Easing the transition from hospital to home after a tracheostomy with discharge planning is a goal of family-centered patient care in pediatric settings. Proper tracheal tube maintenance and emergency management improves outcomes and reduces re-admissions. We hypothesized that family members caring for children with new tracheostomies will report greater knowledge, confidence, and preparedness after simulated training with high-fidelity mannequins. Parents (N=29) of children pending discharge with new tracheostomies were offered simulation training after didactic and hands-on bedside training was complete. Simulation-enhanced training consisted of four scenarios escalating in difficulty of session (training exercises and didactics) with a high-fidelity simulator most closely matching their own child's age. Post-training surveys were collected from January 2014 to January 2016. Caregivers agreed strongly with nine of 10 statements regarding preparedness, confidence, and emergency management, and 97% would recommend simulation training to other parents before discharge. Responses to open-ended questions were varied. First, describing what participants appreciated and learned, 28% noted simulation experience itself, 24% noted general tracheostomy care, and 7% noted emergency management. Second, 76% offered no topics for greater focus and improvement, and 24% suggested specific improvements. Third, general comments about training were positive (80%). Overall, caregivers favorably reported greater preparedness, confidence, and knowledge of emergency management. For unknown reasons, caregivers endorsed simulation training for other parents without consensus on additional training for themselves.