Virtual reality has been a gamechanger for patients at the Shriners Hospitals for Children® – Canada, helping to reduce pain and anxiety associated with medical procedures.
When Argerie Tsimicalis, RN, PhD, was tasked with bringing virtual reality (VR) to the Shriners Hospitals for Children® – Canada (SHC-Canada), she jumped at the chance to work collaboratively with former Chief of Staff, Dr. Reggie Hamdy and Director of Nursing and Patient Care Services, Ms. Kelly Thorstad. Together, they explored with the healthcare team how best to use this technology to alleviate pain and anxiety associated with medical procedures.
An associate professor at the Ingram School of Nursing (ISoN) and associate member of McGill’s Department of Oncology and Faculty of Dental Medicine and Oral Health Sciences, Prof. Tsimicalis is a Fonds de recherche du Québec – Santé Junior 2 research scholar and a nurse scientist at SHC-Canada in Montreal. As she explains, “When a child feels pain, that increases their fear around medical procedures such as cast removals, pin removals, and intravenous inserts. We found that virtual reality is an effective non-pharmacological tool that distracts children, reducing their pain and distress and allowing them to see the hospital as a safe space.”
The work to bring VR to SHC-Canada began in earnest in 2018, where Drs. Hamdy and Tsimicalis co-supervised master’s research student Sofia Addad in McGill’s Experimental Surgery program. Ms. Addad, conducted a systematic literature review of the use of VR in children’s health care, and tested the feasibility of using VR during medical procedures at SHC-Canda. Alongside, Prof. Tsimicalis partnered with Prof Sylvie Le May, a child health pain expert based at CHU Sainte Justine and the Université de Montréal, Together, they were awarded a CIHR grant for a multi-site, pilot randomized control trial on the use of VR during removal of pins and sutures.
Professor Tsimicalis’ team also was awarded an infrastructure grant to survey clinicians in Quebec regarding the use of VR in children’s healthcare settings and provide training and resources to support the implementation of VR into practice. The team has expanded, creating a hub of scientists, trainees, and advocates, where new projects have ensued. The team has welcomed PhD students conducting clinical trials studying the use of VR mindfulness programs depicting nature scenes to ease the perioperative anxiety for children as well as testing the feasibility of incorporating VR for dental, anesthesia and surgical interventions.
Recognized internationally for its expertise in treating rare and painful bone conditions such as osteogenesis imperfecta (OI), SHC-Canada encourages experimentation with innovative technologies. “It’s a magical place where support for new ideas and creativity flourish – a perfect fit for my own creative bent,” notes Professor Tsimicalis. Storytelling features prominently in her research, which uses different media such as comic books, songs and humorous videos as teaching tools. She is particularly proud of her work as an editor for The Dream Machine, a novel about a 16-year-old girl living with OI who witnesses her younger sister fracturing her leg in a downhill skiing accident.
On April 26, 2024, with the support of the Réseau de recherche en santé buccodentaire et osseuse, Professor Tsimicalis hosted a Virtual Reality Workshop at SHC-Canada featuring leading experts in VR and implementation science. Ninety-five healthcare professionals attended the event, which included presentations by Prof. Tsimicalis, Guillaume Fontaine, Sylvie Le May, and Stéphane Bouchard.
Given that implementation of new technologies is a complicated process requiring support from a wide variety of stakeholders, Prof. Tsimicalis continues to work diligently on drafting policies, procedures and resources for the successful integration of VR SHC-Canada. “I’m a firm believer in interprofessional collaboration,” she asserts. “From the beginning, we engaged everyone from top-down to bottom-up, from doctors, nurses and allied health professionals right through administrative, technical and kitchen staff.”
Getting buy-in from patients, families and the general public has been critical to the success of VR implementation at SHC-Canada. To that end, Professor Tsimicalis has pursued creative ways to provide parents and children with information about VR in easily digestible formats. For example, she published two children’s books showcasing the use of VR, one of which was put together with the help of McGill nursing alumni Miranda Harington, and spearheaded the creation of a cartoon to educate children about non-pharmacological approaches to pain management.
“VR has been a gamechanger for our patients,” concludes Prof. Tsimicalis. “I’m excited to see what the future will bring.”
