Comparing adolescents’ experiences in two different emergency department exam rooms using virtual reality simulation

This study aimed to evaluate adolescents’ experiences with two emergency department (ED) exam room layouts that can support different care scenarios using virtual reality (VR). Adolescents frequently seek care in the ED for a wide range of reasons. ED exam rooms are often required to support a range of care needs, including routine medical and mental and behavioral health (MBH) conditions. 23 adolescents aged 12-18 participated in a simulation-based evaluation using a VR immersive experience of two ED exam room layouts (parallel and perpendicular bed positions), designed to accommodate different care needs. Participants explored and evaluated each room through in-simulation feedback and a preference survey. Survey responses showed a strong preference for the parallel layout in terms of privacy, with 85.7% of participants favoring the parallel layout (18/21; p = .002, 95% CI [0.64, 0.97]). Qualitative findings indicated that no single layout met all adolescents’ needs. Some participants favored the perpendicular layout, which enhanced their sense of safety, while others preferred the parallel layout for greater privacy and reduced exposure to hallway activity. Across both layouts, participants valued non-institutionalized environments, control over lighting, projection, and sound, appreciated sensory-friendly features that promoted comfort, and emphasized the importance of family support. The findings suggest that ED design for adolescent patients should support environments that balance safety and patient experience, with appearance, comfort, privacy, control, and family support being important in creating a more hopeful and healing environment. • VR enables adolescents to evaluate ED room designs and provide real-time feedback • Parallel layout improves privacy, while perpendicular layout improves visibility • No single layout meets all needs, reflecting varied adolescent preferences • Environmental controls support personalization and reduce stress • Flexible family zones balance support, privacy, and communication