Physiological response to a virtual reality simulation for preoperative stress inoculation

This paper describes the development of a novel immersive virtual reality (VR) simulation designed to reduce preoperative state anxiety in patients undergoing breast cancer surgery. A custom interactive VR simulation allows participants to experience the setting of an operating room and the key preoperative stages, all the way through the administration of general anesthesia. Interactivity is provided through a self-avatar with which the various simulated medical personnel interact directly. We evaluate the capacity of the simulation to induce an emotional response as measured by the participants’ galvanic skin response (GSR). To our knowledge, this is the first fully interactive simulation of an oncology surgery induction procedure for stress inoculation, and the first preoperative VR study to measure emotional impact using GSR. Out of a larger trial, we analyzed 6 participants who had been randomized to the simulation group and for whom baseline and intra-simulation GSR data had been successfully acquired. Three-minute samples were compared for statistical difference with a 95% confidence interval on the mean. 5 out of 6 showed a statistically significant and visually noticeable increase in GSR, and participants reported a high sense of spatial presence. Early results are encouraging, showing that the described simulation can induce a physiological response consistent with the participants' subjective evaluation of presence. While this was a limited experiment, it provides a basis for a larger trial to be conducted in the future.