Lessons from Crew Resource Management for Cardiac Surgeons


  • Patrick Marvil Division of Thoracic and Cardiovascular Surgery, University of Virginia Health System, Charlottesville, Virginia,
  • Curt Tribble Division of Thoracic and Cardiovascular Surgery, University of Virginia Health System, Charlottesville, Virginia,




Crew resource management (CRM) describes a system developed in the late 1970s in response to a series of deadly commercial aviation crashes. This system has been universally adopted in commercial and military aviation and is now an integral part of aviation culture. CRM is an error mitigation strategy developed to reduce human error in situations in which teams operate in complex, high-stakes environments. Over time, the principles of this system have been applied and utilized in other environments, particularly in medical areas dealing with high-stakes outcomes requiring optimal teamwork and communication. While the data from formal studies on the effectiveness of formal CRM training in medical environments have reported mixed results, it seems clear that some of these principles should have value in the practice of cardiovascular surgery.


Calland JF, Guerlain S, Adams RB, Tribble CG, Foley E, Chekan EG. 2002. A systems approach to surgical safety. Surg Endosc 16:1005-14.

Grogan E, Stiles R, France D, et al. 2004. The impact of aviation-based teamwork training on the attitudes of health-care professionals. J Am Coll Surg 199:843-8.

Kapur N, Parand A, Soukup T, Reader T, Sevdalis N. 2015. Aviation and healthcare: a comparative review with implications for patient safety. JRSM Open 7:2054270415616548.

McGreevy J, Otten T. 2007. Briefing and debriefing in the operating room using fighter pilot crew resource management. J Am Coll Surg 205:169-76.

Moffatt-Bruce S, Hefner J, Mekhjian H, et al. 2017. What is the return on investment for implementation of a crew resource management program at an academic medical center? Am J Med Qual 32:5-11.

Tribble C, Merrill W. 2014. The way we talk is the way we teach. J Thorac Cardiovasc Surg 147:1155-9.

Tribble C. 2016. Failing to prepare is preparing to fail. Heart Surg Forum 19:112-5.

Tribble C. 2016. A practical minded obsession with the possibility and consequence of failure. Heart Surg Forum 19:1-4.



How to Cite

Marvil, P., & Tribble, C. (2017). Lessons from Crew Resource Management for Cardiac Surgeons. The Heart Surgery Forum, 20(2), E077-E081. https://doi.org/10.1532/hsf.1807




Most read articles by the same author(s)