[Surgical teams in extraordinary stress environments : Education, mental resilience and simulation-based training]

Extraordinary stress situations create a dual challenge for surgical teams: they must make technical decisions under time pressure while maintaining communication, leadership and situational awareness. In trauma rooms, intraoperative crises, mass casualty incidents, military deployments and resource-limited environments, risks arise due to stress, cognitive narrowing, unclear roles and impaired team coordination. The literature describes surgical skills, simulation-based education, structured debriefing and resilience training as relevant components to increase reliable team performance. This narrative review summarizes educational concepts, assessment tools and training approaches. A longitudinal curriculum should integrate technical procedures, team communication, crisis leadership and stress regulation. Repeated interprofessional scenarios with realistic stressors, explicit learning objectives and validated feedback are suitable. Resilience is understood as an individual, team-based and organizational capability.