Measures of competence during education and training of the health care workforce are in place, but how can ongoing competence be assessed, especially those who live and work outside metropolitan areas?Pediatrix Medical Group and the University of Texas at Arlington College of Nursing formed a collaboration to develop a comprehensive program of testing that will be designed to eventually provide standardized and validated assessment of neonatal advanced practitioners by creating simulation opportunities using high-fidelity simulators for education across a distance, that is, remote-controlled distance simulation (RCDS).The purpose of this paper is to report the determination of the feasibility testing of training participants using a high-fidelity manikin-based simulator at a clinical site that was being controlled by an operator located at the distant control site. This article seeks to describe the collaboration between the University of Texas at Arlington College of Nursing and Pediatrix Medical Group that enabled the pilot testing of RCDS.SimBaby™, the patient monitor, and SimView™, a high-definition audio and/or visual capture and playback system, were set up at a large metropolitan children's hospital. At the control site, there were two laptops, one of which was used for remote access of SimBaby's™ laptop and the other to control SimView™ remotely. A remote access desktop program enabled the operator access to and the ability to control SimBaby's™ software on the laptop at the clinical site. The scenario scene was set in a delivery room, where a post-term infant had been delivered through thick meconium-stained amniotic fluid. The baby developed respiratory distress and ultimately, a pneumothorax.The feasibility of training participants at a clinical site with a simulator that was being controlled by an operator at a remote distant control site was demonstrated. Minor challenges with the technology occurred but did not interfere with the participants' ability to perform during the simulation.RCDS may offer several advantages for health care provider employers, especially those with multiple locations where physical competency validation with high-fidelity manikins may be difficult or impossible.