Abstract Aim This research employs the HoloLens2™ and a variety of models to evaluate the impact on the confidence and preparedness of ST3 trainees following their engagement in simulated otolaryngology cases. Method A total of 29 ST3 trainees engaged in ten 1-hour long simulation stations across a span of two days. The participants engaged in both technical and non-technical skills within elective, emergency, and ward-based scenarios. Questionnaires were used to document self-reported confidence and preparedness before and after each simulation. Primary outcomes included change in trainee confidence and preparedness pre- and post-station. Results The participants reported a significant increase in confidence (p<0.001) and preparedness (p<0.001) after all stations. The greatest improvements in comparison to all other stations were self-preparedness in the rigid bronchoscopy station and self-confidence in the sphenopalatine artery (SPA) ligation station. A significant improvement in self-confidence (p<0.001) and self-preparedness (p<0.0001) was observed after the non-technical HoloLensTM session. Conclusions The use of Otolaryngology simulation stations improved confidence and preparedness of managing common ENT presentations in the ward, elective, and emergency settings for ENT ST3 trainees. This approach serves as a valuable supplement to the conventional surgical apprenticeship, facilitating the acquisition of both technical and non-technical skills. The implementation of mixed reality technology creates an immersive environment to develop trainees’ non-technical skills. However, future work is required to assess the impact on the long-term benefits of trainee skill retention and clinical proficiency.