The role of virtual reality in enhancing informed consent for shockwave lithotripsy: A mixed-methods study of physician and patient perspectives.

OBJECTIVE: The integration of immersive technologies such as virtual reality (VR) in healthcare is gaining momentum, particularly in patient education and the informed consent process. Traditional patient information leaflets often fail to meet the needs of diverse populations due to literacy barriers and a lack of visual engagement. This study aimed to evaluate the impact of a VR platform (Surgassists®) on patient understanding, anxiety, and satisfaction during the consent process for shockwave lithotripsy (SWL), alongside surgeon perspectives on VR's feasibility and utility. METHODS: A mixed-methods, cross-sectional study was conducted between August 2024 and July 2025. One hundred patients undergoing SWL at the University Hospital Southampton NHS Foundation Trust were recruited to evaluate VR-enhanced consent using pre- and post-intervention questionnaires, including understanding, visual analogue scale pain scores, and the State-Trait Anxiety Inventory scores. Simultaneously, a structured electronic survey was distributed to 50 urologists across Europe, assessing familiarity, current use, and perceptions regarding VR in surgical consent. RESULTS: Patients demonstrated significantly improved understanding (mean score increased from 2.60 to 3.72, p<0.001), reduced anxiety (p=0.004), and high overall satisfaction, with 81% expressing strong approval of VR for future use. Among surgeons, 94% expressed willingness to use VR, with 86% viewing it as a positive advancement in surgical communication. While most were unconcerned about medicolegal issues, concerns about cost, consultation time, and workflow integration were noted. CONCLUSION: VR significantly enhances patient education and emotional preparedness for SWL, with strong surgeon support for future adoption. Addressing logistical and cost-related concerns will be key to broader clinical integration. VR holds considerable promise in modernising and standardising the consent process across surgical specialties.