One of the most relatable scenes for clinicians in James Herriot's beloved classic All Creatures Great and Small is the opening scene in which Dr. Herriot bemoans the extreme disconnect from the textbook idealized image of a cheerful veterinary surgeon in a sterile, comfortable work environment to the actual work environment of a dirty, unheated barn with an unhappy bovine patient. The dissonance between the "work-as-imagined" and the "work-as-done" is a fact of life for many healthcare professionals and a common barrier that we have all overcome. What is frequently absent in traditional lectures, textbooks, and journal articles are the nuances of the system in which medicine is practiced including the distractions, requisite multi-tasking, fatigue, inevitable miscommunications, and technology hiccups.A clinician needs repeated and varied encounters with a disease process to develop the ability to manage it with high reliability within different contexts, regardless of the fidelity of the experience. Historically, clinician training has addressed this gap between the "work-as-imagined" and the "work-as-done" through intensive, supervised real-life experience. However, the natural variation in life sometimes contributes to under-exposure to essential experiences. It is in this gap that simulation-based experiences can become a stepping stone from the imagined to reality. 1 Simulation-based medical education is a ubiquitous tool used to augment and fill in gaps in training experiences; yet, achieving fidelity to real-life experience and immersion can be challenging.Virtual reality (VR) simulation is a novel and potentially powerful, education tool that has been generally well-accepted in medical disciplines where it has been introduced. 2 Building on this body of