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Simulating Crises for Optimal Response in Emergencies (SCORE) is a multidisciplinary medical education course, especially designed to meet the unique challenges of rural and community health care providers.  Health care practitioners in Emergency Medicine, Hospitalist Medicine, Anesthesia, Intensive care and other acute care disciplines must all possess the skills necessary to manage unpredictable, high acuity and high stakes clinical situations. SCORE emphasizes the role of non-technical and human factors in effective team performance for these challenging situations.  Using a combination of high fidelity simulation, in-depth post simulation debriefing and crisis resource management coaching sessions, SCORE provides participants with a chance to develop and practice the types of leadership, communication, teamwork and problem solving skills necessary for effective crisis response. While most of the content is applicable to all practice environments, a particular emphasis on rural and community hospital resource limitations is embedded in the course content.