UChicago Simulation Center

Simulation Request

 

Welcome to our Simulation Request form.  This online tool will help us to conceptualize and implement your simulation, training session, or event. Sim Center staff will assist you in planning, developing, and evaluating the effectiveness of your event.  We ask that you plan 6 to 8 weeks in advance as we may be unable to accommodate late requests. All requests are reviewed on a weekly basis.

 

Reservation Form

We look forward to partnering with you to offer high quality simulation and measure the impact of your intended objectives. Please note the Simulation Center is significantly understaffed, reducing our capacity. We will be reviewing all requests weekly- please expect delays in responses and longer times to availability. 

This form will not save. Be sure to have all information available at the time of completion. For more information about available resources, please visit our equipment and lab space page.

Provide your contact info:

Project: Provide a few lines of information for each section of the form.

Project Type:

Please select this checkbox only if you are a unit educator and are requesting a crash cart for training purposes related to Zoll Defibrillator or crashcart familiarization.

Please note that the crash cart provided is equipped with simulated medications and equipment and is not intended for patient use. It should only be used for training purposes and not for emergency situations. The cart should not be left unattended on the unit floor and staff should be notified of it's presence.

By checking this box, you acknowledge that you have read and understood the above information, and that your request for a crash cart is for authorized training purposes only.

Use this field to request in-unit mock code training/ CPR and crash cart training/ that will be tailored to your unit's needs. Our Sim Center educators will work with you to develop and implement the training in your unit, taking into account your team dynamics and the specific challenges that you face.

Is this event fulfilling an accreditation requirement?
i.e. "X simulations are required annually for internal medicine residency program"
Is this event in response to a patient safety event?
What tools will you use to evaluate objectives?
Learner Types (select all)
Note: Timelines for simulation are longer than normal due to lack of staffing.
What room types are requested?
Type of manikin requested (select all that apply)
We can partner with you to identify the best manikin.
Will moulage be required?
*If yes, you must outline details in the project plan and methods field. This also must be coordinated with a Sim Tech prior to implementation.
Will you require Audio/Visual support:
Select all that apply
Will a vendor be supplying any of the following?
Select all that apply
Provide the name of your primary vendor contact
Provide the name of your primary vendor contact
First Name
Last Name

Maximum file size: 52.22MB

Maximum file size: 52.22MB

Maximum file size: 52.22MB


Surgical Cadaveric Lab 

The surgical cadaveric lab spaces are a shared resource across the entire health system. Even if a simulation specialist is not present during the procedural lab components, each lab requires planning, set-up, clean-up, and appropriate chain of custody for all specimens.

I agree to the following rules:

  • No eating is allowed in the cadaveric lab spaces
  • No photography or videography is permitted
  • PPE is required (minimum of gown and gloves)
  • All trash will be disposed of properly prior to leaving the lab
  • Specimens will be treated with respect and identification papers will remain with the specimen at all time
  • Participants will leave the lab clean after use

Agreement

I understand that submission of this request does not reserve or guarantee requested dates or resources.

I agree to partner with the Simulation Center team to capture outcomes.

I agree to uphold psychological safety for all participants and treat everyone with respect.

If I publish on this work, I will acknowledge the University of Chicago Medicine Simulation Center in my publication.

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