This disclosure relates to systems, methods and techniques for implementing metric-based simulation training and assessment of operators for performing various medical procedures. Operators are able to practice the medical procedures on medical simulators that provide simulations of real-world medical procedures. The simulations can be used to train operators to develop new skill sets for performing the medical procedures or to assist trained operators with maintaining their existing skill sets. The medical simulators can include a training and assessment module that defines the procedural phases and sub-steps of the medical procedures, monitors a set of performance metrics during the simulations, and detects when errors have occurred during the simulations. Performance evaluation information can be output based on operators' performances during the simulated medical procedures. The performance evaluation information can provide feedback and recommendations for improving and/or maintaining skill sets.
