enhance digitalization of healthcare education in Malaysia and Indonesia respectively.

CHAPTER SEA (https://chaptersea.com) aims to enhance healthcare education in Malaysia and Indonesia by training five healthcare schools to adopt and implement virtual patient cases from Europe. Virtual patients are online cases used to improve clinical reasoning and decision-making skills. The project addresses challenges in using technology, especially in lower-middle-income countries, by providing guidance on selecting, adapting, and integrating digital tools into medical programs.

DISCERN-DSS (https://discern-dss.eu/), on the other hand aims to introduce digital scenario- based learning, virtual patients, for teaching digital soft skills to healthcare professionals in Indonesia. Skills such as ethical telemedicine, responsible use of digital tools such as AI and personal health record, are essential for digitally ready healthcare professionals. In that context, digital scenario-based learning in the form of interactive scenarios is essential for experiential teaching of such topics.

Both projects have shared goals in promoting the use of scenario-based digital health education in the Southeast Asian countries of Malaysia and Indonesia. In that context, the multiplier event that was organized had the aim to proliferate the first outcomes of these projects, reinforce their position as digital health force multipliers and new initiatives.

2. Program Flow

The following Table outlines the 3-hour online event program, with time slots in Malaysian time (GMT+8).

2.1 Formal address
The event kicked off with a formal address by Ms. Lauriane Bertrand, Deputy Head of Unit for Erasmus+ International Capacity Building, representing the European Union. Her opening remarks set the tone for the event, acknowledging the significance of international collaboration in advancing digital healthcare education and the European Union's commitment to supporting capacity-building initiatives in Southeast Asia.

2.2 Partner University Introductions
A segment of the program was dedicated to introductions from eleven partner universities. The European partners included:
• Aristotle University of Thessaloniki (Greece), represented by Prof. Panagiotis Bamidis
• Jagiellonian University (Poland), represented by Ms. Joanna Fafarek
• Karolinska Institutet (Sweden), represented by Ms. Natalia Stathakarou
• European Union of Medical Specialists (UEMS), represented by Ms. Isabelle Dumaine

The Southeast Asian partners comprised:

• Universitas Gadjah Mada (UGM), Indonesia, represented by Dr. Wika Hartanti
• Universitas Sebelas Maret (UNS), Indonesia, represented by Prof. Ari Natalia Probandari
• Universitas Muhammadiyah Yogyakarta (UMY), Indonesia, represented by Prof. Erna Rochmawati
• Universiti Malaya (UM), Malaysia, represented by Dr. Tong Wen Ting
• Universiti Putra Malaysia (UPM), Malaysia, represented by Dr. Irmi Ismail
• Taylor's University (TU), Malaysia, represented by Dr. Renukha Sellapans
• UIN Syarif Hidayatullah Jakarta (UIN), Indonesia, represented by Dr. Fika Ekayanti

2.3 Project Overview Presentations

Two foundational presentations introduced the core projects driving this collaboration:

Dr. Panagiotis Antoniou presented DISCERN-DSS, bringing his extensive expertise as a senior research associate and Laboratory Reader in the Lab of Medical Physics and Digital Innovation at Aristotle University of Thessaloniki's School of Medicine. As Implementation Coordinator of DISCERN-DSS, Dr. Antoniou has substantial experience in technology- enhanced learning research projects for healthcare.

Assoc Prof Dr. Lee Yew Kong provided an overview of CHAPTER SEA. As Main Coordinator of the project and Associate Professor at the Department of Primary Care Medicine, University of Malaya, Dr. Lee leads several eLearning and eHealth initiatives, positioning him ideally to articulate the project's vision and objectives.

