As virtual training simulators prove to be an effective learning method, we set out to develop a haptic mixed reality training system for intravenous (IV) needle insertion with variability. IV needle insertion is an essential skill for nurses to master. Traditional learning methods for IV insertions do not offer much variability, which can lead to lower confidence when a new nurse faces an IV insertion task on patients with high variability. This study first looks at what visual variable factors most influence the perception of difficulty for needle insertion through text and image-based surveys. These variables are skin color, vein size, and tattoos. Next, it implements these variables into a mixed reality scene where nursing students can visualize a 3D patient with variable characteristics. After gathering data on the perceived difficulty of variable characteristics, this study combines the visual variability in mixed reality with a virtual training system with haptic feedback, allowing nursing students to train with variability.