Bhattacharyya R, Al-Obaidi B, Sugand K, et al. - This study was undertaken to explore the efficacy of this cognitive task analysis (CTA) tool to enhance practical skills in orthopedic trainees in a real-time interactive simulation setting (Distributed Interactive Simulation (DIS)). Researchers designed a double-blinded, randomized controlled trial recruiting 14 junior orthopedic residents. Individuals were evaluated on a high-fidelity phantom femur model with actual femoral nailing instruments in a simulation mobile operating theatre where the candidate had a simulation patient, and an acting anesthetist, and a scrub nurse (DIS). This research has demonstrated the objective advantages of a novel femoral nailing CTA tool in the enhancement of practical skills for junior trainees in the DIS setting. According to the findings, this adds to the growing data supporting the use of CTA in orthopedic training. It has been considered that this tool can be accessed remotely, is contact-free, and allows repeated sustained practice which is key in simulation training.