Basic Simulation Education Evaluation
CME Accredited
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)
What is your role?
Allied Health
Licensed Practical Nurse
Medical Student
Nursing Student
Paramedic
Pharmacist
Physician
Registered Nurse
Resident
Respiratory Therapist
Student
Other
Were you able to review the pre-reading articles prior to the course? If yes, did the articles prepare you for today's course?
Yes
No
Please comment
Did the course meet the stated learning objectives?
Yes
No
If no, please comment
Did your personal objectives align with the overall objectives of the course?
Yes
No
If not, why?
If no, please comment
Do you have any outstanding questions related to experiential learning, quality improvement or the continuum of learning?
Yes
No
Please state outstanding questions here.
If so, please explain
Please select any/all areas where you require more clarification on the simulation framework:
Prepare
Pre-Brief
Simulate
Debrief
Post Sim
If so, please ellaborate
Facilitation Tools & Resources: Are there areas where you require more review?
Yes
No
If so, please explain
Debriefing Models: Do you understand the various debriefing methodologies?
Yes
No
If so, please explain
Debriefing Models: Are there areas in the debriefing methodologies you would like more clarity?
Yes
No
If so, please elaborate
Practice for Simulation: Please select any/all of the exercises that assisted you in solidifying simulation facilitation. Comments welcome
CRM exercise
Preparing your pre-brief
Plus Delta Practice (Lightbulb)
Puzzle
Did the instructors facilitate discussions to promote your learning?
Yes
No
Please explain
Did you perceive any bias, whether industry or other, in any part of the course?
Yes
No
If yes, 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 course, and share any suggestions for program improvement:
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