IN SITU Simulation
for CME Accredited Program only
Date of Session
Site
100 Mile House District Hospital
Arrow Lakes General Hospital (Nakusp)
Ashcroft & District Hospital
Barriere Health Centre
Boundary Hospital (Grand Forks)
Cariboo Memorial Hospital & Health Centre (Williams Lake)
Castlegar and District Community Health Centre
Chase Health Centre
Creston Valley Hospital
Dr. Helmcken Memorial Hospital (Clearwater)
East Kootenay Regional Hospital (Cranbrook)
Elk Valley Hospital (Fernie)
Elkford Community Health Centre
Golden & District General Hospital
Invermere & District Hospital
Kelowna General Hospital
Kootenay Boundary Regional Hospital (Trail)
Kootenay Lake Hospital (Nelson)
Lillooet & District Hospital
Nicola Valley General Hospital (Merritt)
Penticton Regional Hospital
Princeton General Hospital
Queen Victoria Hospital (Revelstoke)
Royal Inland Hospital (Kamloops)
Shuswap Lake General Hospital (Salmon Arm)
Slocan Community Health Centre (New Denver)
South Okanagan General Hospital (Oliver)
South Similkameen Health Centre (Keremeos)
Sparwood Community Health Centre
St. Bartholomew Health Centre (Lytton)
Vernon Jubilee Hospital
Victorian Community Health Centre (Kaslo)
Unit
What is your role?
Allied Health
Licensed Practical Nurse
Medical Student
Nursing Student
Paramedic
Pharmacist
Physician
Registered Nurse
Resident
Respiratory Therapist
Student
Other
Did the program meet the stated learning objectives?
Yes
No
If no, please comment
Did you perceive any bias, whether industry or other, in any part of the program?
Yes
No
If yes, please explain
Did the program content offer balanced views of treatment options?
Yes
No
If no, please explain
Was the simulation space suitable and did the simulation equipment function appropriately?
Yes
No
If no, please comment
Simulation Experience
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
N/A
The session was clinically applicable to my training or practice
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
N/A
The session enhanced my teamwork or communication skills
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
N/A
This experience will impact the quality and safety of patient care
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
N/A
The facilitators created an engaging and safe environment for open and honest dialogue
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
N/A
If you answered disagree or strongly disagree to any of the answers above, please explain
Reflecting on the program content, I am motivated to change my practice in the following ways:
Can you identify any barriers to incorporating what you learned today into your practice?
Please comment on the strengths and weaknesses of the session, and share any suggestions for program improvement:
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