2.4 Featured Speaker Sessions

The program featured four specialized presentations addressing aspects of digital healthcare education in Southeast Asia:

2.4.1 Culture and Content Adaptation of Virtual Patients

Dr. Puteri Shanaz Jahn Kassim from Universiti Putra Malaysia presented a needs analysis on culturally adapting virtual patients for Southeast Asian settings. Dr. Puteri Shanaz is a Family Medicine Specialist and Lecturer whose PhD research focused on digital behavior change interventions to promote physical activity among adolescents with overweight and obesity. Her work bridges research and education, with particular expertise in lifestyle medicine, behavior change, and evidence-based preventive care. Her presentation addressed the need of localizing virtual patient content to reflect regional medical education contexts and cultural nuances.

2.4.2 Digital Soft Skills Conceptual Framework

Dr. Niki Pandria from Aristotle University of Thessaloniki presented the conceptual framework for digital soft skills in healthcare education. Dr. Pandria brings a unique interdisciplinary background, holding a Medical Degree, B.Sc. in Mathematics, M.Sc. in Statistics and Modeling, and a Ph.D. in Computational Neuroscience focusing on biofeedback and neurofeedback. As a Postdoctoral Research Fellow at the Laboratory of Medical Physics and Digital Innovation, her research bridges neuroscience, biomedical engineering, and digital health.

2.4.3 Curricular Needs for Digital Soft Skills in Indonesia

Dr. Amandha Boy Timor Randita from Universitas Sebelas Maret addressed the specific curricular requirements for integrating digital soft skills into Indonesian medical education. As a lecturer at the Faculty of Medicine, his research focuses on curriculum development, interprofessional collaboration, neuromuscular rehabilitation, pain management, and child growth and development. His presentation illuminated why digital soft skills technology is essential for Indonesian healthcare education.

2.4.4 Best Practices for Open Educational Resources

Prof. Dr. Ardi Findyartini, Director of Transformative Learning Strategies and System at the Directorate General of Science and Technology, Ministry of Higher Education, Science and Technology, Republic of Indonesia, delivered the final speaker session. In her influential governmental role, Prof. Ardi provided high-level strategic perspectives on adapting open educational resources for Southeast Asian contexts, illustrating innovative approaches to strengthen accessibility and implementation of open educational resources throughout the region.

2.5 Panel Discussion

The program's capstone was a 40-minute panel discussion exploring "What is the Vision of Digital Healthcare Education in Southeast Asia?" This session was co-facilitated by Assoc Prof Dr. Lee Yew Kong (CHAPTER SEA Main Coordinator), Universiti Malaya, and Dr.
Anastasia Rodina-Theocharaki (DISCERN-DSS EU Projects Manager), Aristotle University of Thessaloniki.
The panel featured four distinguished experts:

Professor Dr. Lee Ping Yein (CHAPTER SEA) - Professor of Family Medicine and Consultant Family Physician at University of Malaya. Prof. Lee has led multiple projects on reusable learning objects, virtual patients, and eHealth apps. She is founding institutional lead of the Asia Pacific Academic Primary Care Group Foundation and Chief Editor of the Malaysian Family Physician Journal.
Dr. Lutfan Lazuardi, M.Kes, Ph.D (DISCERN-DSS - UGM) - Head of the Department of Health Policy and Management at Universitas Gadjah Mada. His expertise spans digital health transformation, health information systems, and policy innovation, having led national and international projects on digital health interoperability and curriculum development.
Dr. Sri Sundari, M.Kes (DISCERN-DSS - UMY) - Holds a Doctor of Medicine degree, Master of Health degree, and Doctorate in Medicine from Gadjah Mada University. Dr. Sundari is a certified primary care physician and certified professional lecturer by the Ministry of Education, Culture, Research, and Technology of Indonesia.
Dr. Fika Ekayanti, MD (CHAPTER SEA) - Senior Lecturer and Vice Dean of Academic Affairs at Syarif Hidayatullah State Islamic University Jakarta. Dr. Ekayanti has managed medical education projects related to curriculum modification and bioethics, and led her medical faculty's accreditation with distinguished results.
The discussion addressed questions affecting the future of digital health education in the region:
• Are there any regional collaborations or cross-border initiatives currently shaping digital health education in SEA?
• Are ERASMUS collaborations scalable and what is their position in relation to SEA digital health education transformation?
• How can SEA universities collectively address disparities in digital infrastructure and access?
• How do we ensure digital healthcare education reaches rural and underserved communities?
• What strategies are being used to support students with limited digital literacy or access?
• How do we ensure digital education doesn't compromise hands-on clinical training?

