Simulation-based education for enhancing interprofessional crisis resource management and technical competency in perioperative crises: An integrative review

Background Malignant hyperthermia (MH) is a rare, high-acuity perioperative emergency requiring coordinated crisis resource management (CRM). Limited clinical exposure has made simulation-based education central to developing and sustaining CRM competency among perioperative teams. Methods An integrative review guided by the Whittemore and Knafl framework and PRISMA standards searched EMBASE, Scopus, CINAHL, and MEDLINE (October 2025-March 2026). Twenty-seven peer-reviewed publications examining simulation-based CRM and MH management in interprofessional perioperative teams met inclusion criteria. Results Simulation outperformed non-simulation modalities in developing technical and nontechnical skills and team coordination. Structured debriefing drove learning and skills transfer more than active participation. Skills decayed within months without reinforcement but were mitigated by longitudinal and just-in-time training. Cognitive load and human factors frameworks explained performance breakdown and persistent knowledge gaps, and inconsistent readiness emerged as an ongoing patient concern. Conclusion Simulation-based education coupled with structured debriefing and longitudinal reinforcement builds and sustains CRM competency for MH and other perioperative crises. Continuous investment in recurring training, competency assessment, and institutional readiness is needed to translate competence into effective team performance and improved patient outcomes.