In the Ophthalmic Learning and Improvement Initiative in Cataract Surgery (OLIMPICS) Trial, Dean et al1 present results of a randomized clinical study that aims to assess if the addition of simulation-based surgical education to conventional training can improve cataract surgical competence in trainees. The authors must be congratulated on conducting a multinational, multicenter study to determine if surgical competence can be developed prior to live surgical training. In the trial, the intervention group received a 5-day simulation-based cataract surgical course in addition to standard surgical training, with the primary outcome measure being overall surgical competency at 3 months and secondary outcomes including surgical competence, quantity, and outcomes at 1 year, including visual acuity and rate of posterior-capsule rupture. The results suggested that for surgeons similar to the 50 participants in the trial, ophthalmologists receiving a 5-day simulation-based cataract surgical training course in addition to standard surgical training were likely to score between 14 and 19 points higher on a 40-point validated surgical competency assessment outcome compared with a control group of trainees only receiving standard surgical training.1