Forty-four postgraduate year 4 or 5 orthopedic residents were randomly assigned to 1 of 3 skills training protocols in order to learn how to perform an arthroscopic Bankart repair. The purpose of this study was to determine the effectiveness of a proficiency-based progression (PBP) program using simulation in comparison to the same curriculum without proficiency requirements and compared to a traditional resident course. The results showed that the proficiency-based progression curriculum allowed residents to make significantly fewer errors and complete a greater number of procedure steps compared to the traditionally trained or simulator trained groups. In addition, the PBP group was more likely to to achieve the final proficiency benchmark in comparison to the other groups.