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Objective: Ultrasound-guided regional anesthesia with in-plane needle approaches can be challenging due to difficult needle visualization. We hypothesized that an in-plane, multiangle needle guide can help reduce the time it takes novice regional anesthesiologists to perform a simulated ultrasound-guided nerve-targeting procedure and enhance the visualization of the needle., Design: Crossover simulation study., Setting: Simulation environment at an academic institution., Subjects: Volunteer trainees in their postgraduate years 1 and 2., Methods: Sixteen subjects were randomized to repeat a single nerve targeting simulation task four times with and four times without a needle guide. End points were time to complete the nerve targeting, needle visualization, number of passes, and needle approximation to the target., Results: The needle guide reduced median time to complete the task by 27% (95% confidence interval: 4-44%) and increased the odds of an acceptable needle visualization by 355% (95% confidence interval: 171-737%). A learning benefit for the time outcome was also noted, with multiple attempts regardless of whether the needle guide was used or not., Conclusions: A needle guide can help reduce the time needed to complete a simulated nerve targeting procedure and enhance needle visualization for the novice sonographer in a phantom gel simulation. There was no significant reduction in the number of needle passes or in improvement of target approximation noted., (Wiley Periodicals, Inc.)