This high-fidelity simulation course has been incorporated into the pediatric anesthesiology fellowship curriculum with an emphasis on pediatric critical and rare event training. The course specifically focuses on being an effective team leader through improving communication and teamwork skills in management of critical pediatric situations encountered as a pediatric anesthesiology fellow and those that will be encountered as a pediatric anesthesiology attending. The scenarios are designed to teach management of pediatric critical events as well as management of the challenges of supervision and those faced by a solo practicing anesthesiology provider. The simulation environment offers an ideal training environment as fellows approaching completion of training are afforded complete autonomy. The simulation program is highly rated by participants and the curriculum is currently being expanded. For more information, please contact Dr. Kimberly Blasius at Kimberly_Blasius@med.unc.edu or Dr Hemanth Baboolal at Hemanth_Baboolal@med.unc.edu.