“…5,19 Although difficult in practice, the ultimate goal is to demonstrate a relationship between introductory simulated training and safe performance of procedures and operative skills in the live clinical environment. 8,9,14,17,18,20,21 The ACGME now recognizes that structured education equivalent to participation in the SNS PGY1 boot camp courses is a required activity before PGY1 residents can be indirectly supervised for procedures and patient management competencies. 1 Many residency training programs, including one directed by the senior author, use simulated experience at the boot camp courses as a prerequisite for further training, observation, and safety validation in the live clinical environment at the home program, before approving performance of these procedures with indirect supervision.…”