# The Use of Immersive Virtual Reality in Reducing Anxiety Among Emergency Healthcare Professionals

## TL;DR

This study shows that immersive virtual reality can reduce anxiety and stress in emergency healthcare workers.

## Contribution

The study introduces immersive projection-based IVR as a novel on-demand stress reduction tool for high-pressure healthcare environments.

## Key findings

- IVR was associated with reduced self-reported anxiety and acute decreases in heart rate and blood pressure.
- Participants reported feeling emotionally better after IVR sessions compared to usual rest.
- Changes in burnout and perceived stress were small and not statistically significant.

## Abstract

Introduction: Anxiety and burnout are common among emergency department (ED) healthcare professionals. Immersive virtual reality (IVR) may offer an on-demand, feasible strategy to support staff well-being in high-pressure settings. We evaluated whether an immersive projection-based IVR program was associated with changes in anxiety, burnout, perceived stress, and physiological stress markers in ED professionals.

Methods: We conducted a prospective within-subject, quasi-experimental study in a hospital ED. Of 198 eligible professionals, 131 enrolled. The study followed a fixed sequence: a four-week IVR phase (four weekly 20-minute sessions using the MK360 immersive projection system), an eight-week washout, and a four-week control phase (four 20-minute "usual rest" sessions). Emotional outcomes were assessed at baseline and end-of-phase for both IVR and control using the Goldberg Anxiety Scale (GAS; prior 15 days), Maslach Burnout Inventory-Human Services Survey (MBI-HSS), and Perceived Stress Scale-14 (PSS-14; prior month). Heart rate (HR) and blood pressure (BP) were measured immediately pre/post each session.

Results: Sixty-seven participants completed all sessions and assessments. The mean GAS decreased during the IVR phase (4.0±3.2 to 3.2±3.2; p<0.05), while changes in MBI-HSS subscales and PSS-14 were small and not statistically significant. At the end of the IVR phase, 25.4% reported feeling emotionally better, and none reported feeling worse. During the control phase, the mean GAS showed a smaller decrease (2.9±2.9 to 2.6±2.9), and 17.9% reported feeling better, while 4.5% reported feeling worse. Across IVR sessions, pre-post reductions were observed in HR and systolic BP in several sessions, whereas changes during usual rest were generally smaller and less consistent.

Conclusion: In this fixed-sequence, within-subject study, an immersive projection-based IVR program was associated with reduced self-reported anxiety and acute decreases in selected physiological stress markers among ED professionals. Findings should be interpreted in light of attrition and potential period effects; further controlled studies are warranted.