Comparative Evaluation of Ultrasound-Guided Peripheral Intravenous Catheter Insertion Techniques in a Virtual Reality Simulator

Peripheral intravenous catheter (PIVC) insertion is a common yet challenging procedure. Although ultrasound guidance improves procedural accuracy and patient outcome, its complexity limits its routine adoption to highly experienced clinicians. This paper introduces a virtual reality (VR) simulator developed specifically for training in ultrasound-guided PIVC insertions. This study aims to validate the simulator's realism and relevance through face, content, and construct assessments, and to demonstrate its utility as a platform for comparing various approaches to PIVC insertion. Thirty participants from diverse medical backgrounds and levels of expertise completed three scenarios, each featuring a different procedural technique, within the simulator's controlled virtual environment. The simulator demonstrated strong face and content validity, with participants rating its realism at 7.1/10 and enjoyment at 8.2/10. Performance data showed that expert participants maintained higher success rates and performance across all procedural scenarios, supporting the simulator's construct validity. In the standard approach scenario, novices required 230.91 (Formula presented.) 158.77 s to complete the task and achieved only a 45% success rate compared to experts' 95.48 (Formula presented.) 65.74 s and 80% success rate. In the procedural scenario involving an alignment assistance device, where needle insertion was aligned with the ultrasound image plane, novice success rates increased to 75% and the number of attempts decreased from 8.95 (Formula presented.) 6.69 to 2.75 (Formula presented.) 2.67, narrowing the performance gap with experts. These findings highlight the simulator's potential not only as an effective training tool but also as a platform for the objective evaluation of different procedural techniques.