{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T07:01:51Z","timestamp":1793084511937,"version":"4.5.0"},"reference-count":36,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T00:00:00Z","timestamp":1768262400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Neurol."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Myasthenia gravis (MG) is a chronic autoimmune neuromuscular disease characterized by muscle weakness that can significantly impact patients\u2019 lives. Recent patient-led research highlighted a disconnect between healthcare professionals (HCPs) and patients, emphasizing the need for effective and empathetic patient\u2013HCP 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\u2019 knowledge, attitudes and empathy in MG, aiming to strengthen patient\u2013HCP communication and facilitate SDM.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>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 \u201ca day in the life of Julia,\u201d a virtual patient with MG, allowing HCPs to experience MG symptoms and their impact on a patient\u2019s life. The experience was implemented in hospital-based workshops. The outcome evaluation included surveys assessing Moore\u2019s Levels 2\u20134, 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.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      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\u2019 most important learnings were a \u201cbetter understanding of the impact of MG on patients\u2019 lives\u201d (\n                      <jats:italic>n\/N<\/jats:italic>\n                      \u202f=\u202f46\/60) and \u201cdeveloping empathy for how a patient with MG might feel\u201d (\n                      <jats:italic>n\/N<\/jats:italic>\n                      \u202f=\u202f37\/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 \u201cbeliefs about capabilities\u201d emerging as the strongest predictor of SDM.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Our study found that the immersive VR intervention effectively increased HCP empathy, knowledge and attitudes in MG care. The program\u2019s 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.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fneur.2025.1655351","type":"journal-article","created":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T13:00:36Z","timestamp":1768309236000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":3,"title":["ENGAGE: Analyzing the value of virtual reality in a patient-centric immersive learning program in myasthenia gravis for healthcare professionals"],"prefix":"10.3389","volume":"16","author":[{"given":"Ina","family":"Weisshardt","sequence":"first","affiliation":[{"name":"LLH Concepts GbR","place":["Haimhausen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cornelia","family":"Reyes Acosta","sequence":"additional","affiliation":[{"name":"LLH Concepts GbR","place":["Haimhausen, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Trishna","family":"Chauhan","sequence":"additional","affiliation":[{"name":"The University of Liverpool","place":["Liverpool, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaloyan","family":"Haralampiev","sequence":"additional","affiliation":[{"name":"Sofia University","place":["Sofia, Bulgaria"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrijana","family":"Mu\u0161ura Gabor","sequence":"additional","affiliation":[{"name":"Behavioral and Experimental Economics Lab, Zagreb School of Economics and Management","place":["Zagreb, Croatia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alexis","family":"Rodriguez","sequence":"additional","affiliation":[{"name":"MG Georgia","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Allison","family":"Foss","sequence":"additional","affiliation":[{"name":"Myasthenia Gravis Association (MGA)","place":["Kansas City, MO, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashwin","family":"Pinto","sequence":"additional","affiliation":[{"name":"Division of Clinical Neuroscience, University of Southampton","place":["Southampton, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Channa","family":"Hewamadduma","sequence":"additional","affiliation":[{"name":"Academic Neuromuscular Unit, Sheffield Teaching Hospitals NHS Foundation Trust","place":["Sheffield, United Kingdom"]},{"name":"Sheffield Institute for Translational Neuroscience (SITraN), University of Sheffield","place":["Sheffield, United Kingdom"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"John","family":"Vissing","sequence":"additional","affiliation":[{"name":"Department of Neurology, Copenhagen Neuromuscular Center, Rigshospitalet, University of Copenhagen","place":["Copenhagen, Denmark"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas J.","family":"Silvestri","sequence":"additional","affiliation":[{"name":"Department of Neurology, Jacobs School of Medicine and Biomedical Sciences, University at Buffalo","place":["Buffalo, NY, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Lehnerer","sequence":"additional","affiliation":[{"name":"Department of Neurology and Experimental Neurology, Charit\u00e9 \u2013 Universit\u00e4tsmedizin Berlin","place":["Berlin, Germany"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marc","family":"De Backer","sequence":"additional","affiliation":[{"name":"UCB","place":["Brussels, Belgium"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Natasha","family":"Monin","sequence":"additional","affiliation":[{"name":"UCB","place":["Malvern, VIC, Australia"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sophie","family":"Barry","sequence":"additional","affiliation":[{"name":"UCB","place":["Dublin, Ireland"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ivo","family":"Vlaev","sequence":"additional","affiliation":[{"name":"Centre for Behavioral and Implementation Science Interventions (BISI), Yong Loo Lin School of Medicine, National University of Singapore","place":["Singapore"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,1,13]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"259","DOI":"10.1038\/nrneurol.2016.44","article-title":"Myasthenia gravis \u2013 autoantibody characteristics and their implications for 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