The effective use of simulation research in pediatrics is dependent on understanding the benefits and challenges of SBR, the simulation-specific threats to the internal validity of simulation studies, and the implementation of strategies in simulation research studies to minimize these threats as they exist in a pediatric context. Selecting valid outcome measures that are relevant, consistently measureable, and hold a plausible association to the intervention being studied is an important component in designing simulation research studies. Careful consideration of these elements, along with the establishment of a common research agenda for the pediatric simulation community, will help to ensure that high-quality SBR that tackles the most pertinent questions in pediatrics will contribute to improving the quality of care and clinical outcomes for pediatric patients.