TTUHSC SOP
Clinical Simulation and Assessment Center
Learning/Assessment Script
Course Number/Name: __________________________________________
Team Leader Name &Phone Number: ______________________________________________________
Dates, Times & # Students Simulation/Assessment:
Monday
Tuesday
Wednesday
Thursday
Friday
Saturday
Date:
Time:
Date:
Time:
Date:
Time:
Date:
Time:
Date:
Date:
Time:
# Students
# Students:
# Students:
# Students:
# Students
# Students
Campuses
Campuses:
Campuses:
Campuses:
Campuses:
Campuses:
Title of Script: _________________________________________________
Learning/Assessment Objectives For The Session: At the completion of this activity, the
student should be able to do the following skills: (Numbered, measureable objective statements for
only this session, not the entire course/IPPE)
1.
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Brief Description of Learning Activities to Achieve the Learning Outcomes:
Type of Simulation/Assessment: (Check All That Apply)
☐Manikin
☐Existing Program
☐Standardized Pts
☐With Pts Grading ☐With Faculty Grading ☐Pt Training
☐Debriefing Sessions With Students In Groups
☐Faculty Video Copy
☐Students In Teams
☐Team Provided Program
☐Include Patients In Debriefing
☐Individual Student Videos
If Checked: Number Students/Team: 2 students/team; 4 teams total
Other: (Describe) _____________________________________________________________________________________
Special Equipment/Supplies Needed: (Include Number of Supplies Required/Student)
Special Directions For CSA Staff:
Approvals:
Course Team Leader: ____________________________________ Date: ___________________
CSA Director: _______________________________________________________ Date: ________________
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