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Training tasks can be selected based on construct validity (i.e., tasks in which performance has been demonstrated to correlate with higher skill levels). However, face value is also important (i.e., experienced surgeons confirming that a training task is using the same skill sets as those required in clinical practice). All tasks need to be demonstrated clearly and effectively for superior learning. Ideally, trainees have unlimited access to high‐quality video tutorials and demonstrations, complementing and significantly decreasing the need for expert instructor involvement [41].

Training goals in the form of performance targets are generally accepted as superior to time‐based training because individuals may differ considerably in how fast the target is reached. For MISTELS‐based training, performance goals have been clearly defined [24]. For other practice tasks, speed, accuracy, or even motion metrics have shown severe limitations, and appropriate training goals for trainees at different levels of training remain work in progress [41]. A training study in the VALT laboratory failed to document advantages of proficiency goals compared with time control [7], and this observation has also been made by others [42]. Perhaps as the medical field learns more about simulation training, we will become increasingly successful in setting appropriate goals. Despite our experiences in the VALT laboratory, we consider proficiency goals valuable because we have noted that training goals appear to add motivation to practice.