Turning a magnetic resonance imaging (MRI) procedure into an entertaining superhero adventure helps prepare young children for the test and reduces the need for sedation, according to new research by investigators at Weill Cornell Medicine and NewYork-Presbyterian.
The study, published Sept. 27 in the Journal of the American College of Radiology, indicated that the sedation rate for outpatient pediatric MRIs conducted by the institutions’ radiology diagnostic center, Weill Cornell Imaging at NewYork-Presbyterian (WCINYP), decreased by 5.6% for those ages 4–15 since the program started. The program WCINYP established in collaboration with Siemens Healthineers and Marvel Custom Solutions, called MRI-am-a-Hero, was created in 2014 to allay the fears of children undergoing MRI and reduce their need for sedation.
To keep children from being anxious and from moving during an MRI, radiology practices sometimes sedate the young patients. “This program can eliminate the need to undergo sedation, which has its own potential side effects to the child and can also add to the anxiety of the exam, have post effects, and certainly increases the costs,” said senior author Dr. Robert Min, chair of radiology and the John A. Evans, M.D. Professor of Radiology at Weill Cornell Medicine and radiologist-in-chief at NewYork-Presbyterian/Weill Cornell Medical Center.
In 2014, Dr. Min started brainstorming on how to educate children about their upcoming MRI exam and make the experience fun and calming. “Kids have a much greater capacity to learn than adults give them credit for,” he said.
He approached MRI maker Siemens Healthineers, which connected him with Marvel Custom Solutions. The three organizations partnered to develop the MRI-am-a-Hero kit, which includes a one-of-a-kind comic book, cape, Captain America and Iron Man plush toys, an educational DVD and a mini-model of a Siemens Healthineers MRI scanner.
To learn about the MRI process, children are given a comic book that shows Captain America getting an MRI for his injured shoulder, with his friend Iron Man by his side. The children can also watch a live-action video of a girl, about age 10, telling her MRI story.
Before the procedure, the children select a pair of shorts and a T-shirt with a superhero emblem on it—instead of a hospital gown—to wear. They are also given a plush toy of Captain America or Iron Man that they can take into the machine with them. When the MRI scan is complete, they are presented with a cape to take home, along with the plushie, outfit and comic book.
The study, which was co-authored by Dr. Helen Xu, a radiology resident at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine, showed that the percent of MRI cases with sedation decreased from 22.9% to 17.3%, based on 4,234 MRI cases from January 2013 to October 2017. The odds of an MRI being performed with sedation are 40% less since the program started. The program was most successful with patients ages 4–7, followed by patients ages 8–11. The effect was not statistically significant for patients ages 12–15.
The program is coordinated by a child-life specialist, a clinical professional who uses developmentally and psychologically appropriate interventions to prepare children for medical procedures. Child-life specialists were not part of Weill Cornell Imaging at NewYork-Presbyterian before this program and are a critical aspect of MRI-am-a-Hero, Dr. Min said.
“This environment and this program allows kids to complete their exams in a fun and non-threatening way,” said study co-author Rachel Cavaliere, one of two pediatric radiology child-life specialists at Weill Cornell Imaging at NewYork-Presbyterian. “When you’re prepared ahead of time and know what to expect, you’re going to be less scared and more compliant.”
Besides reducing anxiety for both kids and parents, the program empowers the children. “There’s this whole sense of pride and achievement they have afterward,” Cavaliere said.