Purpose or Case Report: Virtual reality (VR) has been used successfully as a psychological preparation tool in the pediatric patient population for elective surgery, oncological procedures and pain management. MRI exams require patients to remain motionless in a small, confined space for extended periods of time creating nervousness and an inability to hold still. VR offers a new way to prepare pediatric patients for MRI through simulations to reduce nervousness and decrease motion, resulting in more successful imaging outcomes. This study is designed to assess if VR simulations of an MRI exam can increase anticipatory knowledge and reduce nervousness in a pediatric cohort.
Methods & Materials: 30 pediatric patients were enrolled at an academic outpatient imaging facility (16 males, 14 females; mean age 11.7 years, range 7 years to 18 years). The VR application provided patients with an immersive simulation of an MRI assisted by a child life specialist. Patients were given the same survey pre and post VR simulation. They were asked to rate their degree of nervousness for the exam on a 10-point likert scale and if they knew what their MRI exam would be like. Patients were also asked pre and post VR simulation to rate whether their head hurt, eyes hurt, had an upset stomach, or felt dizzy to assess for “simulator sickness.” A post MRI survey was also given and patients rated whether the VR simulation made them feel less nervous, helped them practice lying still, and whether they would recommend the VR simulation. Changes in likert survey responses pre and post VR simulation were assessed with non-parametric paired Wilcox signed rank tests (p-value < 0.05).
Results: VR not only increased patients’ knowledge about what to expect for their MRI exam (p < 0.0001) but also subjectively reduced their nervousness for the exam (p < 0.0002). Patients reported not feeling a difference before or after VR as to whether their head hurt (p = 0.7), eyes hurt (p = 0.4), stomach hurt (p =0.1), or they felt dizzy (p = 0.5). Patients felt that the VR simulation reduced their nervousness (average 8.6 out of 10), allowed them to practice lying still (average 6.8 out of 10), and would recommend the VR simulation to other pediatric patients (average 9.1 out of 10).
Conclusions: Based on patient survey responses, VR simulations reduce patient nervousness and increase anticipatory knowledge for pediatric MRI exams. Follow up studies are being performed to look at the effect of VR simulations on imaging outcomes.