Whether increased confidence equates to increased knowledge acquisition remains unknown; however, open-ended survey feedback showed considerable knowledge acquisition and improvement in real clinical practice. Multiple residents reported encounters with very similar critically ill patients within the hospital and noted the direct benefits of knowledge and confidence gleaned from this experiential curriculum in caring for these patients. Unfortunately, this educational intervention and study was designed to increase learner confidence in critical care topics, and data on knowledge acquisition was not collected. This, however, creates opportunity for future work to better define simulation-based knowledge acquisition for critical care events within this annual curriculum.