The Maintenance of Certification in Anesthesiology (MOCA®) part 4, Practice Performance Assessment & Improvement program is sponsored by Cleveland Clinic’s Anesthesiology Institute and it consists of a single day, eight-hour training and CME course. Practicing anesthesiologists who successfully complete this course fulfill their American Board of Anesthesiologists Part 4 required points for the MOCA® 2.0 program. The American Society of Anesthesiologists, through their Simulation Education Network has endorsed this Cleveland Clinic course, recognizing the high quality standards required for this designation.

Additional Resources


Accreditation Council for Continuing Medical Education (ACCME) | Cleveland Clinic

Cleveland Clinic’s Continuing Medical Education Department is accredited by the Accreditation Council for Continuing Medical Education (ACCME) to provide continuing medical education for physicians and designates this live activity for a maximum of 6.75 AMA PRA Category 1 Credits™. Physicians should claim only the credit commensurate with the extent of their participation in the activity.

Contact Information

Carlos E Trombetta, MD, MEd, CHSE
Director, Cleveland Clinic Center for Simulation & Maintenance of Certification in Anesthesiology
9500 Euclid Ave. J4-331, Cleveland, OH 44195

For general information related to the course, please email moca@ccf.org.



Goals and Objectives

The goal of the program is to provide participants with an educational experience that simulates patient management challenges and scenarios designed to improve their skills in managing common and less common scenarios in which it is important to “practice” technical and cognitive skills required to provide successful strategies for providing a high quality, safer anesthesia practice. Through a series of simulations, we will help our participants recognize the importance of incorporating accepted standards of care towards providing high quality and safe anesthetic practices, using fluent communication skills, and employing the appropriate use of principles of crisis resource management into their daily practice.

The objectives of the program will be as follows. Upon completion of this course, participants will:

  • Recognize the importance of the different components of crisis resource management, as a mean to identify the best possible strategies to address an intraoperative emergency.
  • Be able to discuss different quality and patient safety strategies that could be implemented in his/her work areas.
  • Recognize the importance of effective teamwork with fluent and appropriate communication strategies essential to a successful perioperative team.
  • Demonstrate effective skills in diagnosis and management of significant hemodynamic instability, significant hypoxemia, and a difficult airway.
  • Develop a practice improvement plan that they can apply to their own practice environment.

Program Details

The program includes a dedicated a single day, eight-hour course for each session, starting at 8am, with an estimated ending time of around 4pm. During the course, participants will have the opportunity to experience, manage and discuss uncommon, critical events that can occur within an anesthesia practice.

Concepts of crisis resource management in the perioperative period are presented along with emphasizing the importance of communication and team leadership skills. These concepts are initially presented within a lecture format and expand into a small group activity, which are designed to help you refresh these concepts, express their understanding, and identify areas of improvement. By correlating key foundational concepts with prior personal experiences, the stage is set to understand the value of addressing these issues through simulation.

Each anesthesiologist will have the opportunity to play the role of the primary anesthesiologist in one case and as a secondary responder in a different case. Each scenario is followed by a group debriefing activity, where the entire group will have the opportunity to discuss the case.

This course will not be graded and there will not be a test. The goal is to provide participants with the opportunity to reflect on important aspects of safe and quality anesthesia care during a critical event, and translate this experience into practice.

The day concludes with a review of strategies to develop a practice improvement plan that participants can apply to their practice area and submit to the ABA in order to claim their MOCA Part 4 points for this cycle.



Cleveland Clinic Simulation and Advanced Skills Center
Stanley Shalom Zielony Plaza,
8911 Euclid Avenue (corner of East 89th Street) 
Cleveland, OH 44195  

Lodging Information

Hotels and lodging options located on the Cleveland Clinic main campus.

Schedule and Cost

Schedule and Cost

2024 Dates

Please check back at a later time for our 2024 schedule. 


7:30 a.m. - 8 a.m. Check in and breakfast
8 a.m. - 8:30 a.m. Introduction to MOCA and simulation
8:30 a.m. - 9 a.m. Crisis Resource Management
9 a.m. - 9:15 a.m. Morning coffee break
9:15 a.m. - 9:30 a.m. Introduction to simulation center video and tour of center
9:30 a.m. - Noon Simulation sessions 1 – 3
Noon - 12:45 p.m. Lunch
12:45 p.m. - 3:15 p.m. Simulation sessions 4 - 6
3:15 p.m. - 3:30 p.m. Afternoon coffee break
3:30 p.m. - 3:45 p.m. Practice improvement plans
3:45 p.m. - 4 p.m. Conclusion and course evaluation

Cost and Enrollment

Internal CCF/Akron General Employees: $500.

ExternalNon CCF Employees candidates: $1,850.

Cleveland Clinic staff can email moca@ccf.org for details regarding cost and registration.

The cost includes tuition, CME credit, ASA fees, breakfast, lunch, education materials and a parking permit. Cancellations requested less than four weeks prior to the course will incur a $300 administrative fee and there will be no refunds if cancelled within two weeks prior to the course date.

Enrollment is completed on a first-come, first-served basis, upon payment confirmation. There is a limit of 5 participants per course. Any session with fewer than five confirmed participants will be cancelled. Enrolled participants will be notified of cancellation at least four weeks prior to the scheduled course.



Internal Cleveland Clinic/Akron General Employees:

Cost: $500
Register here.

External Non-Cleveland Clinic Employees candidates

Cost: $1,850
Register here.

Cancellation Information

Cancellations made less than four weeks prior to the course will incur a $300 administrative fee and there will be no refunds if cancelled within two weeks prior to the course date.

Confirmations for course attendance will be provided as soon as five participants have been confirmed. Any session that does not have a minimum of five confirmed participants will be cancelled.

Enrolled participants will be notified of cancellation at least four weeks prior to the scheduled course, and given the option of a full refund, or re-scheduling to a different date.