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Ideally, all trainees should have easy access to simulation training at their practices. This preference is based on the fact that distributed practice leads to better skills acquisition and retention compared with intense extended practice [41, 46]. The optimal distribution is presently considered to be one‐hour sessions with a maximum of two sessions per day interspersed by a rest period, allowing the brain the opportunity to internalize the learning [47]. Approximately 10 hours of practice has been demonstrated to lead to fundamentals of laparoscopic surgery (FLS) competency [24]. Skill decay will ensue after rigorous training, but with ongoing practice in small amounts at six months intervals, performance has been shown to be maintained at a high level [47].

Most veterinarians in practice do not and will not have easy access to simulation training curricula. Fortunately, MISTELS‐type exercises lend themselves well to self‐study because there are well‐defined training goals that are easy to monitor. Self‐study guidelines based on performance time have been demonstrated, showing that reliable achievement of 53‐s peg transfer, 50‐s pattern cut, 87‐s ligature loop, 99‐s extracorporeal suturing, and 96‐s intracorporeal suturing times are associated with a 84% chance of passing the FLS test [48], thus demonstrating basic skills competency. Laparoscopic suturing may require training proctored by experienced surgeons, and we encourage self‐study trainees to seek instruction for those exercises. Examples of available training are listed on the VALS website (www.valsprogram.org). Independent training on fresh cadavers may also be highly valuable, prior to or after commercially available live animal model courses. The self‐trained surgeon is encouraged to start with basic surgeries until ample experience of laparoscopic entry and instrument manipulation has been gained.