High fidelity medical simulation is an evolving tool, currently used by many institutions to teach medical students, residents, and other medical personnel. However, there is limited data on its efficacy as an educational intervention. To evaluate high fidelity medical simulation as an educational intervention for teaching emergency pediatric management teamwork and airway skills, we performed a prospective, case control, observational study, using 16 PGY-2 pediatric residents. All subjects were PALS/APLS certified, and had no prior experience with medical simulation. Residents were given a brief intro to the sim center, and then managed 2 scenarios, during which their baseline airway and teamwork skills were assessed. The participants were divided into groups 1 and 2. Group 1 returned to the simulation center for a full-day, simulation enhanced session on pediatric airway management and teamwork skills. Two months later, groups 1 and 2 underwent reassessment of their performance. Following the second assessment, group 2 returned for the same educational intervention as group 1. Finally, both groups returned for a final assessment. During the assessment sessions, data were collected using the RIHMSC Global Competency Score (a Likert scale for subjective competency scoring), the Behaviorally Anchored Rating Scale (BARS), a previously validated teamwork metric (MedTeams™, Dynamic Research Corporation, Andover, MA), and critical action checklists specific for each scenario. Results from the Global Competency Scores (range 1–7) and the BARS scores (range 1–7) are displayed below in tables 1(p<0.05 for both RIHMCSGCS and BARS). The results for successful intubation attempts, appropriate RSI, cricoid pressure and ETCO2 during the 96 total scenarios are also recorded in Table 1(p0.05 for all critical actions).Table OneThe global competency scores show a statistically significant correlation between the intervention and performance. The BARS scores improved with each session, although the educational intervention did not correlate with the improved performance. Critical actions show a trend of improvement, but this trend was not statistically significant. Our data support simulation as an effective tool for teaching teamwork skills and improving global competency in an emergency pediatric setting. Conflict of Interest: Authors indicated they have nothing to disclose.