David Hakim is an anaesthetist (anesthesiologist) who lives, works and chases race cars in Canada. He gave one of the talks at last year's ICMS annual general congress in Indianapolis. The topic he chose was one that he has spent some time exploring in order to try to streamline how motorsport rescue and safety is practiced by the team that he works with. 

This exploration led him to learning more about how we think and behave in certain situations and, more importantly, what we can do about it to get the best outcomes.

Here's a breakdown of what we get into. It isn't everything that you need to know, so check out the references at the end for further reading.

1) What is Crew Resource Management?

There are several varieties of definition, but essentially it boils down to developing ways of doing things (processes, procedures, strategies) that minimise error potential and enhance the capacity for the individuals involved to best use their knowledge, skills and immediately available resources to achieve the best outcome possible for the situation.

It originated from the aeronautical industry as a way of trying to understand why crashes and mishaps occurred and then identifying strategies to prevent their recurrence. A lot of the language and characteristics of the CRM process have been ported over to various areas of medicine, with a number of groups and individuals working to figure out how best to apply these lessons to patient care.

Crew Resource Management (CRM) is also known by several different names including Crisis Resource Management and Cockpit Resource Management. However, direct extrapolation from aeronautics to another industry is not always valid and there often needs to be some tailoring of practice. So the term is often altered to fit and in motorsport medicine, it has been called Race Resource Management.

Regardless of the name, the key element of CRM is careful analysis of processes to identify the strengths and weaknesses leading to the developments of a strategy that promotes the best outcome followed by ongoing assessment to ensure that the target outcomes are being achieved and evolving as new information comes to light. It is an organic process.

2) Why should we care about CRM?

In general, when things are going smoothly, the stress levels are low and we feel like we are on top of our game. However, that time that we are really tested is when things are deviating from the intended trajectory. This is when a situation can feel like either a challenge or a threat, depending upon whether we feel that we have the requisite knowledge, skills and ability to deal with it. If any of these three components fail, the chance of error and therefore a bad outcome rises.