Engage: Analyzing the value of virtual reality in a patient-centric immersive learning program in myasthenia gravis for healthcare professionals

BACKGROUND: Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease characterized by muscle weakness that can significantly impact patients' lives. Recent patient-led research highlighted a disconnect between healthcare professionals (HCPs) and patients, emphasizing the need for effective and empathetic patient-HCP dialogue and shared decision-making (SDM). The power of virtual reality (VR) to increase empathy and provide impactful learning experiences has been established. This outcome evaluation assessed the ability of VR to improve HCPs' knowledge, attitudes and empathy in MG, aiming to strengthen patient-HCP communication and facilitate SDM.

METHODS: The ENGAGE educational pilot program comprised a needs assessment, a VR-based intervention and an outcome evaluation. Content for the VR intervention was developed using a patient-centric approach integrating patient and HCP voices. The VR module simulated "a day in the life of Julia," a virtual patient with MG, allowing HCPs to experience MG symptoms and their impact on a patient's life. The experience was implemented in hospital-based workshops. The outcome evaluation included surveys assessing Moore's Levels 2-4, the Theoretical Domains Framework (TDF), and SDM, and was supplemented by semi-structured interviews. Quantitative and qualitative data were analyzed using SPSS Statistics and thematic analysis, respectively.

RESULTS: Eighty-seven HCPs completed the VR experience across 12 workshops. Sixty HCPs participated in the outcome evaluation survey, and 10 participated in interviews. HCPs reported high satisfaction with the immersive learning, citing its relevance and ease of use. Based on survey responses, HCPs' most important learnings were a "better understanding of the impact of MG on patients' lives" (n/N = 46/60) and "developing empathy for how a patient with MG might feel" (n/N = 37/60). HCPs expressed commitment to changing their practice. Quantitative analysis revealed significant improvements in most TDF domains and SDM post-intervention, with the TDF domain "beliefs about capabilities" emerging as the strongest predictor of SDM.

CONCLUSION: Our study found that the immersive VR intervention effectively increased HCP empathy, knowledge and attitudes in MG care. The program's patient-centric design ensured content relevance. These findings suggest that VR-based learning is a valuable tool for medical education and the improvement of SDM, particularly in rare diseases like MG.