The UTSW High Reliability Team is offering in-situ simulation in Clements University Hospital, Zale Pavilion, and our outpatient clinic locations. Through simulation of an emergent and critical patient event and subsequent debriefing, staff and faculty are able to practice their teamwork and communication skills. This safe learning environment utilizes a high fidelity manikin or high fidelity scenarios that simulates patient decompensation. Through debriefing, participants discuss what went well and what could have been done better in regards to teamwork and communication. They are given tools from the TeamSTEPPS program to increase these skills, participants then repeat the simulation to put those tools into effect, after a final debriefing, the event ends. All in-situ simulations are designed to be interdisciplinary for Physicians, Physician Assistants, Advanced Practice Nurses, Registered Nurses and ancillary staff in clinical areas.