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Conclusions Regular simulation training with deliberate practice can improve PICU nurses' knowledge, clinical teamwork skills, and confidence when managing low-frequency, high-impact events. Practice implications Regular in-situ simulation training with deliberate practice can improve nursing comfort with managing high-impact, low-frequency events in the PICU. This could lead to improved management of actual events, especially for novice nurses with less than one year of PICU experience.Although confirmed cases of the deadly coronavirus