22 orthopaedic surgery residents were randomized into either a simulation group or a standard training group without simulator training to practice arthroscopic shoulder procedures. The purpose of this study was to determine if simulation technology in the graduate medical curriculum would be beneficial in improving resident expertise for shoulder arthroscopy, as assessed using the Arthroscopic Surgery Skill Evaluation Tool (ASSET) score. Findings indicated faster operative times, improved probe distances, and patient safety in the simulation group compared to the standard practice group.