Original Publication
Open Access

Simulation-Based Team Training: Crisis Resource Management and the Use of Emergency Manuals in the OR

Published: December 22, 2014 | 10.15766/mep_2374-8265.9992

Included in this publication:

  • Resource A - Instructor's Guide.pdf
  • Resource A - Instructor's Guide.docx
  • Resource B - Supplies List.pdf
  • Resource B - Supplies List.docx
  • Resource C - Setup List.pdf
  • Resource C - Setup List.docx
  • Resource D - Facilitator's Notes.pdf
  • Resource D - Facilitator's Notes.docx
  • Resource E - Simulation Scenario Stems.pdf
  • Resource E - Simulation Scenario Stems.docx
  • Resource F - CRM Handouts Stanford.pdf
  • Resource G - Use of Emergency Manual in OR.pdf
  • Resource H - Training Evaluation Form.pdf
  • Resource H - Training Evaluation Form.docx
  • Acknowledgments.pdf

To view all publication components, extract (i.e., unzip) them from the downloaded .zip file.

Editor's Note: This publication predates our implementation of the Educational Summary Report in 2016 and thus displays a different format than newer publications.


This resource describes a simulation-based training program focused on teamwork skills for managing critical events and the effective use of perioperative emergency manuals. Emergency manuals are context-relevant sets of cognitive aids, such as crisis checklists, that are helpful for assisting clinical management during critical events and for training clinicians. In this case, both the resource and training program are geared towards the perioperative setting and operating room teams, but the concepts of why, how, and when to use emergency manuals are relevant to many areas of health care. Both crisis resource management skills and appropriate use of cognitive aids support the ultimate goal of assisting trained clinicians in delivering effective and efficient care to patients during critical events. To help other teams, we have included a complete set of resources to assist in inspiring, planning, and evaluating related training programs at their institutions. We successfully implemented this simulation training curriculum in our institution’s operating rooms. In total, 126 staff participated in the training curriculum, including 64 nurses, 30 surgical technicians, 15 operating room assistants, 12 anesthesia technicians, and five staff members from other operating room roles. Following the training sessions, familiarity with the existence and format of the emergency manual increased significantly. Participants reported a greater willingness to use the emergency manual for pre-crisis educational review and as a resource for debriefing. Additionally, participants reported a significant increase in willingness to suggest the emergency manual for use during rare, refractory, and complex events. Participant satisfaction with the sessions was high, with many qualitative responses expressing desire for more trainings of this type.

Educational Objectives

After completion of the training, participants will be able to:

  1. List three important crisis resource management principles, each with an effective technique for implementing to improve teamwork.
  2. Identify the locations of the emergency manual in the operating room.
  3. Identify three critical events for which the participant is able and willing to prompt team use of an emergency manual.

Author Information

  • Sara Goldhaber-Fiebert, MD: Stanford University School of Medicine
  • Vivian Lei, MD: Vanderbilt University School of Medicine
  • Mary Lou Jackson: Stanford University School of Medicine
  • Kristen McCowan: Stanford University School of Medicine

None to report.

None to report.


Goldhaber-Fiebert S, Lei V, Jackson M, McCowan K. Simulation-based team training: crisis resource management and the use of emergency manuals in the OR. MedEdPORTAL. 2014;10:9992. https://doi.org/10.15766/mep_2374-8265.9992