Surgical training requires acquisition of procedural skills as well as competency in medical management. Changes in training and practice patterns have decreased the operative and nonoperative experiences of trainees. With the introduction of new technologies, more complex procedures, and a host of external constraints, the doctrine of learning primarily through supervised patient-care experiences has been superseded by efforts to teach in nonclinical environments1. Increasingly, simulation is being used to help learners develop essential operative technical skills to compensate for the loss of experience that historically has been obtained through exposure to cases. Hip fixation, osteotomy and fusion, and arthroscopy are some of the orthopaedic procedures that are taught through simulation2-4. Despite the attempts to compensate for decreased opportunities for procedural competency training, to our knowledge no one has developed an alternate method to teach clinical skills needed by orthopaedic residents to manage patients in the postoperative period. Residents develop the ability to manage emergency medical situations through exposure to patient problems, just as motor memory is developed through repetitive performance of a procedure. Feedback from more experienced physicians is another important component of learning proper medical management of patients. Whereas operative skill is supervised, thereby providing opportunities for immediate feedback and improvement, postoperative care receives less scrutiny. The simulated setting is an ideal place to practice handling medical emergencies in a standardized manner. Simulation-based medical education is recognized as a method of boosting medical professional performance while enhancing patient safety5. It is being used at a rapidly expanding rate for training of health-care providers, including pediatrics, internal medicine, and anesthesia residents, and for medical students, but we believe that this is the first description of a simulation-based medical education course focusing on postoperative care by orthopaedic residents. Our hypothesis was that simulation-based …