Raven EMS Education Program Manual
Simulation Contract Form

Student’s name:

The purpose of simulation-based training is for the learner to develop skills (including judgment and reasoning) for the care of real patients. The realism of each simulation may vary depending upon the learning goals for the session. The simulated environment and patient have certain limitations in their ability to exactly mirror real life. When participating in the simulations, the learner’s role is to assume all aspects of a practicing medical provider’s professional behavior. Additionally, when a gap occurs between simulated reality and actual reality, it is expected that all participants try to understand the goals of the learning session and behave accordingly.

Instructor responsibilities:

Learner responsibilities:

Student’s signature:

Instructor’s signature:


Change Log (5.93.000.SICF)

DateAuthorDescription of ChangeCitations
2023-12-13Becker, T.Theron Jack BeckerCreated this form.
2024-05-17Becker, T.Theron Jack BeckerMoved this form from appendix to student manual.
2024-05-31Becker, T.Theron Jack BeckerAdded content.(Becker, 2023)Becker, T. (2023). CMH education manual. OzarksEMS. https://ozarksems.com/edman.php
2024-08-01Becker, T.Theron Jack BeckerEach form previously had dedicated sub-section numbers, but they were removed for brevity and as none of the other forms are specifically numbered. 5.93.600 was the Simulation Contract
2025-01-08Becker, T.Theron Jack BeckerMoved online from Adobe InDesign document.



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