Traditional surgical teaching requires an expert trainer to be present during training. This training model allows an expert to observe a novice's performance and provide corrective feedback as errors are made. Virtual simulations offer a much needed alternative to learning through error and allow the trainee to hone skills without the presence of a skilled surgical trainer. However, current simulations limit the scope of training to tool directed learning, focusing training around instrumented simulated tool tips. This paper identifies a need for trainee centered virtual training to complement current approaches. The Outside Observer training methodology provides training feedback based on the observation of surgical tool tip manipulations in conjunction with the external movements a trainee performs during a procedure. It is thought that integrating movement and posture training with current tool tracking methods will provide more effective and accelerated learning.