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• A distance education and simulation curriculum can be delivered using VRR and Zoom. • Locally relevant distance curricula can increase nurse's learning and empowerment. • Distance simulation can increase the learner's teamwork, knowledge and confidence. • International multidisciplinary partnerships are key to distance simulations. The study assessed a distance simulation and education intervention designed to improve nursing empowerment in the pediatric intensive care unit (PICU) in Korle Bu Teaching Hospital (KBTH) in Ghana. This was a single center, mixed methods, longitudinal simulation-based pilot study. A distance pediatric critical care nursing curriculum that combined interactive learning via Zoom and distance simulation using the Virtual Resus Room was designed and delivered from the United States to KBTH PICU nursing staff. The Clinical Teamwork Scale, used to assess team performance after each simulation, demonstrated an upward trend over time in all categories. The modified Simulation Effectiveness Tool was utilized to evaluate the learners' perceptions of the effectiveness of the simulation in meeting their learning objectives. Qualitative content analysis of this free-text feedback highlighted the course's educational content, organizational aspects, learning experience, simulation case scenarios and relevance to pediatric critical care in Ghana. A distance pediatric critical care nursing curriculum, relevant to local practice and resources, was implemented through an international partnership and contributed to nursing empowerment through improved learning and confidence. [ABSTRACT FROM AUTHOR]