Neonatal nurse practitioners (NNPs) have a crucial role in the management and care of critically ill newborns and infants in the neonatal intensive care unit. Their role responsibilities range from daily management of care, oversight of unit and bedside education, execution of advanced procedures, and attendance at high-risk deliveries. During their educational program, there is a mix of didactic and clinical training. To ensure that their graduates are able to competently care for neonatal patients in the ever-advancing neonatal world, the NNP program at the University of Texas Medical Branch–Galveston (UTMB), has implemented simulation-based training into every clinical course. This article describes the history of simulation in the NNP program at UTMB, discusses the current use of simulation at UTMB, explores the synergistic use of undergraduate students in simulations at UTMB, and details the use of professional volunteers from the local medical community to execute the simulations and debriefing process.