Children’s Hospital of Richmond at VCU tested whether a short virtual reality session could fit into routine care for children waiting for elective surgery. In a quality-improvement study from October 2023 through June 2024, 80 children aged 6–15 used VR in the preoperative holding area. Researchers compared each child’s scores before and immediately after the session. There was no concurrent control group.
Children wore a Meta Quest 2 headset and could explore a virtual playroom or a beach scene built in Unity. They could interact using their gaze or a controller. The team refined the protocol across five improvement cycles, adding a tablet view so caregivers could see what their child saw. Sessions lasted a median of nine minutes, with an observed range of five to 20 minutes.
Changes immediately after VR
Abu Rukbah and colleagues reported the following changes among the 80 children between baseline and the immediate post-session assessment.
- On the 0–10 self-rated distress scale, the median within-child decrease was 2 points. The group median fell from 3 to 1.
- On the 0–4 Children’s Fear Scale, the median within-child decrease was 1 point. The group median fell from 1 to 0. The scale was originally validated for ages 7–12.
- Mean heart rate fell by 5.8 beats per minute, and mean systolic blood pressure fell by 4.1 mmHg.
Caregiver anxiety scores were mixed. Among 65 parents or caregivers, scores fell for 35, stayed the same for 15 and rose for 15. The group median stayed at 14 on the six-item State-Trait Anxiety Inventory.
Feedback and practical use
- In post-session feedback, 71 of 80 children (88.8%) said VR helped with their anxiety, and 73 of 80 (91.2%) said they would use it again. Among parents or caregivers, 62 of 65 (95.4%) said they would recommend it.
- In surveys during the study, 82.8% of the 29 participating nurses rated the system extremely easy to manage, and 27 of 29 (93.1%) felt it enhanced patient care. All 29 would recommend it for pediatric procedures. Two reported a workflow disruption.
- The authors reported no equipment failures across 80 sessions at the study site. Setup averaged 7.2 minutes in the final cycle. Three of the 80 children had minor adverse effects.
What the study can establish
The single-site study describes how VR fit into the preoperative workflow and how scores changed over one session. With each child’s baseline as the only comparator, the study leaves open how much of the change came from VR, settling in the holding area or other aspects of care. Its immediate assessments also leave open whether the changes lasted through anesthesia induction or recovery.
The authors reported no specific funding and declared no competing interests.
