This project is part of our established partnership project between stakeholders in Zambia and the UK. The overall aim of the project was to raise the level of education from Diploma to Degree and build sustainability through staff education and training. Part of the project resulted in the enhancement of the critical care simulation centres in two Colleges of Nursing. This presentation outlines the findings of a training of trainers simulation workshop and the development and sustainability of a simulation laboratory. Simulation provides a safe environment in which healthcare professionals can objectively practice situations not commonly seen in practice and develop confidence, technical and non-technical skills. However, its use in low-middle income countries (LMIC) is unclear. The project involved a mixed-methods approach involving a national e-survey of critical care nurses, a review of simulation equipment available and a training needs analysis. The findings were used to develop and deliver a two-day train the trainers workshops. The national e-survey revealed 100% unanimity regarding time spent in practice, and within that group, the majority argued that ideally, it should be 75% (46/62.5%). However, most respondents (55/74.3%) agreed simulation could be used as part of clinical practice to support student development, with nine (12.2%) reflecting the lack of consensus regarding the role of simulation and a further 10 (13.5%) respondents unsure of its role. 27 nurses attended the two-day simulation workshops. During which seven new simulation scenarios were designed, tested and peer-reviewed by participants. Findings from this study have been used to develop policy and practice to build flexibility into current and future critical care nurse programmes and to use different teaching and assessment strategies to respond to the current and future healthcare needs. Recommendations from this study are of importance for those establishing simulation as an educational approach, particularly in an LMIC setting. As part of the scale of critical care resources, the skills laboratories at both the Lusaka College of Nursing and Ndola College of Nursing had additional resources provided including advanced airway trainers, resuscitation manikins and basic life support manikins. Who completed the project? UK Project Team: Chris Carter Professor Joy Notter Strategic Partner: Ministry of Health, General Nursing Council, Zambia. Main Zambian Project team: Mrs Priscar Sakala Mukonka Mrs Lilian Jere Sitwala Mr Godwin Mulawisha Who are we working with? This project was funded by: Department for International Development, Health Partnership Scheme and administered through the Tropical Health & Education Trust (THET) Johnson & Johnson Africa Grants Programme. Administered through the Tropical Health & Education Trust (THET) Rotary Club Solihull