Using Virtual Reality to Promote Mindfulness Among Medical Trainees; A Study of Feasibility and Acceptance

Background: Medical training is an exciting and enriching experience, but can pose physical, emotional and social challenges. Physician burnout is extremely prevalent and found in about two thirds of the physicians worldwide. For trainees and training programs, this issue is now gaining well-deserved attention. There is increasing interest in interventions to curb burnout among trainees who are vulnerable to the stresses of caring for sick patients while still learning to make crucial clinical decisions. Short-term integrative mind-body interventions have been studied and are helpful in building self-awareness and resilience which can both mitigate the risk of burnout. Virtual reality (VR) is a popular technological interface that allows users to experience computer-generated environment within a controlled setting and harness aspects of mindfulness technique. We conducted an observational study to evaluate the feasibility and acceptance of use of a VR tool to help trainees with mindfulness techniques. Our eventual goal involves evaluating burnout after more frequent use of this tool. We present the results of the first phase of the study which determined feasibility and acceptance of the VR tool.

Methods: Five participants were planned to enroll in the feasibility phase. Study information was provided to the seven Hematology/Oncology fellows at their academic noon conferences. Informed consent was obtained from the first five participants who approached the study team and were enrolled in the study. The VR Oculus Go headset, with the "Guided Meditation VR" application downloaded on it, was provided to the fellows and instructions for use were given. They were encouraged to use the VR intervention for at least 10 min per session and at least 3 times per week in a quiet place. After 2 weeks, participants were required to fill out a feasibility post-survey. The survey contained both quantitative and qualitative sections. This study was revised and updated at the 2019 ASH Medical Educator's Institute and was funded by MedStar Washington Hospital Center's Graduate Medical Education department.

Results: Five fellows participated between July 6, 2020- July 31, 2020. The majority (60%) were over 30 years of age, all participants were between post graduate years 4-7 and were sub-specialty fellows. Two-thirds were on an inpatient rotation and the rest were rotating in outpatient clinics. Only 20% reported practicing mindfulness on a regular basis before enrolling in the study. All participants completed the post-survey and had used the VR tool at least 1-5 times. Eighty percent were interested in using this technology again for the purpose of performing mindfulness exercises. Barriers that prevented the use of the VR tool included not getting enough time and technical issues preventing the VR tool from working properly. Most (80%) of the participants reported feeling happier and less stressed after using the VR tool. All participants only used the VR tool at home. Other methods of mindfulness used by the participants included meditation, walking and home exercise routine

Conclusions: This is the first reported study evaluating feasibility and acceptance of a VR-based intervention for mindfulness with the goal of eventually decreasing burn out in medical trainees. Our study shows that the using the VR tool for guided mediation is feasible and accepted by a subset of Hematology/Oncology fellows. Future directions include using a larger sample to determine if the randomized introduction of a VR intervention or no intervention will reduce self-reported burnout in medical trainees.