Request Simulation Education Consult

Submitted by admin on Wed, 11/25/2020 - 14:34

First Name *

Last Name *

Contact Email *

Phone Number *

Job Title *

Institution Affiliation *

CUNY

NYULH

Other

Is this request for an in-situ (on the unit sim)? *

Yes

If you selected Other, please type your institution affiliation here *

What prompted the consult for an in-situ? *

What is the goal/s of the in-situ? *

List the unit/s the in-situ will take place? *

Will your scenario include (check all that apply) *

Standardized Participants (actors)

Manikins (simulators)

Task Trainers

Will you consider using Epic Sim in your in-situ? *

Yes

Unsure

List the names and emails of all who should be included in education consult meeting *

Will this be interprofessional?

Yes

What is the anticipated start date?

Month

Day

Year

Is the in-situ part of a longitudinal curriculum or a one-time event?

How frequently will you run the in-situ (weekly, monthly, quarterly, annually, etc.)?

What education will be provided before the in-situ?

How does the in-situ address patient experience?

List the names and roles of the leads/instructors for the in-situ and describe their experience running an in-situ or simulation session

Please describe how you plan to manage, track, and report the outcomes of the in-situ, and who will be responsible for the data and sharing it with NYSIM?

Describe how the in-situ data will be shared as a research or QI project (publications, posters, presentations)

How can we help you? *

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The mission of NYSIM is to provide simulation education and research that fosters quality care, patient safety, and effective communication with patients and among health care professionals.

Request Simulation Education Consult

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Request Simulation Education Consult

Contact Info

Drop US A LINE!