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].Background Education programs teaching crisis resource management (CRM) skills (problem solving, situational awareness, resource utilization, communication, and leadership) have been shown to positively affect learner competence in handling crisis events. As part of an education program, a high-fidelity simulation program was used as a learning intervention to teach these skills to practicing nurses. Method In this repeated-measures observational study, 11 RNs were evaluated at four time points, measuring the effect of an education pr