Abstract. Existing surgical simulators provide a physical simulation that can help a trainee develop the hand-eye coordination and motor skills necessary for specific tasks, such as cutting or suturing. However, it is equally important for a surgeon to gain experience in the cognitive processes involved in performing an entire procedure. The surgeon must be able to perform the correct tasks in the correct sequence, and must be able to quickly and appropriately respond to any unexpected events or mistakes. It would be beneficial for a surgical procedure simulation to expose the training surgeon to difficult situations only rarely encountered in actual patients. We present here a framework for a fullprocedure surgical simulator that incorporates an ability to detect discrete events, and that uses these events to track the logical flow of the procedure as performed by the trainee. In addition, we are developing a scripting language that allows an experienced surgeon to precisely specify the logical flow of a procedure without the need for programming. The utility of the framework is illustrated through its application to a mastoidectomy.