Challenges in venepuncture skill acquisition and performance: An integrative review.

AIM: To synthesise and critically analyse evidence on the challenges encountered by nursing and medical students and novice practitioners in acquiring and performing venepuncture skills, to inform future training approaches.

BACKGROUND

Venepuncture is a fundamental clinical skill across the healthcare profession. However, learners frequently struggle to master its technical and psychosocial components. These challenges can erode confidence, compromise patient safety and impede the transfer of skills from educational to clinical settings.

DESIGN

Integrative review.

METHODS

This review followed Whittemore and Knafl's (2005) integrative review methodology. Six databases (CINAHL, MEDLINE, Scopus, Web of Science, Embase and ERIC) were searched for peer-reviewed studies published between January 2000 and December 2025. Studies examining challenges in venepuncture learning or performance among students and novice practitioners were included. Methodological quality was appraised using the Joanna Briggs Institute tools. Findings were integrated using a narrative synthesis organised through a deductive six-domain framework.

RESULTS

Twenty-seven studies met the inclusion criteria. Six interrelated domains were identified: cognitive knowledge challenges, psychomotor and technical difficulties, affective and confidence-related barriers, limited practice opportunities, difficulties transferring skills to clinical practice and system-level constraints. These domains interact to produce fragmented learning experiences shaped by inconsistent supervision, variable curricula and limited opportunities for deliberate practice.

CONCLUSION

Venepuncture competency is influenced by interconnected cognitive, technical, affective, experiential and organisational factors. Education providers and clinical partners should adopt integrated training models that combine structured knowledge development, repeated supervised practice, feedback-rich simulation, supportive supervision and alignment between simulation and clinical realities. These strategies may strengthen learner confidence, support skill transfer and improve patient safety and procedural outcomes. Findings support the development of integrated, simulation-to-practice training models that combine deliberate practice, structured clinical mentorship and high-fidelity simulation to improve skill transfer and patient safety outcomes.