The interactive format encouraged speakers to give their take on digital health, fostering engagement between the expert panel.

3. Program result

The event attracted a total of 222 participants who registered for the event.

The event was coordinated by 14 volunteer committee members from both projects and from 5 different institutions.

4. Conclusion

In conclusion, the event demonstrated the untapped potential for regional collaboration in the sector of digital health education. From the event’s discussions it became clear that both DICERN-DSS and CHAPTER SEA can become the initial triggers for a cascade of future endeavors for digital health training in the region. New, disruptive technologies such as Virtual and Augmented Reality (VR/AR), Artificial Intelligence (AI) are quickly coming in the mainstream of healthcare sector. Training and exposure to these newer technologies underpinned by use of established pedagogical frameworks and implementation protocols facilitate a more robust application of these technologies in the region. By mainstreaming pedagogical innovations such as scenario-based learning it is expected that a virtuous cascade of digital health innovations will transform the landscape of tertiary healthcare education in the SE Asia region.

The workshop continued on the fourth day with a discussion on virtual patients from cultural and interprofessional education perspectives. Maxine G. Harjani and Klas Karlgren draw examples from various literature, the use of artificial intelligence (AI) for case adaptation, and several frameworks for understanding cultural differences in virtual patient scenarios.

The main framework discussed is Hofstede's framework, which focuses on six cultural dimensions including power distance, individualism vs. collectivism, masculinity vs. femininity, uncertainty avoidance, long-term vs. short-term orientation, and indulgence vs. restraint, to understand. Power distance shows data on how the distribution of power affects decision-making within a society, while individualism vs. collectivism examines how individual or collective approaches influence decision-making. Individualistic societies focus on personal goals, while collectivist societies focus on collective harmony. The gender approach to masculinity vs. femininity is no less interesting to discuss in relation to the different values between masculine and feminine societies. At the end of the session, Klas focused on data from various countries regarding uncertainty avoidance, long-term vs. short-term orientation, and indulgence vs. restraint. Klas also emphasized that Hofstede's Framework approach is often criticized for oversimplifying the highly diverse cultural landscape, but that it can at least be used to facilitate understanding of how international business and intercultural communication function.

The fourth day's workshop concluded with the creation of a CASUS patient concept map that will be implemented in the local setting.

The Workshop 2 – Implementation and Adaptation of VP’s

Chapter SEA 15^th – 19^th September 2025 Second Project Meeting Krakow

The third day's workshop was themed around implementation plans and action plans. The freezing temperature did not dampen the spirits of all consortium members to give their best presentations. In the morning session, all consortium members from Universiti Malaya, Universiti Putra Malaysia, Taylor University, Universitas Gajah Mada, and UIN Syarif Hidayatullah Jakarta presented their plans for implementing virtual patients at their institutions, as well as more detailed action plans on how cases would be applied in the curriculum, identifying strengths and challenges.
The workshop sessions were interspersed with hot tea and coffee to combat the increasingly cold temperature.

After morning tea, the session resumed with presentations from consortium members, coordinated by the Project Leader of CHAPTER SEA, Dr. Yew Kong Lee, covering case selection, adaptation to cards, adaptation to concept maps, and adaptation of documentation templates.
This session delves into more detail about the preparation for implementing virtual patients in the curriculum that will be used by each consortium member, with the hope that after Workshop 2, virtual patients can be implemented immediately across all consortium members.

