For up-to-date information about COVID-19, click here.
Skip to content
Simulation and Interprofessional Education Center
Search UMMC
Mobile Navigation
UMMC Navigation
⌂
UMMC Home
Education
School of Dentistry
School of Graduate Studies
School of Health Related Professions
School of Medicine
School of Nursing
School of Pharmacy
School of Population Health
Continuing Health Professional Education
Faculty Directory
For Faculty
For Students
Prospective Students
Residents and Fellows
Rowland Medical Library
UMMC Bookstore
Health Care
Health Care Home
All UMMC Services
Children's of Mississippi
Find a Doctor
Find a Location
Pay a Bill
UMMC Pricing
Patient and Visitor Information
Referring Physicians
Health Library
Research
Research Home
Centers and Institutes
Offices
Resources
Research Partnerships
About
A-Z Site Index
About Us
Accreditations
History
Jobs at UMMC
Leadership
Mission and Vision
Give
MyChart
Appointments
Simulation and Interprofessional Education Center
About Academic Affairs
Academic Effectiveness
Accreditation
Assessment
Degree Programs
Potential Academic Changes
Continuing Health Professional Education
Institutional Research
What We Offer
External Surveys
State Authorization
Program Overview
Student Consumer Disclosures
Student Complaint Resolution
Professional Licensure
Academic Development
What We Offer
Faculty Recognition
Faculty Senate
Grants for Faculty
Interprofessional Education Collaborative
Students
Academic Affiliations
What We Offer
Academic Support
What We Offer
Academic Accommodations
Academic Consulting Services
Academic Success Kiosk
Excellent Teacher
University Tutoring Services
Writing Support Services
Center for Bioethics
What We Offer
Community Engagement
What We Offer
eCampus
What We Offer
Outreach Programs
What We Offer
Base Pair
MS Rural Physicians Scholarship Program
MS Rural Dentists Scholarship Program
STEMI
Office of Interprofessional Simulation, Training, Assessment, Research & Safety (ISTARS)
What We Offer
Basic and Advanced Resuscitation Training Center
Gearhart Clinical Skills Center
Mississippi Academy for Simulation Training
Simulation and Interprofessional Education Center
Phi Kappa Phi at UMMC
Learn More
Prospective Students
What We Offer
Admissions and Financial Aid
Deadlines by School
Find the Right Program for You
Student Testimonials
Take Your Next Step
Student Affairs
What We Offer
Associated Student Body
Financial Aid
Title IX and Sexual Misconduct
Student Accounting
Student Information Systems
Office of Enrollment Management
Commencement
Faculty
Academic Affiliations
Academic Development
Community Engagement and Service Learning
Condensed Academic Networking Knowledge
Center for Bioethics
Academic Support
Commencement
Health Careers Opportunity
Interprofessional Simulations, Training, Assessment, Research and Safety
eCampus
U Med Cred
Faculty Affairs
What We Offer
Development
Faculty and Staff Resource Guide
Recruitment
Resources
Continuing Health Professional Education
What We Offer
UMMC Conference Center
Resources
Rowland Medical Library
UMMC Bulletin
UMMC Bulletin Archive
Faculty and Staff Handbook
UMMC Bookstore
Maps and Directions
Nelson Student Union
Student and Employee Health
Office of Academic Affairs
For Students
Interprofessional Simulation, Training, Assessment, Research and Safety
Simulation and Interprofessional Education Center
Simulation and Interprofessional Education Center
Simulation and Interprofessional Education Center Home
Contact Us
SIEC Rules
Faculty and Instructors
Instructor Recruitment
Curriculum
Outline of Policies for SIEC Instructors
Preparation for Entry into the UMMC Operating Room Environment
SIEC Staff
Main Content
Contact the Simulation and Interprofessional Education Center
Simulation and Interprofessional Education Center (SIEC)
University of Mississippi Medical Center
2500 N. State St., SM409
Jackson, MS 39216-4505
(601) 815-9082
siec@umc.edu
Simulation Session Request Form
*
= Required Fields
Faculty
Full Name:
*
Email Address:
*
Department(s)
Participants
Types of participants (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 participants
Level of participants
*
Number of participants
*
Education session
Proposed session dates:
Learning objectives/educational rationale (e.g. learn to intubate, teamwork in OR crisis)
*
Simulation environment
Simulation center (SIEC)
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)