Simulation & Task Training Request Form

Simulation and Task Training Request Form

Please use this form to schedule time at the Center for Experiential Learning.
  • 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.
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  • Limited to 10 per room due to COVID-19
  • Drop files here or
    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.
  • Drop files here or
    Potential researchers need to meet with us a minimum of 12 weeks in advance.