Contact the Simulation and Interprofessional Education Center

• Simulation and Interprofessional Education Center (SIEC)
  University of Mississippi Medical Center
  2500 N. State St., CW-100
  Jackson, MS 39216-4505
  (601) 815-9082
  Fax: (601) 815-9182

Our goal is to find the best and most efficient ways to fit skill and simulation-based training in UMMC educational programs. We need your ideas, suggestions and help! Let us know how we may improve:

• Areas/methods of training
• Supporting your training program's needs
• Our organization
• Availability/accessibility/visibility
• Other areas

Simulation Session Request Form

* = Required Fields

Faculty
Full Name:*
Email Address:*
Department(s)
Lead faculty
Additional faculty/educators
Learners
Types of learners (check as many as applies)* Undergraduate medical education Undergraduate healthcare provider education (SOD, SOP, SON, SHRP) Graduate medical education Healthcare team (postgraduate) CME From UMMC External Interprofessional Other (please specify)
Other type of learner
Level of learners*
Number of participants*
Education session
Proposed session dates
Learning objectives/educational rationale (e.g. learn to intubate, teamwork in OR crisis)*
Total # of sessions
Course structure* Mannequin/case-based scenarios Procedural skills Screen-based Other (please specify)
Other Course Structure
Simulation environment Simulation center In-situ Other (please specify)
Other simulation environment
Research & evaluation Potential for research (please describe) Patient outcome or quality initiatives Educational metrics/assessment Other
Potential for research description
Other research & evaluation
Funding (if applicable)