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Regarding learning curve, or the rate of skill acquisition, an angle error of 43 ± 24° (pre) changed to 22 ± 14° (interim test, P less then .0001 vs. pretest) and remained at that level for the post-test evaluation on both the repeated case (23 ± 16°) and the new case (26 ± 18°). CONCLUSIONS This study describes the learning curve and technical skill acquisition in FoCUS. A simulator-based curriculum improved medical student's skills in an objective and quantifiable manner. The individually paced curriculum allowed for independent knowl