Booking Request

Please complete this booking request form to facilitate the planning of your simulation-based learning session. The simulation team will review your request and may contact you to discuss your specific simulation requirements.

Important Info

  • All education materials must be submitted a week prior to the event.
  • Submitting this form does not guarantee a reservation.
  • Booking requests will be confirmed via email within two working days.
  • Booking includes one Simulation Specialist (who will run the equipment, set up the space and be a facilitator for the session) as well as all equipment associated with the booked room.

Hours of Operation

Monday - Friday 8:00 a.m. – 5:00 p.m. (excluding statutory holidays).
(Booking of the Centre outside regular business hours is based on resource and staff availability.)

Please select the type of booking that you would like to make.



 
  • Requestor Details
  • Requirements
  • Participants
  • Research Details
  • Review

Requestor Details

Session Details


 
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Location Requirements

Select Simulation Site Select all that apply



Simulation Requirements

Please select a simulation site above.

Facility Requirements (St. Michael's Hospital) Select all that apply






Facility Requirements (St. Joseph's Health Centre) Select all that apply


Facility Requirements (Providence Health Centre) Select all that apply


Equipment Requirements (St. Michael's Hospital) Select all that apply










Equipment Requirements (St. Joseph's Health Centre) Select all that apply


Equipment Requirements (Providence Health Centre) Select all that apply









 
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Participant Details

Learners and Participants

We strongly encourage you to consider how you might make your simulation interprofessional. Please select all that apply.











Session Rationale




Evaluation Details

Do you have your own program evaluation form?

If yes, please attach your evalutation form (PDF only, max 3MB).

Do you have your own instructor evaluation form?

If yes, please attach your instrutor evaluation form (PDF only, max 3MB).

Have you performed a needs assessment?

Additional Requirements

What kind of assistance will you need from the simulation team?







 
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Session Details

Anticipated Time Requirements

Protocol Requirements

Please attach a 1-2 page protocol summary (PDF format only, max 3MB) including:
  • Scholarly/research question(s)
  • Background rationale and brief literature review
  • Description of the project and methods to be used in its development and evaluation
  • Description of the potential for impact on the program and externally
Does the scholarship or research align with any of the following Please select all that apply.




Purpose What are the data being used for?



Study Personnel

Have you or someone on your team conducted simulation research before?

If yes, who on your team has the experience to conduct this research?

Do you have existing research capacity or support?

If yes, please specify

Research Ethics

Has formal REB approval been sought or granted?

If not, please indicate the reasons


If yes, please provide the protocol reference number and specify the REB body you applied for
Do you have a research budget?

If yes, please attach a copy of your budget here (PDF only, max 3MB).

Please note that your request for research and 1-2 page protocol will be reviewed by our Research Director and committee. We will be in touch once we have reviewed your application.


 
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Please review the entered information and click Submit to send your request.

Booking Type:

Requestor Details

Name: none
Email: none
Phone: none
Main Faculty / Educator / Lead / Principal Investigator:
Program / Division / Department:

Session Details


Title: none

 
Tour Location: none

 
Date details:

Location Details and Requirements

Site(s): none

Facility Requirements
none
 
Equipment Requirements
none

Participant Details

Number of Participants: none
 
Participant types: none
 
Session Rationale: none
 
Evaluation Details
Evaluation Form: none
Instructor Evaluation Form: none
Needs Assessment:none

Additional Requirements
Assistance needed: none

Research Details

Project Title: none
 
Anticipated Time Requirements
Start Date: none
Number of Sessions: none
Time per Session:none

Protocol: none

 
Alignment
none
 
Purpose
none
 
Data use/dissemination:
none
 
Personnel
Experienced Researchers: none
Research Capacity and Support: none
 
Ethics
REB Approval:none

none

Budget:none


Questions

Want to learn more about our facilities? Do you have questions around how simulation can help you?
Send us an email and you will receive all your answers.

Register for an ACLS Class

The Simulation Program offers both ACLS full certification and re-certification classes. Please download the registration form to sign up and see payment options.

Tour our Facilities

Tours and general access to our Simulation Centres and spaces are available by request and must be pre-approved by the Simulation Program Manager. Simply complete a booking and we will do our best to accommodate your request.

 Start your booking

As per the Royal College of Physicians and Surgeons of Canada accreditation guidelines, every simulation activity is subject to audit for Quality Assurance purposes.