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Simulation was used in this conference to teach and demonstrate techniques to deal with critical operating room scenarios, develop an understanding of potential medical errors, and practice crisis-management skills. The following are a few of the scenarios that were encountered: fire in the operating room, how to handle malignant hyperthermia, and transfusion reaction. Conference attendees also participated in interactive simulation sessions dealing with intraoperative decisions in real time crisis management scenarios. Specific sessions were also held to teach difficult airway management, fiberoptic intubation, and central line placement. This year's conference was a success and WISER looks forward to the next conference in 2013.