This review found moderate evidence for the reduction of pain and functional impairment after IVR in patients with acute pain. Further high-quality studies are required for the conclusive judgment of its effectiveness in acute pain, to establish potential benefits for chronic pain, and for safety.

BackgroundVirtual reality (VR) therapy has been explored as a novel therapeutic approach for numerous health applications, in which three-dimensional virtual environments can be explored in real time. Studies have found positive outcomes for patients using VR for clinical conditions such as anxiety disorders, addictions, phobias, posttraumatic stress disorder, eating disorders, stroke rehabilitation, and for pain management.ObjectiveThis work aims to highlight key issues in the implementation of clinical research for VR technologies.MethodsA discussion paper was developed from a narrative review of recent clinical research in the field, and the researchers’ own experiences in conducting VR clinical research with chronic pain patients.ResultsSome of the key issues in implementing clinical VR research include theoretical immaturity, a lack of technical standards, the problems of separating effects of media versus medium, practical in vivo issues, and costs.ConclusionsOver the last decade, some significant successes have been claimed for the use of VR. Nevertheless, the implementation of clinical VR research outside of the laboratory presents substantial clinical challenges. It is argued that careful attention to addressing these issues in research design and pilot studies are needed in order to make clinical VR research more rigorous and improve the clinical significance of findings.

The management of chronic cancer pain remains challenging and complex, with the process often involving a variety of pharmacological and non-pharmacological approaches. Recent studies have shown virtual reality (VR) therapy to be successful in the management of acute pain. However, it remains unclear whether VR-based applications are effective as an adjunctive therapy for cancer patients with chronic pain. Moreover, there exists a gap in the current research landscape that address patient's perceptions of virtual reality therapy. This qualitative study enrolled patients from a larger ongoing randomized controlled clinical trial in two focus groups covering topics including patients experience with and perspectives on using VR for chronic pain control, both generally, and specific to their own circumstances. Five major thematic categories and 23 sub-categories emerged in the analysis process reflecting the participants' narrative. Similar to other research, this study found mixed results in the use of adjunctive VR therapy to manage chronic cancer pain, although a majority of respondents found it to be beneficial. This study confirms that pain management is a highly complex and individualized process. For maximum efficacy, it is recommended that future designs of VR interventions engage pain patients in the design process to ensure maximum efficacy of experiences to with individuals' preferences.

BackgroundVirtual reality (VR) therapy has been successfully used as an adjunct therapy for the management of acute pain in adults and children, and evidence of potential efficacy in other health applications is growing. However, minimal research exists on the value of VR as an intervention for chronic pain.ObjectiveThis case series examined the value of VR to be used as an adjunctive therapy for chronic pain patients in their own homes.MethodsAn exploratory approach using a case series and personal interviews was used. Ten chronic pain patients received VR therapy for 30 min on alternate days for 1 month. Pre- and postexposure (immediately afterwards, 3 h, and at 24 h) pain assessment was recorded using the Numerical Rating Scale (NRS), and weekly using the Brief Pain Inventory (BPI) and Self-completed Leeds Assessment of Neuropathic Symptoms and Signs pain scale (S-LANSS). Terminal semistructured personal interviews with the patients were also undertaken.ResultsOf the 8 patients who completed the study, 5 of them reported that pain was reduced during the VR experience but no overall treatment difference in pain scores postexposure was observed. VR was not associated with any serious adverse events, although 60% of patients reported some cybersickness during some of the experiences.ConclusionsOf note is that the majority of these study participants reported a reduction in pain while using the VR but with highly individualized responses. One patient also reported some short-term improved mobility following VR use. Some evidence was found for the short-term efficacy of VR in chronic pain but no evidence for persistent benefits.

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Purpose – This paper aims to report on a pilot research project designed to explore if new mobile augmented reality (AR) technologies have the potential to enhance the learning of clinical skills in the lab. Design/methodology/approach – An exploratory action-research-based pilot study was undertaken to explore an initial proof-of-concept design in using AR resources to supplement clinical skills lab teaching. A convenience non-probability sample of 72 undergraduate nursing students tested these resources during lab sessions, and participated in post-exposure surveys and focus groups to help evaluate them. This pilot design aimed to test logistics and gather information prior to further developmental work. Findings – Key similarities emerged between the survey and focus group findings regarding the technical issues and support for student learning. Students clearly expressed a comfort with the technology, and both students and faculty identified the ability to access resources to support self-directed learning and review of skills as positive attributes of using AR. However, technical issues such as slow response times and incompatible smartphones interfered with resource access and frustrated some students, potentially having a negative impact on their learning. Students gave positive feedback regarding the value of mobile access and having AR resources available “at the bedside” where they were practicing. Research limitations/implications – This empirical pilot study was limited to a small number of participants in a single location. However, a deeper understanding of the potential value of AR in clinical health professional education, and best practices in implementing these new technologies, was achieved. Practical implications – This study provides a valuable practical contribution, as the approach for AR resource development described can be readily replicated by teachers with limited technical skills. The practical limitations of AR technologies discovered by use in real-world settings will provide developers and educators with valuable information as they begin to explore the use of AR in the lab and beyond. Social implications – AR represents a rapidly developing field, with increasing social impact. This study provides some initial ideas that will help inform future uptake of AR in wider educational settings, beyond health professional education. Originality/value – This study represents original work in the field, and specifically, an original implementation of AR in an educational context.

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