The climbing costs of healthcare coupled with the alarming rate of malpractice suits have highlighted the need for an efficient and effective method of surgical training. In 2009, approximately 3.4 billion dollars in malpractice payments were awarded. A quarter of these claims stemmed from adverse events in the surgical setting [1]. Surgical errors also increase hospitalization time and adversely affect the health of patients, often resulting in death or major injury [1–3]. Improving surgical training methods has become a priority because the majority of mistakes in the operating room have been attributed to lack of skill and experience [4–6].

While the need for an improved surgical training system is clear, quantifying surgical competence has proved more elusive [7]. By capturing the metrics of surgical training, a surgeon's skill can be objectively evaluated. Expensive, procedure-specific simulators are frequently...

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