Mental Imagery to Enhance Procedural Skills in Peripheral Venous Catheterization: A Randomized Simulation Study in Medical Students.

Introduction: Procedural skill acquisition is fundamental to medical education, yet training opportunities are increasingly constrained. Mental imagery, a cognitive rehearsal method shown to enhance psychomotor performance in various domains, has gained attention in medical training as a low-cost, safe tool to improve technical proficiency. Evidence remains limited and heterogeneous. Specifically, its application to peripheral venous catheter (PVC) insertion, a frequent and essential clinical procedure, has scarcely been studied. Methods: In this single-center, open-label, randomized controlled simulation trial, fifth-year medical students from Nîmes University Medical School were randomized to either a mental imagery or control group prior to a simulated PVC insertion on a mannequin. Primary outcome was uncomplicated first-puncture success rate. Secondary outcomes included variations in adapted Mental Imagery Questionnaire (MIQ) score, number of punctures, and procedural complications. Results: Sixty-four students were included (33 in the mental imagery group, 31 in the control group). Baseline characteristics were similar, although the control group had greater prior experience with PVC insertion. The first-attempt success rate was significantly higher in the mental imagery group (76% versus 52%, p = 0.04). Complications occurred less frequently in the mental imagery group (0% versus 12.9%, p < 0.05). The median improvement in the adapted MIQ score was significantly greater in the mental imagery group (+17 [+12, +22] versus +11 [+8, +18]; p = 0.004), indicating enhanced mental readiness and procedural confidence. Conclusion: Mental imagery is an effective, safe, low-cost strategy that significantly enhances simulation-based procedural performance and learner confidence in PVC insertion.