Simulation Evaluation
1) Date of Session
2) Time of Day
Morning
Afternoon
3) Site
Pritchard Simulation Centre (Kelowna)
Kelowna General Hospital
Rae Fawcett Simulation Centre (Kamloops)
Royal Inland Hospital
Kootenay Boundary Regional Hospital (Trail)
Kootenay Lake Hospital (Nelson)
South Okanagan Simulation Centre (Penticton)
Penticton Regional Hospital
4) Unit
5) What is your role?
Allied Health
Licensed Practical Nurse
Medical Student
Nursing Student
Paramedic
Pharmacist
Physician
Registered Nurse
Resident
Resident (FP R1)
Resident (FP R2)
Respiratory Therapist
Student
Other
6) Simulation Experience
Strongly agree
Agree
Neutral
Disagree
Strongly disagree
N/A
The outlined learning objectives were met
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
7) Reflecting on this session, I am motivated to change my practice in the following ways:
8) Please comment on the strengths and weaknesses of the session, and share any suggestions for program improvement:
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