Consider CRM training

Residency Program Insider, May 9, 2006

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Consider CRM training

Crew resource management, or CRM, is accomplished through a combination of teamwork, communication, and the use of safety tools. The safety improvements that CRM provided in aviation are now being adapted by healthcare systems and academic medical centers. In addition, CRM techniques can be incorporated into standard training for medical students and residents.

CRM helps teams working in environments where safety is critical by:

1) Training teams to use specific teamwork and communication behaviors

2) Implementing safety tools (e.g., procedures, protocols, checklists, etc.) that complement those behaviors to detect and trap small errors before they become serious or even fatal mistakes.

A CRM training program consists of the following basic elements:

1) Building a team: Includes learning the importance of making a checklist, doing a briefing, and stressing the importance of team leaders.

2) Red flags: This entails understanding that every adverse event in a situation is preceded by known warning signs. The idea is that you can prevent adverse events from happening if you recognize the warning signs.

3) Cross-check and communication: This includes knowing your job, as well as what everyone else on your team is supposed to be doing. This skill includes teaching team members to:

  • Get someone's attention
  • Express concern with the situation
  • Clearly state the problem
  • Propose a solution

    While interest in CRM derives from a desire for institutions to decrease errors and improve patient safety, the tenets of CRM training match well with ACGME's six core competency requirements. In particular, CRM highlights:

  • Interpersonal and communication skills
  • Patient care
  • Systems-based practice

    All the best,

    Captain Stephen W. Harden

    President, Lifewings Partners, LLC
    Cofounder, Crew Training International

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