Enhancing Anaesthesia Crisis Resource Management through Simulation: A Narrative Review on Current Evidence and Future Directions

Crisis Resource Management (CRM) is a structured approach designed in maximising teamwork, communication, leadership, and situational awareness under high-risk perioperative conditions. Adapted from aviation, CRM principles have been implemented in anaesthesia to ensure non technical skills can influence patient outcomes to the same extent as technical expertise. HighFidelity Simulation (HFS) is a core facilitator of Anaesthesia Crisis Resource Management (ACRM), allowing clinicians to practice rare but potentially fatal events—such as malignant hyperthermia, perioperative cardiac arrest, and airway disasters in safe, controlled conditions. Simulation-based training enhances crisis preparedness, improves interprofessional communication, and develops team performance, with structured debriefing reinforcing learning and promoting effective behavioural responses. Skill acquisition, retention, and clinical performance can be objectively evaluated using behavioural rating scales, global evaluation forms, and digital analysis. Innovative educational approaches—including mental rehearsal, flipped classroom, video-assisted debriefing, telesimulation, Virtual Reality (VR), and Artificial Intelligence (AI)—are expand access, realism, and overall effectiveness of ACRM programs. Simulationbased CRM education provides a scalable model for enhancing patient safety in anaesthesia by addressing challenges related to standardisation, cost, and scalability. This review examines the clinical application and future directions of ACRM, emphasising technological advancements, current research, and strategies to translate non technical skills into safer perioperative practice. The novelty of this review lies in its comprehensive integration of emerging technologies such as VR, AI, and telesimulation with traditional ACRM methods, offering fresh perspectives on enhancing accessibility, realism, and scalability in anaesthesia crisis management training.