High practice variability in critical care medicine contributes to medical errors and the high cost of ICU care. Clinical guidelines and protocol-based strategies can reduce the variation and cost of ICU medicine, increase adherence to evidence-based interventions, and reduce error, thereby improving the morbidity and mortality of critically ill patients. There are various barriers to guideline adherence, and protocols often are more successful when implemented by nonphysicians. However, this has potential consequences for house-staff knowledge and education. This article discusses the implications of mechanical ventilation protocols on patient care and medical education, and this article offers suggestions for synchronizing the processes for improving patient care to improve medical education.