Advanced technology from the Commonwealth has increased your reaction speed, giving you a higher chance to hit in V.A.T.S.. This perk increases your chance to hit by 10%. As with all perks that increase your chance to hit in V.A.T.S., this bonus is multiplicative, not additive.
To obtain this perk, side with Dr. Zimmer in the The Replicated Man, and report A3-21. It's possible to get this perk while siding with A3-21; tell Dr. Zimmer who A3-21 is, and you will be awarded the perk. Before he and his bodyguard leave the room to reset A3-21, immediately kill them both. If you first tell A3-21 you'll kill Dr. Zimmer for him before revealing his identity to Zimmer, he'll give you A3-21's plasma rifle, which may outclass your current weapons and make the job easier.
Behind the scenes
This perk is a possible reference to the Shadowrun RPG setting, which contains a series of cybernetic enhancements by the same name.