The practice of anesthesiology relies heavily on procedural skill. Although surgeons garner a reputation for having high levels of tactile skill and steady hands, anesthesiologists likely perform an even greater variety of procedures and hand motions than any other specialty. A typical day could start with endotracheal intubation, central and arterial line placement, and trans-esophageal echocardiography. A subsequent case may require an ultrasound-guided peripheral nerve block or a thoracic epidural. These procedures require unique anatomical knowledge, medical decision making, hand-eye coordination, tactile precision, efficiency of movement, and maintenance of sterility, just to name a few components. Cognitive load is further amplified by the multi-tasking required to simultaneously monitor patient vital signs, anesthetic level, and possibly a trainee or hovering surgical colleague.

Assuring that anesthesiology trainees achieve high levels of competency in a wide range of procedural skills is of...

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