Simulator-Limb Training in Phlebotomy among Health Science Students: Implications for Technique-Related Preanalytical Errors—A Systematic Review

Introduction: Phlebotomy is an essential skill that health science students need to develop for future clinical practice. Proper phlebotomy technique can help prevent technique-related preanalytical errors that may compromise specimen quality and patient safety. Simulator-limb training gives students opportunities to practice venipuncture in a controlled environment before performing procedures on actual patients. This study examined the effectiveness of simulator-based limb training in phlebotomy and its potential to minimize technique-related preanalytical specimen errors. Methods: A systematic review was conducted in accordance with the PRISMA 2020 reporting guidelines to examine simulator limb training in phlebotomy among health science students and its implications for technique-related preanalytical specimen errors. Google Scholar, PubMed, and EBSCOhost were searched for English-language studies published from January 2016 to September 2026. Eligible studies evaluated simulator-limb training in phlebotomy among health science students and reported outcomes related to procedural competency or preanalytical specimen errors. Methodological quality was assessed using the Mixed Methods Appraisal Tool (MMAT), version 2018. Due to heterogeneity in study designs, populations, and outcome measures, the findings were synthesized narratively and organized into three themes: clinical competency and learner readiness; safe, repetitive, and experiential learning; and implications for patient safety and the prevention of technique-related preanalytical errors. Results and Discussion: The reviewed literature showed that simulator-limb phlebotomy training improved venipuncture competency, confidence, and psychomotor skills while providing a safe environment for repetitive practice, error recognition, and feedback. However, no included studies directly measured the potential effect on reducing technique-related preanalytical specimen error rates before and after simulator-limb training; improved procedural competency and consistent phlebotomy performance may contribute to specimen quality and patient safety. Lastly, challenges include equipment and maintenance costs, limited funding, faculty training, curriculum integration, and limited clinical authenticity in integrating simulator-limb training for health science students practicing phlebotomy. Conclusion: Simulator-limb training may complement phlebotomy competency development among health science students. Further research directly measuring preanalytical errors and specimen rejection rates is needed to establish its effectiveness in reducing technique-related preanalytical errors.