Residents with at least 40 completed peripheral nerve blocks were given an ongoing set of blocks to perform and were evaluated by their supervising attending using an objective scale. Each resident was tasked an ultrasound guided block they have familiar experience with. A scoring scale of 1-10 was used with certain important tasks having point values attributed. A resident was given 1 point for proper completion of pre-block protocol. This includes performing a patient verification time-out indicating the correct patient, site, surgery and block to be performed. This protocol also included proper preparation for the block including, proper drugs, materials, ultrasound, and proper sterile technique. If the resident was unable to perform this task correctly, the resident would receive a score of 0/10 and the resident would not be permitted to complete the block. The following 9 points were given to proper completion of the ultrasound guided block with a heavy weight given towards autonomous completion of the tasked ultrasound guided block. If the attending had to intervene, the resident's score would drop by 5 points of the remaining 9 points allowed for block completion. If the resident completed the block after attending intervention, 4 points were awarded. The goal being, is the resident proficient in ultrasound technique and most importantly, the skill of needle visualization via ultrasound guidance and hand eye coordination. This scoring is exemplified in the table: * Pre-op: – Time out, preparation, site marked, 1 point; * Ultrasound guided block: – Resident performed block with no intervention by attending, 9 points; – Attending intervened during resident block, resident completed block, 4 points; – Resident unable to complete block, attending completed block, 0 points; * Total, 10 points. No resident was deemed competent using the above criteria was able to be deemed competent using the above criteria.