Background: Resident physicians often observe stroke alerts before managing them alone. However, this practice exposes patients to potential harm from trainees’ lack of experience. To address this, we created a acute stroke simulation course. Simulation training offers a low-risk environment for skill acquisition, complimenting the Royal College’s recent transition away from a time-based to competency-based learning curriculum. The purpose of this project was to develop and implement a stroke simulation training program into resident neurology rotations at the University of Saskatchewan. Methods: Six high-fidelity acute stroke simulation cases were developed with the aid of a Simulation Operation Specialist. We identified objectives corresponding to Royal College Entrustable Professional Activities for Adult Neurology encompassing several diagnostic and therapeutic goals of acute stroke care. To increase fidelity, a standardized patient was recruited and trained on how to respond to neurologic exams given a specific stroke syndrome. A standardized debrief was given after each session in a safe, non-judgemental environment. Results: Simulation sessions have been running monthly since March 25, 2021. Conclusions: The creation and implementation of high-fidelity simulation training into a resident curriculum is feasible. Ongoing data is being collected to explore residents’ experiences and knowledge improvement in stroke, and to asses local reductions in treatment delays.