Many aspects of clinical medicine can be taught and evaluated in a simulated setting with the goal of trained execution in live patient care scenarios that include codes, complex care triages, and executing decisions in systems derived interdisciplinary teams. The performance feedback loop is a critical part to any successful intervention. During clinic week, residents engage in simulation exercises in replicas of patient rooms that include high fidelity mannequins with monitors that present objective patient data. Control desks with trained personnel, real time observation windows and multidisciplinary debriefing are a part of the exercise. Residents practice managing acutely unstable patients and engage in diagnostic reasoning exercises in small groups of 3-4 residents with peers, faculty leaders from Pulm-CCM medicine, and IM core faculty/chief residents. A strong emphasis is placed on teamwork and collaboration between residents, nursing, respiratory therapists and pharmacists with physical supervision.