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Resident skills are acquired with incremental gains in competence reflected in the achievement of technical milestones.¹ The development of foundational skills, such as the precise sculpting of cortical planes as described in Chapter 4, set the stage for progress through these milestones, which approximate the sequence of steps as laid out in this manual. The achievement of technical competence is further aided by the provision of specific, formative, and timely feedback by an instructor. Such feedback helps the learner set goals for subsequent practice and is likely to maximize the benefits gained from the use of temporal bones, burs, and time, all examples of valuable and finite resources.

The Mastoidectomy Checklist Instrument (Fig. 7.1

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