This article describes a modern framework for teaching new procedures to practicing surgeons (Figure). Although many groups have described frameworks for teaching surgical skills to surgeons in training and practice,1,2 none incorporate all the modern elements required for a comprehensive, efficient, effective, and sustainable training pathway. This framework, like previous ones, not only is grounded in evidence-based principles of learning and training (eg, behavioral modeling)3 but also provides a clear definition of where modern tools, such as telementoring and video coaching, fit into that training. Furthermore, it emphasizes the need for a train-the-trainer pathway and uses this pathway to create a sustainable program. Defining this modern framework creates a shared mental model that curriculum design teams can use to foster meaningful discussion and planning. What follows is a description of each of the framework elements.