Brad Scoggin
Welcome back to the XR Industry Leaders podcast by Arbor XR. I’m your host, Brad Scoggin, CEO and co-founder, and I’m joined by my co-host, Will Stackable, our CMO and also a co-founder. Today, we’ve got a fascinating interview with Dr. Christina Potter from Nicklaus Children’s Hospital in Miami, Florida. They’re seeing some remarkable results using VR to reduce pain in pediatric patients.
Dr. Christina Potter, thanks for joining us today.
Christina Potter
Thank you very much for having me. It’s a pleasure to be here.
Brad Scoggin
You initially joined Nicklaus in 2021 to help bring virtual reality into the hospital setting. Could you tell us a bit about how that started? What was your role, and what problems were you aiming to solve?
Christina Potter
Sure. I started at Nicklaus exactly four years ago as a project manager, leading a one-year grant from the Taft Foundation. Our focus was to explore how VR could be used in our same-day surgery area to reduce preoperative anxiety in children.
Patients typically arrive very early—our procedures start around 7 a.m., which is standard for many hospitals. We chose to start in our same-day surgery unit, which has eight bays. A lot has changed since then, but at the time, these bays were small and only separated by curtains.
If you can imagine, you're a child waiting for surgery, anxiety is running high. Even if you're calm, you can still hear another child a few bays over getting upset, which adds to the stress. We knew this pre-surgery period was a crucial window that could impact post-surgical outcomes.
So our goal was to reduce fear and anxiety before surgery, ultimately improving both the patient experience and clinical outcomes post-operation.
Brad Scoggin
That’s fascinating. I didn’t realize pre-op stress could impact surgical outcomes. One of the early highlights of your program was partnering with Stanford. Can you tell us more about that?
Christina Potter
Absolutely. When I joined, my boss, Dr. David Seo, who is the SVP and Chief Innovation and Information Officer, had already established a partnership with the Stanford Chariot Program at Lucile Packard Children’s Hospital. They had a well-established VR program.
Rather than reinventing the wheel, we decided to adapt their approach. We ordered our initial hardware through their program—six Oculus Go headsets and six Nebula projectors.
The projectors clipped to the patient beds and came with screens designed by Stanford that could be tucked under the bed structure. This setup created a mobile, mini-theater experience for patients.
Our goal was to see if we could replicate that success in a Nicklaus Children’s setting.
Brad Scoggin
That’s a great takeaway—partner with those who’ve already done it. But I’m sure it wasn’t all smooth sailing. What challenges did you face in launching the VR program?
Christina Potter
Definitely. One of the first challenges was that it was just me. I was new to Nicklaus, trying to start a brand-new program in a large, busy hospital. I didn’t know many people, so just building those relationships and trust took time.
I was the one placing headsets on patients, enrolling them in the study, and collecting data. It was incredibly resource-intensive—but that was my full-time role, and it worked. So my advice to anyone launching a similar program: make sure you have a dedicated full-time person to run it.
We also spent a lot of time testing hardware—figuring out whether the Oculus Go was the right device, and if the projectors and screens were compatible with our hospital beds. Turns out, what worked at Stanford didn’t always work for us.
For instance, in our minor procedure suite, the screens kept toppling over due to the bed designs. Staff were understandably frustrated. We had to pause, reassess, and pivot toward what would work best for our environment.
We liked the concept, but we needed to adapt it—adjusting for our specific needs, beds, and staff workflows.
Brad Scoggin
What I love about your story—and we hear this often—is that impactful XR programs usually start with one person who really believes in the mission and is willing to do the hard work to get it off the ground. We all appreciate your grit and dedication.
Fast-forward to today—over 8,000 patients and staff used VR last year alone. That’s huge progress from just a few beds and some trial-and-error. Tell us about the current use cases.
Christina Potter
I could talk about this all day! Truly.
That first year was our proof of concept. I quickly realized I couldn’t be everywhere at once, so I launched our Innovation Ambassador Program—empowering staff who were passionate about bringing VR to their patients.
It started with just three ambassadors. Today, we have 65 across the hospital. We also now have a small team of digital innovation support technicians who manage the equipment—charging, cleaning, and coordinating device distribution.
While the patient experience remains 90% of our focus, our use cases have expanded. We’re active in 12 different hospital units. Each of our 12 Child Life specialists has their own VR headset, which they use daily with patients.
Staff have also driven innovation—many of the new ideas have come directly from them. Whether it’s developing training modules or exploring new ways to use VR during procedures, our staff have embraced it. We even have a nurse wellness program that uses VR for guided meditation and stress relief.
Brad Scoggin
That’s incredible. When your staff are not just adopting the tech but actively driving its expansion, that says a lot. The numbers are great, but that kind of staff engagement is a powerful indicator of success.
Christina Potter
Absolutely. The success in the early units created a ripple effect. Staff in other departments heard about it and asked, “Hey, can we get VR too?” That kind of organic growth has been really exciting to see.
