Clinical Skills Development Service

#HcSimWeek: The success of EMAC

CSDS chatted with Doctor Kersi Taraporewalla about the inception and success of EMAC. Dr. Taraporewalla became an anaesthetist in 1985 and worked as an anaesthetist until two years ago. Dr. Taraporewalla is semi-retired and is currently working on his PhD in teaching procedural skills.

What is EMAC?

Effective Management of Anaesthetic Crises (EMAC) is a mandatory The Australian and New Zealand College of Anaesthetists (ANZCA) training program in the management of anaesthetic emergencies. It covers five modules: human factors, airway management, cardiovascular emergencies, anaesthetic emergencies and trauma management.

How was EMAC born?

Dr Taraporewalla:

EMAC originated when Dr. Brendan Flanagan from Melbourne visited the United States in 2000 and observed the use of high-fidelity simulation for emergency training. He came back to Australia with the idea of developing emergency training to manage anaesthetic crises. As an anaesthetist himself he recognised a gap in the teaching curriculum relating to management and emergencies. That was the reason emergencies were often poorly handled.

Initially, combined with a few people and simulation centres that were interested at that time, they established sessions in simulation centres in Perth, Sydney and in Wellington. Between the centres they ended up writing the first EMAC course.

In 2020 there was still some opposition to constructivist teaching practices in medicine. Behaviourism learning theory was preferred because that was the traditional way. However, the result of this is that you can do things in bases, but anything that comes out extraordinary, such as a crisis, you end up falling apart.

Why do you think EMAC has been so successful?

Dr Taraporewalla:

I think the original factor that led to its success was its novelty; people realised it was teaching previously unexplored concepts. Another key aspect was its focus on human factors in management, going beyond the technical aspects.

While EMAC was initially aimed at anaesthesia trainees, it garnered interest from experienced anaesthetists who recognised its value. As EMAC underwent further development, it gained acceptance within the college. The college considered it essential to trainees to become a consultant. With becoming compulsory the demand obviously kept increasing. Despite this, there’s still a significant number of consultants attending. Moreover, completing one two-and-a-half-day CPD course often fulfils most annual CPD requirements.

And of course, the course owes much of its success to the dedicated team behind it. Without the contributions of Dr. Brendan Flanagan, Dr. Roberta Edmeades, Dr. Gabriel Mar Fan and Dan Host, the course wouldn’t have achieved such a success.


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