After overseeing a successful pilot feasibility study implementing virtual reality in intensive pain rehabilitation, Dr. Laura Simons launched a randomized clinical trial (RCT) comparing best practice physiotherapy with physiotherapy augmented with virtual reality for youth with chronic musculoskeletal pain. Pragmatic implementation in outpatient practice has presented several challenges (e.g., comfort level and familiarity of providers with VR, logistical constraints of varying schedules). Dr. Simons will describe strategies to enhance engagement of both clinicians and patients that focus on training, education, and streamlining processes. The benefits of VR are evident (e.g., provides exposure to progressive challenge, real-time feedback, reinforcement for movement and can include activities difficult to achieve in the real world) but can be hindered by real-life clinical implementation challenges.