Background: Laparoscopic cholecystectomy (LC) is one of the most frequently performed surgical procedures worldwide with occasional serious complications, including bile duct injuries, that may reflect surgeon misperception, rather than errors of skill and knowledge. Intraoperative cholangiography (IOC) is an imaging procedure that may prevent or identify these complications by defining biliary anatomy, identifying choledocholithiasis, and preventing or identifying common bile duct injury during LC. No formal curriculum exists for training surgical residents on how to perform and interpret IOCs; typically, residents rely on intraoperative guidance from attending surgeons and experience to develop the necessary skills. Since IOCs are not performed routinely, surgical residents have limited learning opportunities and therefore may have difficulty performing and interpreting them. Training programs based on perceptual learning (PL) principles, where learners experientially become more efficient and accurate at extracting valuable information from their environment, expedites the development of the necessary pattern recognition skills needed to improve image interpretation. To address the lack of a formal IOC curriculum, we designed a PL-based training module for surgical resident IOC, or cholangiogram, interpretation. Given PL benefits to other disciplines, there is an opportunity to leverage this approach to transform how we educate surgical residents to improve their pattern recognition abilities and subsequent surgical outcomes. Methods: Surgical residents from post-graduate year (PGY) 1 to 4 were assessed on their ability to identify cholangiogram completeness, differentiate between anatomic variants and abnormal findings, and provide diagnosis and management recommendations using a computer-based program. Pre- and post-training assessments were conducted, measuring residents' accuracy and response time, along with an evaluation of attending surgeons as a baseline. Confidence levels in cholangiogram interpretation were surveyed before and after the training. A subset of participants was interviewed to gather qualitative insights on their experience. Additionally, we explored the impact of combining simulator-based training for performing IOCs with the online interpretation module on residents' accuracy, response time, and confidence. First-year residents who were not exposed to the previous training modules participated in a pre/post control group design study. Results: 23 residents participated in the initial training and assessment component. Most residents (95.7%) found the training helpful and effective. Significant improvements were observed in residents' confidence levels for identifying complete versus incomplete cholangiograms (p=0.024), anatomic variants (p<0.001), abnormal findings (p<0.001), and overall cholangiogram interpretation (p=0.016). The accuracy of residents' interpretations increased significantly from pre-training (mean accuracy 75.3 ± 10.7%) to post-training (mean accuracy 81.9 ± 6.1%, p<0.001). There was a reduction in average response time per question from 25 ± 12 seconds to 17 ± 12 seconds (p<0.001). In the combined procedural simulator and online interpretation training study, 20 first year residents participated. The training was found to be helpful by 88% of participating residents. The training group showed significant improvements in confidence levels, pre/post training, compared to the control group for various aspects of IOC interpretation: identifying complete versus incomplete cholangiograms (p <0.001), anatomic variants (p<0.001), abnormal findings (p=0.029), and overall cholangiogram interpretation (p=0.004). Although the training group demonstrated improved accuracy gains compared to the control group, the differences were not statistically significant. Both groups showed decreased average response times, with a greater, non-significant reduction observed in the training group. Conclusion: A perceptual learning-based training module is a viable approach to educate surgical residents on performing and interpreting IOCs effectively. Further research is necessary to establish the validity of the training module, assess long-term retention, and evaluate its impact on clinical practice. [The dissertation citations contained here are published with the permission of ProQuest LLC. Further reproduction is prohibited without permission. Copies of dissertations may be obtained by Telephone (800) 1-800-521-0600. Web page: http://www.proquest.com/en-US/products/dissertations/individuals.shtml.]