I’ve been repeatedly surprised by the variety of use cases our staff come to us with—and the best part is, it works. VR has been effective in nearly every scenario they’ve requested it for.
Brad Scoggin
You’re making a great point, and it’s something we talk about often—the importance of that first impression. You've now scaled across multiple use cases, and everyone’s on board, but it all traces back to that initial success. That thoughtful approach in the beginning laid the foundation.
That early success is just so critical.
Will Stackable
For listeners trying to visualize how this actually plays out—can you take us into a typical day? It’s Monday, everyone’s arriving at the office. What does VR use look like at Nicklaus?
Christina Potter
That’s a great question. It really depends on the space. Some units have dedicated devices in-house. Others will submit a request. Our digital innovation team, which I lead, is based in IT, so staff can request a device through our IT ticketing system. Once the request is in, someone from my team delivers the headset.
Staff are already trained on how to use it. We primarily use Meta Quest 2 and 3 devices, though we've tested other technologies. Once they have the headset, they’ll load the app or experience needed—usually a game or distraction app—and the patient puts on the headset. And just like that, they're immersed.
For patient distraction, it's pretty straightforward: the child selects a game, and they’re off. For staff training, the sessions are structured around that team’s schedule and current training needs.
Brad Scoggin
It’s worth highlighting that in those patient distraction scenarios, you’ve seen a 60% reduction in anxiety and perceived pain in children. That’s an incredible result.
Christina Potter
Yes, and that really surprised me early on. In our first year, funded by the Taft Foundation, we collected a lot of data pre- and post-op. We also measured parent anxiety—given my academic background and interest in parent-child dynamics—and we found parent anxiety dropped significantly too, by around 70%.
It’s not that anxiety disappears, but when parents see their child calm and relaxed, it has a huge emotional impact. If you're a parent, that makes complete sense.
We’ve even had parents use the headsets themselves, which I can talk more about.
Will Stackable
Could you share some specific examples of how VR has improved patient experiences at Nicklaus?
Christina Potter
Absolutely. One case that stands out involved an eight-year-old girl who came in with a broken arm. She needed the bone reset, pins placed, and a cast applied—all done in our fracture care clinic. We had just introduced VR there. The physician put a headset on her during the procedure. She was fully immersed in an underwater adventure and didn’t cry once—just local anesthetic, no heavy meds.
That physician was so impressed she decided to start using VR regularly. When the patient came back to have her cast removed, they used the headset again. It made a difference not just for the patient but for the staff too—less stress, less resistance from the patient, and overall smoother care.
Another powerful example comes from our psychiatry department. Dr. Villani Capó began integrating VR into her sessions, and she’s found that her patients are opening up more quickly and meaningfully. The immersion seems to help reduce anxiety and lower their emotional defenses.
Will Stackable
That’s amazing. And for those listening who might be skeptical—who wonder how this is different from just watching TV—why does VR work?
Christina Potter
It’s the immersive nature of it. It’s not a flat screen—you’re surrounded by the experience visually and audibly. We also have a bedside gaming program and immersive therapy sessions, all designed to transport patients out of the hospital environment.
No one wants to be in a hospital—especially not kids or their parents. VR offers a way to escape that environment. Psychologically, we only have so much attention to give. If that attention is focused on something fully immersive, it shifts perception—especially pain perception. That’s why VR has such a profound effect on pain and anxiety.
Will Stackable
I can relate. I was hit by a car as a kid—thankfully okay—but back then my friend brought a GameCube to the hospital. I had to get painful stomach shots every few hours, and playing that game made a huge difference. I was so distracted, I barely noticed. VR is like that but on a completely new level.
Are there any other stories—especially from the early days—where a specific moment really validated what you were doing and helped you take the next step?
Christina Potter
Definitely. One is our VR Drive program, which helps neurodiverse young adults, particularly those with autism, learn how to drive. Many of them have intense anxiety around driving and won’t even get in a car. We created a full VR-based curriculum and simulator. So far, 18 students have gone on to get their licenses. It’s been life-changing for them—opening doors to jobs, college, independence.
Another recent story is more emotional. It came from our palliative care unit. A young patient near the end of life wanted to use the headset but physically couldn’t. So, we had his mom use it, and we cast the headset feed onto a screen so he could watch and interact with her. She was flying in a virtual environment, and it gave them a way to connect in his final days. After he passed, she told us how meaningful that experience was for her.
Stories like that remind us to stay creative and responsive to what patients and staff need. Nurses especially know where VR fits best and when it’s not the right tool. It’s all about listening and being thoughtful.
Brad Scoggin
This might be my favorite interview we’ve done so far.
Will Stackable
And he doesn’t say that often!
Brad Scoggin
One of the main reasons we started Arbor was to see VR used for good—and this is such a perfect example. It’s clearly making a real difference. Now, let’s shift a bit and talk about how you're using VR for staff training. I’ve got a curveball coming your way...
