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

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 $\pm$ 158.77 s to complete the task and achieved only a 45% success rate compared to experts' 95.48 $\pm$ 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 $\pm$ 6.69 to 2.75 $\pm$ 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.