Patient Perception of the Use of the Apple Vision Pro Virtual Reality Headset in an Anesthesiology Informed Consent Process: Prospective Randomized Controlled Crossover Trial

Abstract Background Augmented reality (AR) and virtual reality (VR) have become mainstream commercial technologies, with AR integrating virtual elements into displays of reality and VR offering fully immersive computer-generated visual experiences. The Apple Vision Pro is a VR headset with an outward-facing display that depicts the user’s eyes to the outside world. This headset is actively incorporated into patient care, but questions remain about the impact of such a device on the patient-physician relationship. Objective This study surveyed patients’ responses to the use of an Apple Vision Pro VR headset by anesthesiologists during an informed consent discussion for sedation for endoscopic gastrointestinal procedures. We sought to qualify the impact, if any, of the Apple Vision Pro on patients’ perceptions of connectedness with their anesthesiologist, including compassion and empathy felt from their physician. Methods This prospective randomized controlled crossover study involved 60 patients undergoing sedation for gastrointestinal procedures at the University of California, San Diego Health’s Hillcrest Medical Center and Jacobs Medical Center. An anesthesiologist had 2 encounters with each patient prior to their procedure, 1 while the anesthesiologist wore an Apple Vision Pro and 1 without wearing any headset. After both encounters, patients completed a standardized, validated survey regarding the compassion and empathy they felt from the anesthesiologist during each encounter. They also completed a custom survey with additional questions related to their perception of technology in health care and their own personal prior experience with AR and VR. Results While 16.7% (10/60) of the participants owned an AR or VR headset of their own, 73% (44/60) had no prior experience with AR or VR. Participants reported consistently high ratings across all empathy and compassion measures for both the with-headset and without-headset conditions; however, mean Sinclair Compassion Questionnaire scores were statistically significantly higher for the no-headset condition (4.69, SD 0.48) when compared to the with-headset condition (4.42, SD 0.87; P =.003). Participants reported significantly reduced ability to focus on their conversation with the anesthesiologist when they were wearing the Apple Vision Pro ( P <.001), with a large effect size ( r =0.614). The most pronounced difference was observed with regard to patients’ satisfaction with eye contact made with their physician, which decreased significantly when they wore the Apple Vision Pro ( P <.001; large effect size: r =0.736). Conclusions This study examined the impact of physicians wearing the Apple Vision Pro during patient interactions, revealing a statistically significant reduction in patients’ perceived compassion from and connectedness with their anesthesiologist. This highlights the need for caution when integrating AR or VR technology into clinical practice as it may interfere with the patient-physician relationship. Careful evaluation of the potential effects on patients’ trust in their physician is essential before adopting AR or VR in health care settings.