Gearhart Clinical Skills Center

Main Content

Simulated Participant Application

* = Required Fields

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City/State/Zip Code*
 
Zip Code -  
Day Phone Number*() -    
Evening Phone Number*() -    
Mobile Phone Number*() -    
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Your personal health status and experiences will impact your simulated participant portrayals. Please answer the following questions briefly to help us best match your characteristics to our curriculum needs.

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Please check if you have problems associated with any of the following:*































 
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Availability

SPs are used primarily in morning or afternoon sessions lasting 2-4 hours. Occasionally, SPs are needed for several consecutive full days. Please indicate your availability to work as an SP.

Please indicate what days you would be available.*



 
Please indicate the time(s) you would be available.*

 

Types of SP Experiences

The UMMC College of Medicine needs SPs for many types of learning and testing situations. You will not be asked to participate in any type of examination you are not comfortable with. Please indicate which of the following types of educational experiences you would not be willing to participate in.*


 
Role Preferences*