Inspired by the classic Oregon Trail game, The Vascular Access Trail is an interactive tabletop simulation exercise that challenges participants to navigate the unexpected realities of vascular access care. Working in interprofessional teams, participants will respond to evolving clinical scenarios, transportation barriers, and system-level challenges while making real-time decisions with limited resources. Through collaborative problem-solving and facilitated debriefing, participants will discover that successful vascular access depends not only on sound clinical decisions, but also on recognizing the systems that shape patient outcomes.