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Overview

Glowing Stars was a time-limited digital arts and technology research project completed in May 2025, aimed to improve the hospital experience of children aged 4–11 undergoing MRI scans by using the Xploro digital educational app, which incorporates augmented reality, avatars, and gamification. The project was conducted at Leeds Teaching Hospitals NHS Trust and focused on children’s self-reporting on preoperative anxiety, enhancing understanding, and supporting emotional regulation for paediatric patients through innovative digital means. Glowing Stars has established a strong foundation for the use of digital educational tools in paediatric MRI services. The study’s findings support the continued development and clinical adoption of innovative, non-pharmaceutical interventions to improve the hospital experience for children, with the potential for broader application across healthcare settings.

Approaches & Methodology

The Glowing Stars study utilised a mixed-methods approach, combining quantitative, qualitative, and arts-based tools to assess the app’s usability, acceptability, and impact. Children and their families participated in pre- and post-intervention assessments, including visual analogue scales and questionnaires, and creative activities such as drawings and doodles. The methodology was designed to capture both statistical outcomes and rich, qualitative insights into the children’s emotional and cognitive responses to the MRI experience and the digital intervention. 

Aims & Objectives

The primary aim was to determine whether children (aged 4 to 11)  at MRI paediatric services could use the digital platform Xploro | Radiology, whether it was acceptable to them and their caregivers, and whether it helped reduce anxiety and support emotional regulation while waiting for MRI scans. Objectives included evaluating improvements in procedural understanding, emotional security, and active coping strategies among children, as well as gathering feedback to inform future app development and paediatric MRI support systems. 

Outcomes & Measured Impact

The study found that Xploro was easy to use, well-received, and effective in improving children’s understanding and confidence before MRI procedures. 

  • 77.8% of children reported that the app helped them understand MRI better
  • 84.2% of caregivers agreed that using the app aided in understanding and emotional regulation. 

Qualitative feedback alongside children’s creative expressions (children’s pre and post-intervention drawings and doodles )indicated a shift from anxiety to calmness, increased emotional security, and active engagement with the app. This included 

  • Children showing emotional security, a shift from passive to active coping while waiting for their scan.
  • Children showing creative expression and signs of reduced anxiety (drawings, smiling, verbal engagement) from anxiety to calmness.
  • Children showing procedural understanding of the MRI Scan, what is expected of them to do during the treatment and active involvement with the app.

The research laid important groundwork for future clinical trials and the broader adoption of digital educational tools in paediatric healthcare. For example ,clinical staff gained a better understanding of its potential benefits. Based on the study’s findings, staff now are willing to support moving toward future clinical trials to enhance patient experience and increase the effectiveness of paediatric MRI services.

Key Enablers

Key enablers included strong partnerships between academic, clinical, and technology stakeholders, as well as the innovative use of non-pharmaceutical, digital educational solutions. The study’s success increased clinical staff awareness of the benefits of digital preparation for MRI scans and fostered support for future clinical trials to further improve paediatric MRI services. 

Key Challenges/Barriers

A major challenge identified was the need for further research with a larger and more diagnostically diverse sample to ensure the findings are generalisable. Balancing representation across diagnostic categories and scaling the intervention for broader use remain ongoing considerations. 

Glowing Stars image 3

Image © Glowing Stars

Demographics, Settings & Referral Routes

Demographics: The project targeted early years, children, and adolescents (ages 4–11) undergoing MRI scans in acute hospital settings. The intervention was designed to be inclusive, supporting children with varying levels of anxiety, different learning styles, and diverse backgrounds. 

Settings: Acute hospital settings

Referral Routes: Participants were recruited through clinical pathways within the hospital. The study also engaged families and caregivers to ensure a holistic understanding of the intervention’s impact.

Evaluation Methods

Evaluation was conducted through independent research partnerships, employing both quantitative and qualitative methods as approved by the Health Authorities for England and Wales, the LTH NHS Trust site and the Higher Education Institution leading the study. Ethical considerations included informed consent, safeguarding of children’s data, and the use of arts-based activities to ensure child-friendly participation. The study’s design prioritised the emotional safety and agency of young participants. 

Participant & Stakeholder Feedback

Feedback from staff at Leeds Teaching Hospital paediatric team highlighted the study’s inspirational impact, noting its potential to inform digital support tools for other procedures and diverse patient groups. 

“The success of the Glowing Stars study inspires digital support tools to be developed in areas which involve blood tests, surgery prep and similar for different age groups and for those with autism, language barriers and sensory sensitivities”. 

Staff described Glowing Stars as “an innovative way to support hospitalised children through the digital arts, address disadvantages they experience because of anxiety and improve their wellbeing during MRI treatment.” 

Alignment with National Strategy & System Learning

Glowing Stars aligns with NHS priorities for digital innovation, patient-centred care, improved patient experience and wellbeing, engagement for young patients, and the reduction of preoperative anxiety in children. The project supports the integration of non-pharmaceutical, digital educational tools into paediatric healthcare and paves the way for future clinical trials and system-wide improvements in MRI services. 

 

 

 

 

 

 

Further information: 

https://www.leedsbeckett.ac.uk/blogs/leeds-school-of-arts/2025/06/glowing-stars/

https://www.leedsbeckett.ac.uk/news/2024/11/glowing-stars/ 

Publication: Sextou P, Loizou M, Bray L, Fabri M (2026;), "GLOWING STARS: improving the NHS hospital experience of children (aged 4–11) having an MRI scan using a digital app with augmented reality/avatar, and gamification". Journal of Enabling Technologies, Vol. ahead-of-print No. ahead-of-print. https://doi.org/10.1108/JET-10-2025-0074

This Case Study was submitted as part of a call out for Createch Case Studies, and demonstrates good practice in digital innovation within creative health.

Innovation & Digital Transformation

The project exemplifies healthcare innovation by integrating digital arts, VR/AR, and gamification and arts-based evaluation tools into paediatric care. The Xploro app’s success demonstrates the potential for digital transformation in preparing children for medical procedures, reducing anxiety, and enhancing patient experience.