Project summary With the increasing maternal mortality in the USA, modalities to reverse this trend is an imperative. Improvement in knowledge for individual health care workers and enhancement of team performance, especially communication, has been clearly identified as a gap in providing quality care. Simulation-based training as an educational tool is a proven entity for team performance and communication; however, widespread dissemination of simulation technique is hampered by the present model of on-site training by specialists. This project will evaluate the effectiveness of a hybrid simulation program - combining online training (telesimulation) with a shortened in- person training in lower resource hospitals. If successful, simulation-based training will be more accessible to hospitals that have a high burden of populations that are affected disproportionately by maternal morbidity and mortality, such as those with higher underserved minority and socio- economically challenged populations and rural communities.