Enhanced consent and patient counselling using Virtual Reality for patients undergoing shockwave lithotripsy: Prospective outcomes from a university teaching hospital

Dara Bamerni, Loretta Tear, Tanya Davis, Phoebe CJ Reynolds, Amelia Pietropaolo, Bhaskar K. Somani

Objective: To discover the effectiveness of VR in improving patient understanding and enhancing the consent procedure for patients undergoing extracorporeal shockwave lithotripsy (SWL). The primary outcomes measured include patient knowledge, pain perception, and emotional well-being.

Methods: For this prospective study (ERGO 92019), patients with kidney stone disease (KSD) undergoing SWL were given a Surgassists VR headset before their treatment. The VR glasses visually explained the SWL process (3 minutes) and its success and complications through an audio explanation linked to a 3D animation. The content followed the patient information leaflet (PIL) from European and British associations. Participants were provided with three questionnaires that covered pain, anxiety, and patient understanding of SWL via the VR enhanced consent (one questionnaire each).

Results: 100 patients completed all three questionnaires. 68 patients reported an improved understanding of SWL with Surgassists VR, and the overall improvement in patient understanding was statistically significant. Participants also found the Surgassists VR headset significantly more helpful and accessible and felt more confident explaining the procedure. 66 participants preferred Surgassists VR to current teaching methods, and 81 firmly favoured using Surgassists VR for future procedures.

Findings also demonstrated a positive emotional impact, with participants reporting more positive and fewer negative emotions after VR use.

Conclusion: Our study showed that incorporating Surgassists VR into the consent process effectively improves patient understanding and experience, with widespread approval. Surgassists VR improved the psychological well-being of patients undergoing surgical procedures, highlighting the potential for VR to play a significant role in enhancing consent.

Keywords: Virtual Reality, Enhanced consent, Patient Understanding, Shockwave Lithotripsy, Informed consent, Shared Decision Making, Decision Aids