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Surgeons in training must be able to accurately gauge their own ability and performance to better understand where additional practice is needed and can help inform self-directed learning endeavors. This study had the following 3 goals: (1) to examine the accuracy of residents’ assessments of their endoscopic skills, (2) to investigate if accuracy improves over time and practice, and (3) to compare the efficacy of 3 interventions—practice only (PO), self-observation (SO), or expert observation (EO)—on self-assessment accuracy.