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Wednesday 16 June 2021
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Staff training

COSBART (Continuing Scenario Based Anaesthetic Resuscitation Training)

COSBART (Continuing Scenario Based Anaesthetic Resuscitation Training) started in Salford Royal in December 2006 after we realised that the triennial ALS© type courses were aimed at managing crises on either medical wards or emergency departments.  Using standard guidelines drawn from recognised authorities (Resuscitation Council (UK), Difficult Airway Society, AAGBI) we created a high fidelity resuscitation practice simulation that was non-threatening and peer to peer. There is no faculty and there are no candidates; all those attending are recognised as experts, so the situation is analogous to an orchestral rehearsal. The completely flat hierarchical structure and courses running in an operating theatre with ancillary staff in their day-to-day roles gives extremely high fidelity at very low cost (about £40 per person). The course is recognised by the RCOA as of great value and is in the ACSA ‘Good Practice Library’.


We practice typical anaesthetic crises and update our scenarios based on local critical incident themes or SALG reports.


The courses are run every two months and every consultant in the department attends (either as facilitator or attendee) at least once a year which prevents skill degradation. 


We are happy to share the concept with any hospital that would like to use it but we do ask that Salford Royal intellectual property is acknowledged.  

If you have any questions please contact us.

Key market

Anaesthetists, surgeons, and other theatre staff worldwide.


Annual practice of in situ scenarios based on real critical incidents using existing, authoritative algorithms to rehearse teamwork and expert skills for rare, unexpected anaesthetic crises in a multidisciplinary framework with increased awareness of the effect of human factors on performance.


The repeated nature separates it from the FANZCA EMAC course, the frequency and anaesthetic specificity from ALS and the in situ nature from almost all other simulations. Multidisciplinary attendance meets ACSA standard



Like rehearsal in a string quartet it is practice; a team approach to scenarios.

  • Human factors: real time
  • Flat hierarchy: no ‘candidates’, no ‘faculty’
  • Respectful of attendees’ expertise and skills
  • Flexible responsive content from adverse incident report and SUI feedback



What COSBART is not

  • A didactic training program
  • Hierarchical
  • Assuming only basic knowledge
  • ‘High tech’