Simulation Experience

Asterisk (*) indicates a required field.

First Name*

Last Name*

Email Address*

Date*

Unit*

Years as RN*

Months since last simulation*

Type of experience, this could be*

Using equipment in actual clinical setting that was practiced in simulation Procedures (med administration) Patient education Teamwork/communication Safety Other

Please describe the experience where a simulation scenario played a key role in preparation for the clinical setting. Per HIPAA, please protect patient privacy when disclosing experiences.*

I agree to share this information with St. Jude*
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