Mohammad Raihanul Bashar, Alejandro Olivares Hernandez, Yahia Zine et al.
Virtual reality (VR) is widely used for procedural medical training, yet most simulators emphasize realism while providing limited formative feedback. We examine how gamification affects performance, workload, and experiential quality in VR training for ultrasound-guided peripheral intravenous catheter insertion. We developed a gamified simulator with semantically aligned visual and auditory feedback (e.g., progress indicators, alignment guidance, rewards) while preserving procedural fidelity. Two studies were conducted with novices (N=24) and clinicians (N=12). Results showed that gamification reduced task time, improved usability, and lowered workload across expertise levels. Qualitative findings indicate improved goal clarity and confidence for novices and better pacing for experts. Overall, gamification can function as an effective formative feedback in VR medical training.