When it's time to cut a neck, float a pacer, or delivery a breach baby, you cannot be dusting off Roberts and Hedges. This talk will review how we learn, why we forget, and simple practices you can put in place to be ready for all High Acuity Low Opportunity (HALO) procedures. Walking through an actual case, we will discuss learning and forgetting curves, spaced repetition, and stress inoculation with the talk culminating in an actionable plan for each audience member to take with them for improved procedural competence.