This document proposes a study to determine the optimal frequency of simulation training to maintain competency in procedural skills. The study would randomly assign healthcare providers to groups that receive simulation training every 3 months, 6 months, or 12 months. Outcomes like confidence, skills performance, and competency would be measured before, during, and after the study to evaluate which frequency best helps providers maintain their skills over time. The document asks how to implement the study, whether it should be single or multi-center, and whether trainees or faculty should be involved.