The use of simulation is increasing in medical training, in part due to its success in other industries such as aviation. Although studies of simulation training have found positive effects on team communication and adherence to recommended processes, the effect of simulation on subsequent patient outcomes remains unclear. This study represents a significant advance in the simulation literature, as it found that anesthesia residents who underwent high-fidelity simulation training performed better at weaning patients from cardiopulmonary bypass than residents who underwent standard classroom-based training. Studies such as this, demonstrating that simulation training improves real-life clinical performance, strengthen the case for integrating simulation into medical education in an era of restricted duty hours.