Comparison of Virtual Reality and Podcasts for Improving Patient Experience During Colposcopy: A Randomized Controlled Trial

Purpose Colposcopy-related anxiety affects up to 80% of women, increasing pain perception and reducing satisfaction. Virtual reality has shown promise, but no study has compared it with other active distraction methods. This three-arm randomized controlled trial evaluated the effectiveness of virtual reality versus podcast versus standard care in reducing anxiety and pain during colposcopy. Methods Between March and June 2025, 90 women undergoing colposcopy at a tertiary gynecologic oncology center in Turkey were randomized equally to virtual reality, podcast, or standard care. Interventions began 5 minutes before and continued throughout the procedure. The primary outcome was change in State-Trait Anxiety Inventory scores; secondary outcomes included Visual Analog Scale pain scores, patient satisfaction, Perceived Stress Scale scores, and 24-hour analgesic use. Results Eighty-seven participants (96.7%) completed the protocol. Both interventions reduced anxiety significantly compared with control (State-Trait Anxiety Inventory change: virtual reality − 8.4, podcast − 10.9, control + 6.5; p < 0.001). Virtual reality provided the strongest analgesic benefit (Visual Analog Scale 1.7 vs. 3.0 with podcast and 4.3 with control; p < 0.001) and the highest satisfaction (9.4 vs. 7.9 vs. 4.2; p < 0.001). Analgesic use was lower in the virtual reality (46.4%) and podcast (55.2%) groups compared with control (76.7%; p = 0.047). Perceived Stress Scale scores and physiological measures showed no group differences. Two participants in the virtual reality group experienced mild, self-limiting adverse effects. Conclusions Both virtual reality and podcasts significantly reduced colposcopy-related anxiety, with virtual reality providing superior pain control and satisfaction. Podcasts, as the first tested spoken-word distraction, represent a practical, low-cost alternative. These findings support integrating distraction-based strategies to improve patient experience during colposcopy.