Background: Effective crisis management in operating rooms (OR) is crucial for patient safety. Despite their benefits, adherence to OR crisis checklists is often limited, highlighting the need for innovative solutions. Objective: To evaluate the efficacy of augmented reality (AR)-enhanced checklists compared with traditional paper checklists and no checklist scenarios in improving protocol adherence during simulated OR crises. Methods: Methods: A randomized comparative efficacy study comparing the utility of AR, paper, and no checklists using four validated simulated OR crises scenarios: asystolic cardiac arrest, air embolism, unexplained hypotension/hypoxia, and malignant hyperthermia. The study took place in a simulated OR setting and has applicability to the standard procedures in OR, critical care units, and urgent care scenarios in the emergency department. Fifty Professionals including 24 anesthesiologists, 24 nurses, 1 surgeon, and 1 scrub nurse from two academic hospitals forme