The third day's workshop concluded with a "Walk Away" around Jagiellonian University to see more of the culture, history, and buildings of Poland's oldest university, and ended with a Social Dinner for all consortium members at Cafe Oranzeria Restaurant (Hotel Kossak 7th Floor) to allow all consortium members to get to know each other better and exchange experiences.

The Workshop 2 – Implementation and Adaptation of VP’s

Chapter SEA 15^th – 19^th September 2025 Second Project Meeting Krakow

Workshop 2, themed "Virtual Patient Implementation and Adaptation," began with a presentation by Dr. Andrzej Kononowicz on Implementation Science and its benefits in curriculum implementation and shifting from a "let it happen" to a "make it happen" paradigm. Five theories were presented as approaches to implementation science: process models; determinant frameworks; implementation theories; classic theories; and evaluation frameworks. The next session continued with Joanna Fąferek, who emphasized the need for a systematic review to determine the best framework for curriculum implementation. ICoVIP Framework 14 themes can be one of the frameworks for curriculum implementation, and one important thing to remember in curriculum implementation is that curriculum implementation is a continuous process that never ends. In Session 3, Małgorzata Sudacka added an explanation of the challenges and difficulties in implementing the clinical reasoning curriculum thru her multi-center research at several health faculties in Europe. Thru this qualitative research, many obstacles and challenges were found in the implementation of the clinical reasoning curriculum, including time, culture, teaching, assessment, motivation, infrastructure, and concepts.

The final workshop session by Klas Karlgren from the Karolinska Institute explained that curriculum implementation requires a lot of learning and some pilot tests need to be done, and not to be afraid of failure because challenges and failures will lead to more improvements, just like the story of the Andree's Arctic Balloon Expedition, which reinforces that success and failure are part of implementing educational innovation. The pre-lunch session was deepened with the sharing of educational innovation implementation by consortium participants from Universiti Malaya, Universiti Putra Malaysia, Taylor University, Universitas Gajah Mada, and UIN Syarif Hidayatullah Jakarta, while also identifying the challenges and strengths of each consortium member in implementing the curriculum. The first day's two-day workshop concluded with hands-on training on VP curriculum implementation, including details and assessments.

Chapter SEA 15^th – 19^th September 2025 Second Project Meeting Krakow

On September 15, 2025, all teams from the CHAPTER SEA consortium reconvened in Krakow, Poland, following a meeting at Universiti Malaya in Malaysia 9 months prior. In the tranquil city of Krakow, various delegations from Universiti Malaya (UM), Universiti Putra Malaysia (UPM), Taylor University (TU), Universitas Gajah Mada (UGM), UIN Syarif Hidayatullah Jakarta, and Karolinska Institute (KI), met at Jagiellonian University (JU), the oldest and number one university in Poland.

The opening ceremony was opened by the Vice-Rector for Research and Infrastructure, where the Vice-Rector emphasized the importance of international cooperation in improving education, including thru the CHAPTER SEA grant. After the opening, the Project Leader of CHAPTER SEA, Dr. Yew Kong Lee, did not forget to give a souvenir to the Vice-Rector for Research and Infrastructure for the exceptional reception by Jagiellonian University.

The event continued with Dr. Andrzej Kononowicz explaining the workshop's 5-day agenda in Krakow, including what would be achieved during the workshop. During this session, Dr. Yew Kong Lee, the Project Leader of CHAPTER SEA, also presented a "Summary of Current Project Status" to remind participants of the goals and outcomes to be achieved thru CHAPTER SEA, one of which is the implementation of virtual patient cases for 1000 students, approximately 120 – 400 students at each institution. Not to be forgotten, the first day included an icebreaking session led by Małgorzata Sudacka from Jagiellonian University, starting with morning exercises together, BINGO games, singing Polish songs, dancing traditional Polish dances, reading Polish poetry, and concluding with a presentation of traditional Polish costumes. The first day concluded with a Project Steering Committee Meeting for all teams.