Simulation Facilitator Application

Demand for simulation is growing across Intermountain Healthcare. This educational modality is extremely effective, yet it costs more than other approaches. The need for quality facilitators who will innovate and champion simulation-based education is crucial for program support and participant success.

Applicant Information

Name: ______

Title: ______

Region: ______Hospital:______Unit: ______

Date of application: ______

First choice of course dates requested: ______

Second choice of course dates requested: ______

**Course dates – please see website for course dates

Applicable Employment History:

Education:

Highest degree earned:

Describe why you are interested in becoming a simulation facilitator and how your participation will benefit your unit and/orIntermountain Healthcare:

In order to maintain competency, you will be required to facilitate a minimum of 4 simulation sessions per year (One session= 2-3 scenarios). What programs will you develop or participate in to meet this requirement?

Signature Date

I have read and understand the Simulation Facilitators Education Standards (page 3). I will complete the initial training as outlined and participate in the recommended ongoing education.

ManagerRecommendation for:______

After reviewing the Simulation Facilitator’s Education Standard, observe the applicant teaching. During observation, use the scale below to rate these characteristics identified in effective facilitators.

Rating Scale / 1 / 2 / 3 / 4 / 5 / 6 / 7
Descriptor / Extremely Ineffective/
Detrimental / Consistently Ineffective/
Very Poor / Mostly Ineffective/
Poor / Somewhat Effective/
Average / Mostly Effective/
Good / Consistently
Effective/
Very Good / Extremely Effective/
Outstanding

Please rate the candidate on the following characteristics:

______Communication ability?

______Credibility with superiors, peers, and associates?

______Ability to engage an audience?

______Ability to guide learners to discover answers (rather than giving answers)?

______Ability to patiently work with new employees or those needing extra mentoring?

______Receptive to feedback?

______Ability to use constrictive feedback to improve oneself?

Other considerations prior to approval include:

  • What is this candidate’s clinical experience?
  • Is this candidate a content expert (currently at the bedside or has significant relevant experience)?
  • What makes this candidate a good facilitator, not just a good trainer?
  • Will this candidate require significant mentoring and on-boarding into the facilitator role?
  • Will this candidate be a champion for Simulation?
  • How will this candidate be able to apply this knowledge on your unit?
  • How will you cover the cost of the course ($500 plus 24 hours participant time) and internship sessions (approximately 10-15 hours) as well as the continuing requirements to maintain competency (see page 3)?

Final comments for recommendation:

Signature: (please sign & print) Date

Regional Simulation Coordinator - I approve the above candidate attend the Simulation Facilitator Course

Signature: (please sign & print)Date

Employee Manager or Education Director - I approve the above candidate attend the Simulation Facilitator Course

Signature (Central Office)Date

Simulation Facilitators Education Standard

New Instructor Training Requirements

Purpose:To identify consistent training requirement for new instructor’s system-wide

  • Attend Intermountain Simulation Facilitator Course and
  • Complete internship consisting of 3 classes with Senior Instructor (turn completed form into Regional Simulation Coordinator)

Internship Sessions: ______

To be completed within one year of Intermountain Approved training course

Senior Instructor Name / Date / Brief session description
Observed Only
Co-Debrief
Debrief (with instructor)
Debrief (optional)

Continuing Education for Simulation Facilitators

  • Instructor must lead at least 4 simulation sessions a year, with no longer than 6 months between sessions.
  • Attend semi-annual simulation facilitator continuing education.
  • Yearly performance evaluation using approved standardized evaluation tool by Regional Simulation Coordinator or designee.

Regional Simulation Representative

The role of a Regional Simulation Representative is to provide support for new Simulation Facilitators. They assist in arranging Simulation internship sessions and provide ongoing support for creating Simulation education.

Please note: All proposed Simulation Education must be submitted and approved through Strategic Clinical Education Team and the Simulation Guidance Council using an education plan.

System Simulation Director: Nancy

System Simulation Medical Director: Jared W.

System Simulation Coordinator: Ashley Cassity

System Simulation Coordinator: Stephanie

North Region Lab Coordinator: Marlene Summer

Central Region Simulation Manager: Jenny Simmonds

CentralRegion Lab Coordinator: Patricia

Primary Children’s Medical Center Lab Coordinator: Brenna Thomas

South Region Simulation Manager: Angie

South Region Lab Coordinator: Kristi Stevenson

Southwest Region Lab Coordinator: Brenda

*Please note – application submission does not guarantee acceptance into course. You will not be able to register for this three-day course until your application is approved by the Central Office Simulation Guidance Council.*