Simulation & Task Training Request Form
**If this is a new activity, the request may require a consultation with the CELS staff. **
With each simulation activity that is scheduled, we need to obtain information about the following requirements. All Request for simulation include Simulation Technologist support and designated debriefing room.
Limited to 10 per room due to COVID-19
Please upload the simulation scenario, with flow chart, and script to be used during your session.
Note- there are several adult simulators that may be used almost interchangeably.
list "n/a" if not applicable
An individual other than the patient, who is scripted in a simulation to provide realism, additional challenges, or additional information for the learner, e.g., paramedic, receptionist, family member, laboratory technician
Include the NAME of the case and provide a description. If not applicable list "n/a".
If you think your simulations may have a research component now or in the future, please select "Yes" or "Maybe" to the Research question.
Potential researchers need to meet with us a minimum of 12 weeks in advance.