Simulation training has been increasingly employed in health care, largely due to its success in the aviation industry. Prior research suggests that simulation programs can lead to improved knowledge, skills, and behaviors among health care professionals. In this study, researchers video recorded 263 board-certified anesthesiologists performing two mannequin-based simulated emergencies to determine whether this type of simulation is a reliable way to evaluate competency. Blinded anesthesiologists then evaluated the recordings using standardized rating tools to assess the percentage of critical performance elements carried out and to provide an overall rating of participants' technical and nontechnical skills. In 284 of the simulated emergencies, the participating anesthesiologists completed 81% of the critical performance elements successfully. About 25% of the participants were given low overall ratings. The authors conclude that assessing anesthesiologists' skills in simulated medical emergencies can help identify opportunities for improvement and better inform continuing medical education initiatives. A past PSNet perspective discussed the literature on health care simulation.