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Virtual Reality to Improve the Experience of the Mohs Patient—A Prospective Interventional Study

Higgins, Shauna MD*,†; Feinstein, Shera BA*; Hawkins, Makenzie MSPH; Cockburn, Myles PhD*,‡,§,║; Wysong, Ashley MD, MS*,†

doi: 10.1097/DSS.0000000000001854
Original Article

BACKGROUND Nonmelanoma skin cancer is the most common cancer in the United States with significant quality of life impact.

OBJECTIVE To assess the utility of a highly immersive virtual reality (VR) experience in the context of outpatient skin cancer surgery as a means to minimize patient-reported feelings of anxiety or pain. The authors also sought to assess the effects on patient-reported overall satisfaction.

MATERIALS AND METHODS Patients completed a pre-VR experience survey after completion of their first Mohs surgery layer, followed by a 10-minute VR experience, and a post-VR experience survey. Differences in the pre-VR survey and post-VR survey were compared using the chi-square test. The anxiety scores were compared using a t-test.

RESULTS In all but 2 questions, there was a trend toward improvement of the anxiety-related sensations after completion of the VR experience. There were statistically significant differences for 4 questions: “Are you currently feeling unable to relax” (p = .0013), “are you currently feeling fear of the worst happening” (p < .0001), “are you currently feeling terrified or afraid” (p = .0046), and “are you currently feeling nervous” (p < .0001).

CONCLUSION Virtual reality experiences during the Mohs surgical day significantly improved measures of anxiety and patient satisfaction.

*Department of Dermatology, Keck Medicine of the University of Southern California, Los Angeles, California;

Department of Dermatology, University of Nebraska Medical Center, Omaha, Nebraska;

Cancer Prevention and Control Program, University of Colorado Cancer Center, University of Colorado, Aurora, Colorado;

§Department of Dermatology, School of Medicine, University of Colorado, Aurora, Colorado;

Department of Preventive Medicine, Keck School of Medicine of the University of Southern California, Los Angeles, California

Address correspondence and reprint requests to: Ashley Wysong, MD, MS, 985633 Nebraska Medical Center, Omaha, NE, 68198‐5633 or e-mail:

The authors have indicated no significant interest with commercial supporters.

Springbok Cares provided the personnel and virtual reality equipment required for completion of this study free of cost.

© 2019 by the American Society for Dermatologic Surgery, Inc. Published by Wolters Kluwer Health, Inc. All rights reserved.
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