This article reviews the VA Manchester Healthcare System's journey to develop a robust simulation program and how an in situ simulation for malignant hyperthermia (MH) laid the foundation. Nurse educators collaborated with a certified registered nurse anesthetist to develop a simulation in the operating room using our MH protocol, which included the support of the Malignant Hyperthermia Association of the United States. The positive reaction from this in situ training led to additional simulation requests for the education department. [J Contin Educ Nurs. 2020;51(11):523-527.].
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