Across veterinary education, students are required to develop complex clinical skills and in-depth knowledge of diagnostic techniques to achieve the best possible outcome for patient care. One of which is the process of cerebrospinal fluid (CSF) collection, vital for the diagnosis of disease progression of animal neurological disease and degeneration. Ethical and educational barriers across this industry such as access to ethically sourced specimens and a lack of education resources have neglected clinical skill development across the veterinary curriculum, resulting in fatal consequences for animal welfare. The use of virtual reality (VR) has been researched as a supplementary educational tool, providing a platform to visualise abstract concepts in knowledge acquisition, however, little empirical data regarding the use of fully immersive technology in psychomotor training for clinical skills and the parameters that impact this acquisition process currently exists. This study developed a simulation development pipeline for providing insights regarding interaction paradigms and associated factors that improve or hinder technical skill acquisition across virtual skill training. This was achieved via the design and assessment of a VR CSF sampling training simulator. Despite the current consensus of hand tracking presenting a sense of dissonance in immersive environments, findings from this study found that hand tracking was objectively perceived to be the most immersive paradigm compared to controller-based interactions, providing a more valid experience for transferable psychomotor skills Findings from this study propose a potentially safe and ethical solution for repeated practice and refinement of veterinary skills, however, more research should be conducted to understand the impact of high versus low fidelity of VE’s and their contribution to skill development, independent of the interaction paradigm.