I Feel Better! Doc McStuffins Virtual Reality Helps to Relieve Anxiety in Children Undergoing Surgery

Los Angeles (Nov. 17, 2021) — Virtual reality is not a new technology, but investigators at Children’s Hospital Los Angeles are using it in new ways to change how children experience healthcare. In a special collaboration with Disney Junior, CHLA doctors and scientists developed an interactive virtual reality experience featuring popular television character Doc McStuffins. In a recent study, the experience—called Doc McStuffins: Doctor for a Day (DocVR) reduced fear in children facing surgery.

Nearly 5 million children undergo surgery every year, and more than half of them experience anxiety leading up to their procedure. Preoperative anxiety is linked to slower recovery, sleep disturbances and other difficulties in the weeks following surgery.

Jeffrey I. Gold, PhD, has spent years developing new ways to manage pain in children without the use of additional medications.

“Children undergoing routine painful medical procedures will often report feeling better if they are engaged with a book or have something to focus on like playing with toys or bubbles,” says Dr. Gold, who is the Director of the Biobehavioral Pain Lab and the Children’s Outcomes, Research, and Evaluation (CORE) Program at Children’s Hospital Los Angeles. “Pain is very complex, but we know that shifting the patient’s attention away from the pain can be very powerful.”

19 years ago, Dr. Gold began investigating the use of VR for children having to undergo a blood draw. Some children were so immersed in the game, they didn’t even notice the procedure. “What began as a small research project is now routinely available for children who request it,” he says. “We have kids coming to the hospital excited because they know they’ll get to play the game, and they are reporting less distress and pain. As far as I’m concerned, that’s the best possible impact our research could have.”

Because VR so powerfully reduces discomfort, pain and fear, Dr. Gold wondered if he and his team could apply it in other areas, such as surgery—where anxiety can greatly affect not only a patient family’s experience, but the well-being of the child. “There is evidence demonstrating that if a child is calm as they go under anesthesia, they wake up calm,” he says. “But when a child is anxious prior to surgery, they can wake up irritable. We want to ease their worry without adding more medications to the equation.”

So how can healthcare professionals help a child feel safe and relaxed before something as daunting as surgery?

Dr. Gold explains that when children engage in what is called medical play — they are happier and less fearful. Facilitated by trained professionals such as child life specialists, medical play allows children to work through their feelings or anxieties regarding medical experiences. Dr. Gold sees VR as a perfect tool for medical play. He and his team at Children’s Hospital Los Angeles partnered with Disney Junior to create an immersive, virtual experience to help children feel more comfortable before surgery.

"The 'Doc McStuffins: Doctor for a Day' VR experience is something that has been years in the making,” says Vicki Ariyasu, Senior Vice President, Disney Branded Television Educational Resource Group and Diversity, Equity and Inclusion. “We are thankful to Dr. Gold and his team for their meaningful collaboration, which we hope will continue to help spread Doc's message of health, wellness and compassion to kids who need it most."

She adds, "the ability to positively impact kids and families’ lives in a hospital setting, while also utilizing the VR technology in such an innovative and unique way inspired all of us."

The experience, which was developed by Disney's Media and Entertainment Distribution Consumer Experiences and Platforms division in partnership with the CHLA team, allows each child to engage in play with Doc McStuffins, a popular character from the Disney Junior television show of the same name.

“They get to be a doctor for a day,” says Dr. Gold. “They’re virtually stitching seams on stuffed animals. They’re using an interactive hand-held wand and moving it in space to an animated character to hear its heartbeat.” This may sound like lighthearted fun, but the impact on the children was profound.

The study followed 51 patients undergoing surgery at Children’s Hospital Los Angeles. After playing the game, 97% of the children reported feeling more comfortable at the hospital and 74% said they felt less frightened.

The results of the study are a powerful proof of concept that allowing children to engage in immersive play can impact their experience prior to surgery. Reducing fear before a procedure may have ripple effects, improving the child’s health throughout their recovery, and beyond.

“The plan is to eventually provide VR as a routine service for kids, so they expect it and look forward to it before they even arrive,” says Dr. Gold. “I’d love to have VR available to help children get through a variety of routine medical procedures.”

“We don’t want the healthcare experience to contribute toward a child’s adverse childhood experiences,” he says. A stressful experience at the hospital can snowball when a child has to return for medical appointments or another procedure. More than two-thirds of Children’s Hospital Los Angeles patients are seen for chronic conditions, so most children come for multiple appointments per month.

“It’s impossible to remove all the fear from surgery,” says Dr. Gold, “but we want to remove as much fear as we can. We want to create comfort and show these kids that we really do care about their entire person: mind and body.”

Additional authors on the study are Erin T. Annick, Arianna S. Lane, Katherine Ho, Ryan T. Marty, and Juan C. Espinoza, MD, all of Children’s Hospital Los Angeles. Disney Junior provided research support to develop and execute the study at Children’s Hospital Los Angeles. The authors are grateful to the child life specialists for allowing the team to work within the preoperative area and to the patients and their families.

Virtual reality headsets pre-loaded with the “Doc McStuffins: Doctor for a Day” experience have been made available by the Starlight Children’s Foundation, whose mission is to deliver happiness to seriously ill children. Thanks to their contribution, the “Doc McStuffins: Doctor for a Day” experience was available to participating patients at Children’s Hospital Los Angeles and is also available to other children on over 1,800 headsets at more than 400 pediatric facilities across the country.

About Children's Hospital Los Angeles

Founded in 1901, Children's Hospital Los Angeles is the highest-ranked children’s hospital in California and fifth in the nation on the prestigious U.S. News & World Report Honor Roll of Best Children’s Hospitals. U.S. News ranks Children’s Hospital Los Angeles in all 10 specialty categories. Clinical care at the hospital is led by physicians who are faculty members of the Keck School of Medicine of USC through an affiliation dating from 1932. The hospital also operates the largest pediatric residency training program at a freestanding children’s hospital in the Western United States. The Saban Research Institute of Children’s Hospital Los Angeles is home to all basic, translational, clinical and community research conducted at the hospital, allowing proven discoveries to quickly reach patients. Our mission: to create hope and build healthier futures. To learn more, follow us on Facebook, Instagram, LinkedIn, YouTube and Twitter, and visit our blog at CHLA.org/blog.