As the time available for medical education is shortened by reductions in training hours and the demands of modern healthcare delivery, educators are increasingly looking towards simulation as a means of providing safe and reproducible situations for clinical skills teaching, decision-making and team training. The tools available for simulation-based training have developed rapidly over the past 15 years. There is an increasing range of manikins and part-task trainers - devices that permit selected elements of a skill or task to be practised independently of a whole-body manikin. Those interested in simulation have also focused significantly on adult learning theory to ensure that the training offered through simulation is appropriate, effective and complementary to other educational approaches. By mapping simulated scenarios to the Royal College of Paediatrics and Child Health Curriculum for General Paediatric Training at Level 1, the authors have developed two complementary courses aimed at preparing the general paediatric trainee for progression to the middle grade role. It is hoped that such approaches will become integral to paediatric training in the future.