And if this is wrong, maybe we just edit it, but I mentioned this before we started — we used some stats we found several years ago from Nicklaus Children’s Hospital while we were raising money. It really helped us. It was one of the use cases we referenced. I don’t think we were even working with you at the time, but we found this stat.
So I’m going to share the stat, and you can tell me if it’s accurate or not. Either way, we want to hear how you're using VR to train staff. I pulled this from an old pitch deck: 80% retention rate after one year for life-saving skills training.
Do you know if that’s accurate?
Christina Potter:
Yeah, I know the program you're talking about. That actually started about a year before I joined Nicklaus, but yes, that stat is accurate. We still have that VR training program active, and since then, we’ve expanded our staff training to include six other modules. I can’t speak in detail about the original program since I wasn’t there for its development.
Christina Potter:
And I haven’t seen all of the original data myself.
Brad Scoggin:
One other quick comment — now that I’m thinking back — when you pitch something enough times, it just sticks with you. I think the other funny thing about that slide is we used to reference the Office episode where the staff gets CPR training. I don’t know if you remember that one — it’s so bad. But we’d use that as a contrast, and people always got a laugh. So yeah, tell us what VR staff training looks like today.
Christina Potter:
Sure. We’ve actually had three units come to us requesting VR training for staff — our psychiatry team, our adaptive care program, and most recently, our hemodialysis team. Each use case is very different. For example, with our psychiatry team, we have patients who’ve been Baker Acted…
Not sure if you’re familiar with that term — maybe it's a Florida-specific thing — but it refers to patients experiencing a psychiatric crisis who need to be brought to the hospital. When these patients enter the psych unit, we often have to call a “Code Bear.” You probably know Nicklaus Children’s logo is a bear.
“Code Bear” is our behavioral emergency code, similar to code blue or code red. It’s now actually used across hospitals throughout Florida. A Code Bear means the patient is showing dangerous behaviors — they might harm themselves or others — and they’re typically restrained and sedated. But we don’t want to call a Code Bear if we can avoid it.
So we developed VR training to help staff recognize early warning signs. It teaches them to identify behaviors and triggers and use de-escalation techniques to calm the patient before things escalate. Staff wear a headset and interact with an increasingly agitated avatar, and they’re graded on how they respond. We can even make it more difficult based on their skill level.
We created it this way because we can’t ethically train staff with real patients in those situations. So this gives them a chance to practice safely. And we’ve seen similar results to the original program you mentioned — skills improve with repeated practice, and they’re retained over time. We're currently evaluating whether the number of Code Bears has decreased since the training began.
We’ve also created VR environments for room searches — we hide items in a virtual room, and staff have to find them. These are things patients might use for self-harm, like a pen or shoelace. We also have a VR patient search module, where staff perform virtual pat-downs to find unsafe items, like hoodie drawstrings that need to be removed.
All of that training helps staff prepare for real-world situations in a safe, repeatable environment.
And then, like you mentioned earlier, we quote Dr. Jeremy Bailenson from Stanford often — he talks about VR being ideal for things that are difficult, dangerous, or expensive to do in real life. That first example really illustrates that. How else do you safely train a staff member to handle an agitated patient?
Will Stackable:
Interesting.
Brad Scoggin:
Exactly. It’s just such a perfect example. You mentioned working with content creators — I’d love to hear about that process. How do you get content developed? How do you go about it?
Christina Potter:
So far, it’s all been grant-funded or through donations. That’s why progress has been slower than I’d like — we have to wait for funding. Once we secure that, we choose a developer and collaborate closely with the unit staff. It’s a co-creation process. We work together to integrate best practices and tailor the training to Nicklaus Children’s.
We’ve collaborated closely with unit staff in a co-creation process. Our Adaptive Care Team and Psychiatry Team have worked alongside my team and our developer to identify best practices and tailor a solution specifically for Nicklaus Children's.
Arbor has been an incredible help. As our program expanded, it became clear we needed a more effective management system. I have a couple of technicians who make daily rounds to ensure all the VR devices are accounted for and properly charged—but I can’t be everywhere at once. We started with six headsets and now have 37 across the health system. That may not seem like a lot, but tracking them system-wide becomes complex. Arbor has made tracking and charging status much easier. Even more, its ability to manage and push content has been a game-changer, especially with our wide variety of use cases.
For our staff training in VR, we’ve sideloaded API-connected training modules into Arbor. So, for example, when our psychiatry team conducts a training, I can see that the module was accessed eight times in a week—fantastic insight. Being data-driven, that kind of information makes it easy for me to demonstrate impact to leadership.
In our first year, I was estimating impact by tallying headset use—"18 kids this week" and so on. I thought we had reached around 800 patients that first year between myself and three ambassadors. But when we pulled actual data last year—only ten months’ worth—we saw over 8,000 uses. Even if some were repeat sessions with the same patient, it’s a powerful number. As a donation and sponsorship-driven program, this data is incredibly helpful in justifying scaling and requesting additional team support.
