The ACRM Training Course

The ACRM curriculum uses several teaching modalities to achieve the training goals:

Readings from Crisis Management in Anesthesiology, didactic presentations, and discussions concerning anesthesia safety, decision making and action, and generic principles of crisis management and resource management in the operating room
Analysis of a videotape of an aviation accident
Small group exercises analyzing a videotape of an actual anesthetic mishap or a simulator reenactment of an anesthetic mishap
Didactic module on systems thinking in order to help participants realize systems-related failures affecting patient safety and human performance in health care institutions
Exercises in debriefing and analysis of critical incidents in order to help participants contribute to Mortality and Morbidity meetings (M&M) effectively



			The ACRM trainee (anesthesia resident) interacts with the surgeon about the situation. In many scenarios, the surgeon is scripted to be argumentative so the trainees can practice good communication skills.

Simulator Sessions in which the realistic simulator is set up in an "operating room" in the dedicated Simulation Center. Groups of 4-5 participants undergo several hours of simulation during which each participant was the primary anesthetist for 30-45 minutes (1-3 critical event scenarios). The remainder of the time they play other roles including that of another anesthetist who will be the first to be called into the room if help is needed ("first responder" who comes into the simulation "cold") and that of the scrub nurse (which gives another perspective on the unfolding scenario). An OR nurse plays the role of the circulating nurse, while an instructor, surgical resident, or OR nurse plays the role of surgeon. Most scenarios are designed to require significant interaction with the nursing and surgical personnel. The simulation sessions are recorded on videotape (multiple views) and participants are encouraged to "think aloud" so as to aid the debriefing process .



			Steve Howard debriefs the trainees using the videotape from the previous scenario.

Debriefing Sessions follow each simulation scenario, and lasts approximately 30-45 minutes. The participants view the videotapes and critique their own performance with the assistance of a specially trained anesthesiologist instructor. While medical and technical issues related to the scenario are discussed, the emphasis is on analyzing performance and options related to the generic principles of crisis management behavior.